Thursday, November 03, 2005

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Administration's Flu Plan Gets Mixed Reception in Congress

November 3, 2005
Administration's Flu Plan Gets Mixed Reception in Congress
By GARDINER HARRIS

WASHINGTON, Nov. 2 - The Bush administration's long-awaited plan to deal with the threat of pandemic flu received a mixed reception on Capitol Hill Wednesday, as senators chided top health officials as taking too long and questioned their spending priorities.

Senator Arlen Specter, Republican of Pennsylvania, asked Health and Human Services Secretary Michael O. Leavitt why the plan had taken years to complete. Top government health officials started drafting the plan in 1991.

"When did we first have any indication that this type of a problem might confront us?" Mr. Specter asked. "Could we have acted sooner to avoid a situation where we're now in effect running for cover?"

Mr. Specter said that as late as last year "we had to do handstands" to get as little as $10 million appropriated to help keep open the nation's only major flu vaccine manufacturing plant. Senators of both parties have said for months that the administration was not taking the threat of pandemic flu seriously.

Mr. Leavitt answered that a 1997 outbreak of avian flu among chickens in Hong Kong was the first hint that a problem could soon be in the offing. Now that the virus is spreading to birds throughout Asia and in Europe, health officials are worried, he said.

"We find ourselves in a vulnerable position were this virus to move to a person-to-person transmittable virus," Mr. Leavitt said.

Senator Tom Harkin, Democrat of Iowa, said the administration's plan to force state governments to buy 31 million of the 81 million doses of antiviral drugs intended for the national stockpile was wrong-headed. Under the administration's plan, states will have to pay 75 percent of the cost of those drugs.

"It almost seems then that they will be allocated based upon a state's ability to pay," Mr. Harkin said. "How are you going to ask Louisiana right now to come up with the money for that. Take Mississippi. They've been hit hard."

Mr. Leavitt stood by the administration's plan, although he said state contributions could be negotiated.

"We very clearly believe that the states should contribute to this," he said. "Just like in a co-pay for a prescription, there's a need for co-pay for the states."

Of the $7.1 billion emergency appropriation that President Bush is seeking for pandemic flu preparations, $100 million would be given to state and local health departments to help them complete their own flu plans.

Mr. Harkin said this amount was not nearly enough, and state health officials made similar complaints. The administration has simultaneously proposed cutting $130 million this year from money that the federal government provides to state and local health departments to prepare for problems.

"You can't take away $130 million with the right hand, give us $100 million with the left hand, with strings attached, by the way, and expect that that's going to get us where we need to go," Dr. Rex Archer, president of the National Association of County and City Health Officials, said in a telephone interview.

Dr. Archer said that simply providing a bit of money for states to write plans was misguided. "Anybody can write a plan," he said. "It's having the staffing to carry out the thing that's the problem."

Mary Selecky, Washington State's secretary of health, described the administration's financing priorities as "a little out of whack."

The administration should spend less money buying drugs to fill stockpiles and more beefing up state health departments, Ms. Selecky said.

Dr. George Hardy, executive director of the Association of State and Territorial Health Officials, made a similar complaint. But he tempered it with praise for the plan.

"To do nothing but whine is a mistake," Dr. Hardy said. "A lot of work has gone into this plan, and there are some very good things here."

The plan details how an influenza pandemic might affect the United States. It calls for increased surveillance efforts globally to spot a pandemic early, the creation of large national stockpiles of vaccines and antiviral drugs, increased capacity within the United States to manufacture vaccines and cooperation among federal, state and local governments.

Many of the difficult decisions about who will be in charge if a pandemic strikes have yet to made. Such an "operational plan" is under development, the plan states.

Dr. Peter Patriarca, who began working on the government flu plan in 1991 and continued working on it until his retirement in 2001, said he was elated that the plan was finally released.

"It's a long time coming," Dr. Patriarca said. "You could write a book about what went on."

Dr. Patriarca, a captain in the Public Health Service who worked at the Food and Drug Administration, said he and four or five other flu experts scattered throughout the government took their drafts to top government officials several times.

"They would say: 'What are you talking about? How likely is this? This doesn't sound important to me,' " Dr. Patriarca recalled.

The group knew, though, that someday when a pandemic threatened, their efforts would be appreciated.

"It was a labor of love," Dr. Patriarca said.

Copyright 2005 The New York Times Company
http://www.nytimes.com/2005/11/03/politics/03flu.html?ex=1288674000&en=fd23bc9b7842cbd9&ei=5088&partner=rssnyt&emc=rss

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