sharon sanders
Editor-in-Chief & President
Pandemic Planning Update VI
(PDF - 1.32 MB)
A scant 33 months ago, I sent my first message about a race that HHS had just begun. As I said then, it was a race against a fast-moving virulent virus with the potential to cause an influenza pandemic. Since then, we have mobilized experts and resources across the country and around the world. I now send you this final message, as I look back at the unprecedented progress we have made in energizing a national pandemic influenza preparedness movement in those 33 months.
?The history of pandemics is not so much the history of health as it is the history of humanity. When pandemics strike, they cause massive sickness and terrible loss of life. They even reshape nations.?
Today, many people mistakenly think influenza pandemics are a thing of the past, but influenza has struck hard in the era of modern medicine ? much harder than most people realize. And it will strike again. Pandemics are hard things to talk about. When one discusses them in advance, it sounds alarmist. After a pandemic starts, no matter how much preparation has been done, it will be inadequate.
In November 2005, President Bush mobilized the nation to prepare for an influenza pandemic. He called for the deployment of a $7.1 billion national pandemic plan. Congress responded quickly. As Secretary of HHS, I was given responsibility to implement the plan.
Ultimately, the key to preparing for a pandemic is to develop, stockpile, and prepare to distribute vaccines and antivirals ? vaccines to prevent people from becoming infected by a virus, and antivirals to treat them if they are infected. But, how to achieve this? Developing and stockpiling vaccines is not a job for any one government. It is not even a job for any one nation.
Rather, it requires cooperation among nations, cooperation among different government entities within nations, and cooperation between governments and the private sector. Pandemic preparedness requires that all of these different elements work together. The better they do so, the better prepared we will be as a nation.
Local preparedness is the foundation of pandemic readiness. In addition to State governors, leadership must come from mayors, county commissioners, school principals, faith leaders, college presidents, corporate planners, and the entire healthcare infrastructure.
One of our highest priorities is to enhance and expand U.S.-based vaccine production capacity to the point that it can generate enough pandemic influenza vaccine for every American within six months of the time that the actual pandemic virus is identified, wherever in the world it is identified.
Today with over $1 billion of HHS funding, six companies are in various stages of implementing commercial-scale production of cell-based methods and/or expanding their capacity for conventional manufacturing using chicken eggs. We will reach our goal of having the needed capacity by 2011.
Partly as a result of these efforts, we have now procured 12.2 million treatment courses (each course provides a full treatment for one person) of H5N1 pre-pandemic influenza vaccine. If the virus mutates to where it has pandemic properties, a new vaccine will be developed to match it exactly, but this stockpiled vaccine will provide some protection in the interim.
This stockpile is available to support clinical trials and to protect healthcare workers, first responders, and other critical workers in the early stages of a pandemic. We plan to stockpile additional doses of pre-pandemic vaccine by the end of 2008.
We have reached our goal of stockpiling enough pandemic influenza antivirals to cover 44 million people, which will help slow the spread of an emerging pandemic.
?The Federal government has a role, as do state and local governments, not-for-profit organizations, the business community large and small. We are all in this together. The challenge remains.?
State governments have taken advantage of a chance to purchase up to 31 million treatment-courses of antiviral drugs while receiving a 25 percent federal subsidy and while making use of federal "best price" contracts. Some states have also purchased additional antiviral drugs, using these federal contracts, with unsubsidized funds. To date, the States have purchased 22 million treatment courses of Tamiflu? and Relenza? pandemic stockpiles.
We have awarded a total of $600 million for State and local preparedness. Through these grants, HHS has assisted in building response elements in local communities and has supported expanded interoperability. This means States can help each other on an almost interchangeable basis.
We have worked with States and local communities to update their pandemic influenza plans and to ensure that they evaluate their plans by conducting exercises. To make sure that States knew the importance of this effort, we conducted a pandemic influenza summit in each of the fifty United States and every one of the U.S. territories. I personally attended about three-quarters of the State summits. The summits brought together government representatives with healthcare professionals, schools, and the private sector, to advance State and community preparedness.
In addition to all of this, we purchased more than 150 million masks and respirators. We have obligated $100 million for the purchase of ventilators, syringes, intravenous antibiotics, and other supplies for potential distribution in case of an influenza pandemic. We have developed a highly sensitive rapid diagnostic test for avian and seasonal influenza. This will serve as the gold standard worldwide for confirming the first cases of avian or potentially pandemic influenza.
