President Bush unveiled a $7.1 billion plan yesterday to guard against an avian flu pandemic, calling for the stockpiling of 20 million doses of vaccine and enough anti-viral drugs to protect health care and public-safety workers in case of an outbreak.
In a speech at the National Institutes of Health in Bethesda, Bush said a worldwide avian flu pandemic could cause far more havoc than any natural disaster the nation has seen in recent memory.
"Unlike storms or floods, which strike in an instant and then recede, a pandemic can continue spreading destruction in repeated waves that can last for a year or more," he said.
The president, criticized for the government's plodding response to Hurricane Katrina, seized the avian flu issue and called for fast-track research into techniques that could rapidly produce vaccines against new strains that might emerge. He also said the United States will work with other nations to improve the ability to detect outbreaks anywhere in the world.
Bush said he will ask Congress to appropriate funds for the program, with the largest part - $2.8 billion - financing research into faster vaccine production methods.
Companies producing vaccine against seasonal flu and the avian strain now circulating in Asia use 1950s-era technology that involves growing influenza virus in chicken eggs. That process can take up to nine months, but researchers believe they can shave several months off that by growing the virus in cell cultures.
Although the president unveiled the broad outline of his plan yesterday, the details are expected today in a document to be released by Health and Human Services Secretary Michael O. Leavitt. At the heart of the plan will be guidelines for state and local government preparations, said Dr. Rajeev Venkayya, a special assistant to the president.
Pressure to mount a national strategy against pandemic flu has been building since 2003, when an influenza strain called H5N1 began infecting millions of poultry, migratory birds and farm animals in Southeast Asia.
The virus has infected an estimated 120 people in Thailand, Cambodia, Vietnam and Indonesia, killing about 60. All but a few were infected by direct contact with poultry; so far the disease has not spread from person to person.
Though no human cases have been seen outside the region, scientists are concerned that infections found among migratory birds in Central Asia and Europe could signal a wider risk to humans.
A 1997 outbreak in Hong Kong was snuffed when the government ordered the destruction of the nation's poultry flock.
The disease's fatality rate - 50 percent among humans - is extraordinarily high, attributed to the fact that humans have never been widely exposed to the virus before. Thus, they have had no chance to build natural immunity.
Scientists worry that a simple genetic change could enable avian flu to travel from person to person. At that point, the world could be at risk for a pandemic comparable to the 1918-1919 Spanish flu, which killed more than 50 million people worldwide, experts say.
Since then, flu pandemics have struck in 1957 and 1968, but neither was nearly so lethal as the earlier one.
The president's speech drew generally favorable reaction from public health and infectious disease experts, some of whom have warned that the nation is woefully unprepared for an outbreak.
"It's very clear that this has gotten the attention of the highest level of government," said Michael T. Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy.
Osterholm said the president was right to acknowledge that the nation does not have the capacity to produce enough vaccine to meet its needs - especially if faced with a strain unlike the one now circulating.
He said Bush's call for cell-based technology that could produce vaccine within six months of a virus' arrival was "laudable."
"But on the other hand, it reminds people that if this pandemic were to take off tomorrow, for much of those six months we'd be basically fighting this without a vaccine," Osterholm said.
Dr. John Bartlett, director of the infectious diseases division at the Johns Hopkins School of Medicine, also praised the plan. He said there were no surprises except for the amount proposed for the development of faster vaccine production.
"We didn't know it was coming or that it would get that emphasis," said Bartlett, who like Osterholm, attended the NIH speech.
The plan includes $1.5 billion for federal agencies to purchase flu vaccine tailored for the strain infecting birds and humans in Southeast Asia. No one knows whether that vaccine will match whatever strain triggers a pandemic - but experts hope it will provide at least limited protection.
Sen. Arlen Specter, chairman of the Appropriations subcommittee that oversees the Department of Health and Human Services budget, said the president should have little trouble getting his plan through Congress.