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  • Anthrax "Emergency" Powers Declared by DHHS

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    [Federal Register: October 6, 2008 (Volume 73, Number 194)]
    [Notices]
    [Page 58239-58242]
    From the Federal Register Online via GPO Access [wais.access.gpo.gov]
    [DOCID:fr06oc08-76]

    ================================================== =====================
    -----------------------------------------------------------------------

    DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Office of the Secretary


    Declaration Under the Public Readiness and Emergency Preparedness
    Act

    October 1, 2008.
    AGENCY: Office of the Secretary (OS), Department of Health and Human
    Services (HHS).

    ACTION: Notice.

    -----------------------------------------------------------------------

    SUMMARY: Declaration pursuant to section 319F-3 of the Public Health
    Service Act (42 U.S.C. 247d-6d) to provide targeted liability
    protections for anthrax countermeasures based on a credible risk that
    the threat of exposure to Bacillus anthracis and the resulting disease
    constitutes a public health emergency.

    DATES: This notice and the attached declaration are effective as of the
    date of signature of the declaration.

    FOR FURTHER INFORMATION CONTACT: RADM W.C. Vanderwagen, Assistant
    Secretary for Preparedness and Response, Office of the Secretary,
    Department of Health and Human Services, 200 Independence Avenue, SW.,
    Washington, DC 20201, Telephone (202) 205-2882 (this is not a toll-free
    number).

    HHS Secretary's Declaration for Utilization of Public Readiness and
    Emergency Preparedness Act for Anthrax Countermeasures

    Whereas significant changes in the nature, regularity and degree of
    threats to health posed by the use of infectious agents as weapons of
    biological warfare have generated increased concern for the safety of
    the general American population particularly following the deliberate
    exposure of citizens in the

    [[Page 58240]]

    United States to Bacillus anthracis (B. anthracis) spores in 2001 that
    demonstrated the ease of dissemination, infectivity, and mortality;
    Whereas the Secretary of Homeland Security has determined that B.
    anthracis and multi-drug-resistant B. anthracis present a material
    threat against the United States population, sufficient to affect
    national security;
    Whereas there are covered countermeasures to treat, identify, or
    prevent adverse health consequences or death from exposure to B.
    anthracis;
    Whereas such countermeasures, including vaccines, antimicrobials/
    antibiotics, and antitoxins for pre-exposure and post-exposure
    prevention and treatment, diagnostics to identify such exposure, and
    additional countermeasures for treatment of adverse events arising from
    use of these countermeasures exist or may be the subject of research
    and/or development;
    Whereas such countermeasures may be used and administered in
    accordance with Federal contracts, cooperative agreements, grants,
    interagency agreements, and memoranda of understanding, and may also be
    used and administered at the Regional, State, and local level in
    accordance with the public health and medical response of the Authority
    Having Jurisdiction;
    Whereas, the possibility of governmental program planners obtaining
    stockpiles from private sector entities except through voluntary means
    such as commercial sale, donation, or deployment would undermine
    national preparedness efforts and should be discouraged as provided for
    in section 319F-3(b)(2)(E) of the Public Health Service Act (42 U.S.C.
    247d-6d(b)) (``the Act'');
    Whereas, immunity under section 319F-3(a) of the Act should be
    available to governmental program planners for distributions of Covered
    Countermeasures obtained voluntarily, such as by (1) Donation; (2)
    commercial sale; (3) deployment of Covered Countermeasures from Federal
    stockpiles; or (4) deployment of donated, purchased, or otherwise
    voluntarily obtained Covered Countermeasures from State, local, or
    private stockpiles;
    Whereas, the extent of immunity under section 319F-3(a) of the Act
    afforded to a governmental program planner that obtains covered
    countermeasures except through voluntary means is not intended to
    affect the extent of immunity afforded other covered persons with
    respect to such covered countermeasures.
    Whereas, in accordance with section 319F-3(b)(6) of the Act, I have
    considered the desirability of encouraging the design, development,
    clinical testing or investigation, manufacturing, labeling,
    distribution, formulation, packaging, marketing, promotion, sale,
    purchase, donation, dispensing, prescribing, administration, licensing,
    and use of such countermeasures with respect to the category of disease
    and population described in sections II and IV below, and have found it
    desirable to encourage such activities for the covered countermeasures;
    and
    Whereas, to encourage the design, development, clinical testing or
    investigation, manufacturing and product formulation, labeling,
    distribution, packaging, marketing, promotion, sale, purchase,
    donation, dispensing, prescribing, administration, licensing, and use
    of medical countermeasures with respect to the category of disease and
    population described in sections II and IV below, it is advisable, in
    accordance with section 319F-3(a) and (b) of the Act, to provide
    immunity from liability for covered persons, as that term is defined at
    section 319F-3(i)(2) of the Act, and to include as such covered persons
    such other qualified persons as I have identified in section VI of this
    declaration;
    Therefore, pursuant to section 319F-3(b) of the Act, I have
    determined there is a credible risk that the threat of exposure of B.
    anthracis and the resulting disease constitutes a public health
    emergency.