We have awarded funds to developers of new point-of-care influenza rapid test devices. These will enable doctors and other health-care professionals to diagnose avian influenza rapidly and easily in a clinical office or other outpatient setting. Clinical trials and FDA approval are anticipated by the end of 2009.
We have supported pandemic influenza preparedness activities in approximately 40 countries around the world. Since 2005, HHS has committed over $350 million internationally. This assistance is helping other countries improve their laboratory capacities, develop and strengthen disease-surveillance systems, develop preparedness plans, and train health workers to respond rapidly to outbreaks.
We have deployed teams of experts to help investigate suspected cases of possible human transmission of bird flu in 12 countries in Asia, Africa, and Europe. We have led workshops to provide country-level rapid response training in 112 countries, from all six regions of the World Health Organization (WHO).
In summary, we are much better prepared today than we were in the spring of 2005. But much still needs to be done. As I turn over this responsibility to the next Secretary of HHS, there are four priorities I would suggest they consider.
First, finish the vaccine manufacturing facilities. By the end of 2008, we plan to award approximately $500 million in contracts to companies that will build cell-based vaccine production facilities in the United States.
Second, strongly defend the global influenza virus sample-sharing network. For sixty years, nations have openly and freely shared virus samples. It has been one of the most important global health success stories, and it is being threatened right now by a few nations.
Third, concentrate on countermeasure distribution. We have developed an impressive stockpiling system that will allow the deployment of federal supplies in the early stages of a pandemic emergency. However, getting pills into the palms of people?s hands fast is critical, and not every State has adequate plans to carry that out.
And, finally, my last suggestion is directly related: continually remind States, communities, businesses, and families about their responsibility to be prepared. This is a never-ending task. The media buzz has died down, but the ?bird flu? virus has not.
The federal government has an indispensable role to do things that no individual state can do on its own, and to provide added capacity and coordination. In the last three years, there has been tremendous progress in the federal government?s capacity to meet its indispensable role.
However, local and State governments know their communities; they understand their unique needs. The key to success in preparing for a pandemic or any potential disaster is collaboration.
Preparation is a continuum. Each day that we prepare brings us closer to being ready. We are better prepared today than we were yesterday. And we will be better prepared tomorrow than we are today.
I believe we can prepare successfully for a pandemic. But it will require determination. It will require change.
Thank you.
(PDF - 1.32 MB)
- Message from the Secretary
- Pandemic Preparedness and Planning
- Monitoring and Surveillance
- Medical Countermeasures
- State and Local Preparedness Planning
A scant 33 months ago, I sent my first message about a race that HHS had just begun. As I said then, it was a race against a fast-moving virulent virus with the potential to cause an influenza pandemic. Since then, we have mobilized experts and resources across the country and around the world. I now send you this final message, as I look back at the unprecedented progress we have made in energizing a national pandemic influenza preparedness movement in those 33 months.
?The history of pandemics is not so much the history of health as it is the history of humanity. When pandemics strike, they cause massive sickness and terrible loss of life. They even reshape nations.?
? HHS Secretary Mike Leavitt
Today, many people mistakenly think influenza pandemics are a thing of the past, but influenza has struck hard in the era of modern medicine ? much harder than most people realize. And it will strike again. Pandemics are hard things to talk about. When one discusses them in advance, it sounds alarmist. After a pandemic starts, no matter how much preparation has been done, it will be inadequate.
In November 2005, President Bush mobilized the nation to prepare for an influenza pandemic. He called for the deployment of a $7.1 billion national pandemic plan. Congress responded quickly. As Secretary of HHS, I was given responsibility to implement the plan.
Rather, it requires cooperation among nations, cooperation among different government entities within nations, and cooperation between governments and the private sector. Pandemic preparedness requires that all of these different elements work together. The better they do so, the better prepared we will be as a nation.
Local preparedness is the foundation of pandemic readiness. In addition to State governors, leadership must come from mayors, county commissioners, school principals, faith leaders, college presidents, corporate planners, and the entire healthcare infrastructure.
