Can States Pay for Bird Flu Preps?

Dec. 5, 2005 - The Bush administration is counting on cities and states to do most of the work to prepare for a possible bird flu pandemic. But many state officials are now complaining that they don't have the money to prepare the way Washington wants them to.

Federal officials have repeatedly stressed that only local communities can truly prepare for a potentially devastating flu pandemic. That's because unlike a hurricane or a terrorist attack, bird flu outbreaks would likely occur across the entire nation at once, simultaneously threatening large cities and thousands of small communities.

'Worst Case' Planning

According to a federal "worst case" planning scenario, a human outbreak of the H5N1 bird flu virus could sicken 90 million Americans and kill 2 million in a matter of months. Schools, airports, hospitals -- even grocery stores and utilities could all be affected or even brought to a standstill.

"The hard reality is they play out in home towns, countless home towns," Health and Human Services Secretary Michael O. Leavitt said of historical pandemics to a meeting of city and state officials gathered in Washington Monday to discuss preparedness plans.

Leavitt announced Monday that federal officials would meet with authorities in every state over the next four months to help with preparedness plans. Administration officials are also distributing a checklist designed to help state and local jurisdictions prepare for a potential outbreak.

Who Pays for Bird Flu Drugs?

Several state officials tell WebMD that they support Bush administration efforts to stockpile a flu vaccine, buy supplies of antiviral drugs, and encourage local preparedness. But they also argue that cities and states may not be able to get the job done with what they see as an inadequate amount of money from Washington.

"We are out of money. We cannot do some of the things we need to do," says Joann Schaefer, MD, the medical director for the Nebraska Department of Health and Human Services. Schaefer said that the state is "begging and borrowing" to pay for current efforts to increase public awareness of preparedness efforts.

Part of the national preparedness plan unveiled by Bush last month calls for Washington to distribute some of a planned 44 million-dose purchase of the antiviral drug Tamiflu to states. After that, states are to pay 75% of the cost of 31 million additional doses.

Schaefer said she does not yet know how much of the drug her state may need to purchase in order to be ready for a potential outbreak. But she worried that under current financial conditions, purchasing the drug could be "off the table" for Nebraska.

The federal plan calls for $100 million -- out of a proposed $7.1 billion total -- to go to assisting states with readiness plans. That money -- an average of $2 million per state -- won't go far enough, says Marc Metayer, Vermont's deputy commissioner for public safety.

"Not when you start dividing it up among the states," he says.