    I. Covered Countermeasures (As Required by Section 319F-3(b)(1) of the
    Act)

    Covered Countermeasures are defined at section 319F-3(i) of the
    Act. At this time, and in accordance with the provisions contained
    herein, I am recommending the manufacture, testing, development,
    distribution, dispensing; and, with respect to the category of disease
    and population described in sections II and IV below, the
    administration and usage of anthrax countermeasures as defined in
    section IX below. The immunity specified in section 319F-3(a) of the
    Act shall only be in effect with respect to: (1) Present (see Appendix
    I) or future Federal contracts, cooperative agreements, grants,
    interagency agreements, or memoranda of understanding involving
    countermeasures that are used and administered in accordance with this
    declaration, and (2) activities authorized in accordance with the
    public health and medical response of the Authority Having Jurisdiction
    to prescribe, administer, deliver, distribute or dispense the Covered
    Countermeasure following a declaration of an emergency, as defined in
    section IX below. In accordance with section 319F-3(b)(2)(E) of the
    Act, for governmental program planners, the immunity specified in
    section 319F-3(a) of the Act shall be in effect to extent they obtain
    Covered Countermeasures through voluntary means of distribution, such
    as (1) Donation; (2) commercial sale; (3) deployment of Covered
    Countermeasures from Federal stockpiles; or (4) deployment of donated,
    purchased, or otherwise voluntarily obtained Covered Countermeasures
    from State, local, or private stockpiles. For all other covered
    persons, including other program planners, the immunity specified in
    section 319F-3(a) of the Act shall, in accordance with section 319F-
    3(b)(2)(E) of the Act, be in effect pursuant to any means of
    distribution.
    This declaration shall subsequently refer to the countermeasures
    identified above as ``Covered Countermeasures.''
    This declaration shall apply to all Covered Countermeasures
    administered or used during the effective time period of the
    declaration. This declaration also shall apply to all Covered
    Countermeasures (see Appendix I) administered or used by or on behalf
    of the Department of Defense.

    II. Category of Disease (As Required by Section 319F-3(b)(2)(A) of the
    Act)

    The category of disease, health condition, or threat to health for
    which I am recommending the administration or use of the Covered
    Countermeasures is anthrax, which may result from exposure to B.
    anthracis.

    III. Effective Time Period (As Required by Section 319F-3(b)(2)(B) of
    the Act)

    With respect to Covered Countermeasures administered and used in
    accordance with present or future Federal contracts, cooperative
    agreements, grants, interagency agreements, or memoranda of
    understanding, the effective period of time of this Declaration
    commences on signature of the declaration and extends through December
    31, 2015.
    With respect to Covered Countermeasures administered and used in
    accordance with the public health and medical response of the Authority
    Having Jurisdiction, the effective period of time of this Declaration
    commences on the date of a declaration of an emergency and lasts
    through and includes the final day that the emergency declaration is in
    effect including any extensions thereof.

    [[Page 58241]]

    IV. Population (As Required by Section 319F-3(b)(2)(C) of the Act)

    Section 319F-3(a)(4)(A) of the Act confers immunity to
    manufacturers and distributors of the Covered Countermeasure,
    regardless of the defined population.
    Section 319F-3(a)(3)(C)(i) of the Act confers immunity to covered
    persons who may be a program planner or qualified persons with respect
    to the Covered Countermeasure only if a member of the population
    specified in the declaration as persons who use the Covered
    Countermeasure or to whom such a Covered Countermeasure is
    administered, is in or connected to the geographic location specified
    in this declaration, or the program planner or qualified person
    reasonably could have believed that these conditions are met.
    The populations specified in this declaration are all persons who
    use a Covered Countermeasure or to whom a Covered Countermeasure is
    administered in accordance with this declaration, including, but not
    limited to: Department of Defense military personnel and supporting
    civilian-employee and contractor personnel; any person conducting
    research and development of Covered Countermeasures directly by the
    Federal government or pursuant to a contract, grant, or cooperative
    agreement with the Federal government; any person who receives a
    Covered Countermeasure from persons authorized in accordance with the
    public health and medical emergency response of the Authority Having
    Jurisdiction to prescribe, administer, deliver, distribute, or dispense
    the Covered Countermeasure, and their officials, agents, employees,
    contractors, and volunteers following a declaration of an emergency;
    any person who receives a Covered Countermeasure from a person
    authorized to prescribe, administer or dispense the countermeasure or
    who is otherwise authorized under an Emergency Use Authorization; any
    person who receives a Covered Countermeasure as an investigational new
    drug in human clinical trials being conducted directly by the Federal
    government or pursuant to a contract, grant, or cooperative agreement
    with the Federal government.