One of our highest priorities is to enhance and expand U.S.-based vaccine production capacity to the point that it can generate enough pandemic influenza vaccine for every American within six months of the time that the actual pandemic virus is identified, wherever in the world it is identified.
Partly as a result of these efforts, we have now procured 12.2 million treatment courses (each course provides a full treatment for one person) of H5N1 pre-pandemic influenza vaccine. If the virus mutates to where it has pandemic properties, a new vaccine will be developed to match it exactly, but this stockpiled vaccine will provide some protection in the interim.
This stockpile is available to support clinical trials and to protect healthcare workers, first responders, and other critical workers in the early stages of a pandemic. We plan to stockpile additional doses of pre-pandemic vaccine by the end of 2008.
We have reached our goal of stockpiling enough pandemic influenza antivirals to cover 44 million people, which will help slow the spread of an emerging pandemic.
?The Federal government has a role, as do state and local governments, not-for-profit organizations, the business community large and small. We are all in this together. The challenge remains.?
? Dr. William Raub,
Science Advisor to the HHS Secretary
Science Advisor to the HHS Secretary
State governments have taken advantage of a chance to purchase up to 31 million treatment-courses of antiviral drugs while receiving a 25 percent federal subsidy and while making use of federal "best price" contracts. Some states have also purchased additional antiviral drugs, using these federal contracts, with unsubsidized funds. To date, the States have purchased 22 million treatment courses of Tamiflu? and Relenza? pandemic stockpiles.
We have awarded a total of $600 million for State and local preparedness. Through these grants, HHS has assisted in building response elements in local communities and has supported expanded interoperability. This means States can help each other on an almost interchangeable basis.
In addition to all of this, we purchased more than 150 million masks and respirators. We have obligated $100 million for the purchase of ventilators, syringes, intravenous antibiotics, and other supplies for potential distribution in case of an influenza pandemic. We have developed a highly sensitive rapid diagnostic test for avian and seasonal influenza. This will serve as the gold standard worldwide for confirming the first cases of avian or potentially pandemic influenza.
We have awarded funds to developers of new point-of-care influenza rapid test devices. These will enable doctors and other health-care professionals to diagnose avian influenza rapidly and easily in a clinical office or other outpatient setting. Clinical trials and FDA approval are anticipated by the end of 2009.
We have supported pandemic influenza preparedness activities in approximately 40 countries around the world. Since 2005, HHS has committed over $350 million internationally. This assistance is helping other countries improve their laboratory capacities, develop and strengthen disease-surveillance systems, develop preparedness plans, and train health workers to respond rapidly to outbreaks.
We have deployed teams of experts to help investigate suspected cases of possible human transmission of bird flu in 12 countries in Asia, Africa, and Europe. We have led workshops to provide country-level rapid response training in 112 countries, from all six regions of the World Health Organization (WHO).
In summary, we are much better prepared today than we were in the spring of 2005. But much still needs to be done. As I turn over this responsibility to the next Secretary of HHS, there are four priorities I would suggest they consider.
First, finish the vaccine manufacturing facilities. By the end of 2008, we plan to award approximately $500 million in contracts to companies that will build cell-based vaccine production facilities in the United States.
Second, strongly defend the global influenza virus sample-sharing network. For sixty years, nations have openly and freely shared virus samples. It has been one of the most important global health success stories, and it is being threatened right now by a few nations.
Third, concentrate on countermeasure distribution. We have developed an impressive stockpiling system that will allow the deployment of federal supplies in the early stages of a pandemic emergency. However, getting pills into the palms of people?s hands fast is critical, and not every State has adequate plans to carry that out.
And, finally, my last suggestion is directly related: continually remind States, communities, businesses, and families about their responsibility to be prepared. This is a never-ending task. The media buzz has died down, but the ?bird flu? virus has not.
The federal government has an indispensable role to do things that no individual state can do on its own, and to provide added capacity and coordination. In the last three years, there has been tremendous progress in the federal government?s capacity to meet its indispensable role.
However, local and State governments know their communities; they understand their unique needs. The key to success in preparing for a pandemic or any potential disaster is collaboration.
Preparation is a continuum. Each day that we prepare brings us closer to being ready. We are better prepared today than we were yesterday. And we will be better prepared tomorrow than we are today.
I believe we can prepare successfully for a pandemic. But it will require determination. It will require change.
Thank you.