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U.S. Criticized Over Bird Flu Plans

Stockpiles, Vaccine Plans Moving Too Slowly, Critics Charge

Flu Vaccine Stockpile Inadequate?

Experts and several lawmakers criticized Bush administration officials over the stockpile, saying it will not go far in the event that a pandemic emergency depletes commercially available supplies.

"The 2.3 million doses we have in the stockpile now clearly are inadequate," says Andrew T. Pavia, MD, chairman of the Infectious Diseases Society of America task force on pandemic influenza. The group recommended Thursday that the government purchase enough Tamiflu to treat half the U.S. population.

Officials said they are moving to purchase more drugs for the stockpile but defended their decision not to engage in a massive buildup. While the drug can lessen disease severity if taken with 48 hours of the start of symptoms, no studies have shown that it improves patients' chances of surviving bird flu, Gerberding says.

"Making enormous purchases in stockpiling may be a premature decision," she says. "The studies simply haven't been done."

"We don't want you to get the impression that this is a knockout drop for the virus. It is not," Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases, told lawmakers.

Slow Going

Others criticized Bush health officials over a flu epidemic response plan that has been in progress for more than five years. A draft of the plan was completed in August 2004 but remains incomplete in key areas, a Government Accountability Office official says.

Marcia Cross, the agency's director for health care, told lawmakers that federal officials have yet to determine what role the federal government will take in purchasing supplies of vaccine against bird flu and other flu strains. The government has also not cemented which population groups would be priorities for emergency vaccination in the event of an outbreak or finalized plans for possible quarantines or travel restrictions.

The delay has left state health departments unable to properly plan for flu emergencies, she says.

"It is important for the federal government and the states to work through these issues before we are in a time of crisis," Cross says.

Bruce G. Gellin, MD, who heads the National Vaccine Program Office in the Department of Health and Human Services, told lawmakers that the plan would be finalized "this summer."

Vaccine Debate

An experimental bird flu vaccine is undergoing safety and effectiveness testing at the National Institutes of Health. Early safety data are expected this summer, Fauci says.

Questions over increasing the U.S. flu vaccine supply extend beyond a bird flu vaccine, however. Last year's vaccine shortage has resparked a debate in Congress over how to offer incentives to vaccine makers to enter the flu market. Only one company, Sanofi-Pasteur, has a flu vaccine manufacturing facility in the U.S.

"With ordinary vaccine production so low, the amounts we can produce in the face of a global pandemic are insufficient," says Rep. Joe Barton (R-Texas), chairman of the House Energy and Commerce Committee.

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