    V. Geographic Area (As Required by Section 319F-3(b)(2)(D) of the Act)

    Section 319F-3(a) of the Act applies to the administration and use
    of a Covered Countermeasure without geographic limitation.

    VI. Qualified Persons (As Required by Section 319F-3(i)(8)(B) of the
    Act)

    With regard to the administration or use of a Covered
    Countermeasure, Section 319F-3(i)(8)(A) of the Act defines the term
    ``qualified person'' as a licensed individual who is authorized to
    prescribe, administer, or dispense the Covered Countermeasure under the
    law of the State in which such Covered Countermeasure was prescribed,
    administered or dispensed. Additional persons who are qualified persons
    pursuant to section 319F-3(i)(8)(B) are the following: (1) Any person
    who is authorized to prescribe, administer, deliver, distribute or
    dispense Covered Countermeasures to Department of Defense military
    personnel and supporting civilian-employee and contractor personnel,
    (2) Any person authorized in accordance with the public health and
    medical emergency response of the Authority Having Jurisdiction to
    prescribe, administer, deliver, distribute or dispense Covered
    Countermeasures, and their officials, agents, employees, contractors
    and volunteers, following a declaration of an emergency, and (3) Any
    person authorized to prescribe, administer, or dispense Covered
    Countermeasures or who is otherwise authorized under an Emergency Use
    Authorization, including, but not limited to Department of Defense
    military personnel and supporting civilian employee and contractor
    personnel.

    VII. Additional Time Periods of Coverage After Expiration of
    Declaration (As Required by Section 319F-3(b)(3)(B) of the Act)

    I have determined that, upon expiration of the time period
    specified in Section III above, an additional twelve (12) months is a
    reasonable period to allow for manufacturers and other covered persons
    to take such other actions as are appropriate to limit the
    administration or use of the Covered Countermeasure, and the liability
    protection of section 319F-3(a) of the Act shall extend for that
    period. Further, as to doses shipped by the CDC to the DoD pursuant to
    the DoD/CDC Interagency Agreement (IAA) dated March 10, 2008, an
    additional period of time of liability protection shall extend for as
    long as the SNS or its successor exists and the IAA remains in effect,
    plus, if the additional twelve (12) months following the time period in
    Section III above has expired, an additional twelve (12) months upon
    expiration of the IAA.

    VIII. Amendments

    This declaration has not previously been amended. Any future
    amendment to this declaration will be published in the Federal
    Register, pursuant to section 319F-3(b)(4) of the Act.

    IX. Definitions

    For the purpose of this declaration, including any claim for loss
    brought in accordance with section 319F-3 of the PHS Act against any
    covered persons defined in the Act or this declaration, the following
    definitions will be used:
    Administration of a Covered Countermeasure: As used in Section
    319F-3(a)(2)(B) of the Act includes, but is not limited to, public and
    private delivery, distribution, and dispensing activities relating to
    physical administration of the Covered Countermeasures to patients/
    recipients, management and operation of delivery systems, and
    management and operation of distribution and dispensing locations.
    Anthrax Countermeasure: Any vaccine; antimicrobial/antibiotic,
    other drug or antitoxin; or diagnostic or device to identify, prevent
    or treat anthrax or adverse events from such countermeasures (1)
    Licensed under section 351 of the Public Health Service Act; (2)
    approved under section 505 or section 515 of the Federal Food, Drug,
    and Cosmetic Act (FDCA); (3) cleared under section 510(k) of the FDCA;
    (4) authorized for emergency use under section 564 of the FDCA ; (5)
    used under section 505(i) of the FDCA or section 351(a)(3) of the PHS
    Act, and 21 CFR Part 312; or (6) used under section 520(g) of the FDCA
    and 21 CFR part 812.
    Authority Having Jurisdiction: The public agency or its delegate
    that has legal responsibility and authority for responding to an
    incident, based on political or geographical (e.g., city, county,
    tribal, State, or Federal boundary lines) or functional (e.g., law
    enforcement, public health) range or sphere of authority.
    Covered persons: As defined at section 319F-3(i)(2) of the Act
    include the United States, manufacturers, distributors, program
    planners, and qualified persons. The terms ``manufacturer,''
    ``distributor,'' ``program planner,'' and ``qualified person'' are
    further defined at sections 319F-3(i)(3), (4), (6), and (8) of the Act.
    Declaration of an emergency: A declaration by any authorized local,
    regional, State, or federal official of an emergency specific to events
    that indicate an immediate need to administer and use anthrax
    countermeasures, with the exception of

