Bird flu: Bush plan would take five years

WASHINGTON — Preparing for the possibility of a devastating flu pandemic, President Bush on Tuesday outlined a $7.1 billion plan to provide enough vaccine for the nation and create drug stockpiles to treat those who are infected.

"There is no pandemic flu in our country, or in the world, at this time," Bush said in a speech at the National Institutes of Health. "But if we wait for a pandemic to appear, it will be too late to prepare and ... many lives could be needlessly lost."

Such a huge initiative would take years to implement — Bush's goal is 2010 — and his plan drew immediate fire from critics who said it wouldn't provide enough protection in the meantime. States also received an unpleasant surprise when they were ordered to purchase about 40 percent of an anti-flu drug with their money.

Bush's plan also would protect vaccine manufacturers from liability lawsuits but offer no compensation for individuals who suffer serious reactions to a vaccine.

Public-health experts say it is only a matter of time before a super-flu develops with the potential to spread around the globe and kill millions.

Pandemics occur when a viral strain for which humans have no immunity mutates and is transmitted from person to person. Such viruses commonly appear first among birds, and scientists are closely tracking an especially virulent strain — H5N1 or "bird flu" — first identified in China in 1996. That strain has killed 62 people.

Public-health experts expressed concern that Bush's plan would place the Department of Homeland Security — not the Department of Health and Human Services — in command of the government response if a pandemic were to erupt. Homeland Security oversaw the much-criticized federal response to Hurricane Katrina.

The highlights


• $1.2 billion to acquire 40 million vaccine doses, enough for 20 million people, by 2009

• $1.6 billion to accelerate production of cell-based vaccines with a goal of being able to produce 600 million doses within six months by 2010

• $739 million to purchase 24 million treatment courses of antivirals, which stem the effects of the disease if contracted

• $600 million to add vaccine manufacturing capacityThe Associated Press

"When the emergency occurs," said Kim Elliott, deputy director of the nonprofit, nonpartisan Trust for America's Health, "it would be handed to folks most of whom have not been trained on the public-health aspects."

In the case of H5N1, there have been 122 known human infections, virtually all among people in close contact with affected birds. The virus has not developed the ability to pass easily among humans. If it does, it could kill between 2 million and 7.4 million people worldwide, according to the World Health Organization (WHO).

Health and Human Services Secretary Mike Leavitt on Tuesday released some details of the flu plan, which took the administration months to prepare. Leavitt recently returned from a tour of Asian nations hit by the H5N1 virus. More details are expected in a Health and Human Services report to be released today.

Bush said Tuesday that working with other countries is the first step in his three-part pandemic plan. The administration has set up an international partnership, whose 88 member nations have pledged to share information and provide virus samples to the WHO. Bush's plan seeks $251 million — or 3.5 percent of the total program — to help foreign governments track flu viruses and respond to outbreaks.

The second part of Bush's plan — and its core — is a $6 billion effort to purchase vaccines and antiviral drugs and to revolutionize the way vaccines are manufactured. He set a goal of having enough vaccine for every American.

Vaccines are made using a 1950s technique that involves inoculating a virus into fertilized hens' eggs. New, more efficient approaches would use cell cultures to make vaccine.

However, it may be impossible to develop an effective vaccine until after a pandemic flu has struck, because scientists ideally should first isolate a specific strain of flu.

To address what could be a time lag of six months or more, Bush called for stockpiling the antiviral medicines Tamiflu and Relenza. Taken early, they can help reduce the severity of the illness. They also can prevent some people from becoming infected in the first place.

Bush's plan calls for a national stockpile of 81 million courses of antiviral treatments, about four times what had been deemed sufficient. States would be responsible for purchasing 31 million of those treatment courses — a provision that critics say represents a weakness in the plan, since some states may not have the money.

A White House official said the federal government would subsidize 25 percent of the states' cost and would help them obtain the same discounts that the federal government receives.

The plan for a stockpile is not strong enough, said Sen. Edward Kennedy, D-Mass., who helped lead Senate passage of $8 billion in emergency funding for pandemic preparations last month.

"Stockpiles alone aren't enough without the capacity to make use of them," he said, calling for steps to help states, cities and hospitals prepare for a flood of panicked patients.

The federal antiviral stockpile would be reserved for medical personnel, first responders, air crews and others likely to be in harm's way. With the added state supplies, the United States would be able to cover about 25 percent of its population of more than 297 million, a level recommended by international health experts.

The final part of Bush's plan calls for engaging state and local governments, as well as individual Americans, in making preparations. The president launched a government Web site, www.pandemicflu.gov, to help educate the public.

Los Angeles Times reporter Charles Piller contributed to this report; comments by Kennedy were provided by The Associated Press.