    [[Page 58242]]

    a federal declaration in support of an emergency use authorization
    under section 564 of the FDCA unless such declaration specifies
    otherwise.

    This first day of October, 2008.
    Michael O. Leavitt,
    Secretary of Health and Human Services.

    Appendix I--List of U.S. Government Contracts
    ----------------------------------------------------------------------------------------------------------------
    Contract Manufacturer Covered countermeasure PL 85-804 coverage*
    ----------------------------------------------------------------------------------------------------------------
    HHSO100200500007C................... Cangene................ Anthrax immune globulin-- No.
    AIG.
    HHSO100200500006C................... HGS.................... Anthrax monoclonal antibody- No.
    ABThrax.
    HHSO100200600019C................... Emergent Biodefense BioThrax (Anthrax Vaccine Yes.
    Operations. Adsorbed, AVA).
    HHSO100200700037C................... Emergent Biodefense BioThrax (Anthrax Vaccine No.
    Operations. Adsorbed, AVA).
    W9113M-04-D-0002.................... BioPort (Emergent BioThrax (Anthrax Vaccine Yes.
    Biosolutions). Adsorbed, AVA).
    DAMD 17-97-D-00003.................. BioPort (Emergent BioThrax (Anthrax Vaccine Yes.
    Biosolutions). Adsorbed, AVA) Shipping.
    HHSN 272200700035C.................. Elusys................. Anthrax monoclonal No.
    antibody--ETI-204.
    HHSN 272200700033C.................. Pharmathene............ Anthrax monoclonal No.
    antibody--Valortim.
    HHSN 272200700034C.................. Emergent BioSolutions.. Anthrax immune globulin-- No.
    AIG.
    NO1-A1-30052........................ Avecia (Pharmathene)... Recombinant protective No.
    antigen (rPA) anthrax
    vaccine.
    V797P-5777x......................... Shering Corp........... Cipro 250mg/5ml; 100ml No.
    suspension.
    V797P-5977x......................... Cobalt Pharmaceuticals. Cipro 500mg tablets........ No.
    V797P-5941x......................... Blu Pharmaceuticals.... Doxycycline 100mg tablets.. No.
    V797P-5883x......................... Pfizer, Inc............ Doxycycline 25mg/5ml No.
    suspension 60ml.
    V797P-5669x......................... Abraxis Bioscience, Inc Doxycycline 100mg vial IV.. No.
    V797-DSNS-8002...................... Sandoz, Inc............ Amoxicillin 500mg capsules. No.
    V797-DSNS-8002...................... Sandoz, Inc............ Amoxicillin 400mg/5ml; No.
    100ml suspension.
    V797BPA0015......................... Bedford Labs........... Rifampin 600mg vial IV..... No.
    V797P-5396x......................... Hospira................ Clindamycin 150mg/ml 6ml No.
    vial IV.
    V797P-5669x......................... Abraxis Bioscience, Inc Vancomycin 1 g vial IV..... No.
    V797P-1020x......................... McKesson............... Penicillin GK 20 million No.
    unit vial IV.
    V797P-5387x......................... Johnson and Johnson Levofloxacin 5mg/ml 150ml No.
    Healthcare. bag IV.
    ----------------------------------------------------------------------------------------------------------------
    * Status of indemnification coverage under P.L. 85-804 (An Act to authorize the making, amendment and
    modification of contracts to facilitate the national defense.)

    [FR Doc. E8-23547 Filed 10-1-08; 4:15 pm]

    BILLING CODE 4150-37-P

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    Re: Anthrax "Emergency" Powers Declared by DHHS

    more info.
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