THE UNIVERSITY just concluded its "Flu Fest" yesterday, but disease experts worldwide are in anything but a partying mood. Most agree that the world is about due for the outbreak of a new pandemic, and H5N1, or the avian flu, has the potential to be just that.
This virus, which as yet is not capable of being transmitted from one person to another, contains some of the same mutations as the influenza virus of 1918, which killed 50 million people worldwide. According to a report released by the Department of Health and Human Services, an outbreak in the United States could kill as many as 1.9 million Americans, reason enough for concern, even though the virus has not yet been found in this country.
In response to this threat, President Bush announced on Tuesday that he would seek $7.1 billion in federal funding for a comprehensive plan to protect the country from the disease. Included in the plan are $1.2 billion for vaccine against the current strain (approximately 20 million doses), $1 billion for antiviral drugs, and $2.8 billion to revamp the vaccine industry through research and development.
Rare kudos should be given to the administration for showing forethought in the face of this threat and trying to address the problem from a number of different angles simultaneously. Unfortunately, the plan as proposed has a couple of important flaws.
One of the most noticeable is the large number of Americans the plan leaves unprotected, which Sen. Charles Schumer, D-N.Y., referred to as a "gaping hole." The plan provides for about 20 million doses of vaccine and 44 million doses of antiviral drugs, which sounds like a hefty enough reserve. The U.S. population, however, is nearly 300 million, meaning that the plan only provides protection for about a fifth of the population. Provisions have been made for those at highest risk, like the elderly, and for health care workers, but this flu strain is no ordinary flu; more people than normal need protection.
Granted, stockpiling a dose for every single American would be neither feasible nor necessary, but 20 percent of the population just isn't enough, especially when, according to Health and Human Services, a third of the population could become infected. A bigger investment in the stockpile would be prudent; some European countries have enough supplies to treat 40 percent of their people. Of course, the Bush plan hopes to improve the vaccine industry to the point where it will be able to produce enough vaccine for everybody within six months of outbreak, but this portion of the plan will take a long time to implement. The optimistic projection for completion of this part is 2010, and the danger isn't going away between then and now.
The issue of funding for the antiviral drugs is another problem. The president wants the states to pay for 75 percent of the cost of 31 million of the treatments. This is a big strain on state budgets, especially since states also need to improve their health systems and capacity to respond to outbreaks. Keeping the impact on the federal budget to a minimum is obviously a consideration in preparing for a pandemic, but it shouldn't be the most important one.
The worst error in the Bush plan, however, is the figure of $251 million earmarked for fighting the avian flu abroad by helping other countries detect cases better and contain the spread of the disease. This figure is much too small.
Stockpiles of vaccines and drugs are absolutely necessary and would be vital in the case of an outbreak on U.S. soil. But both come into play after the battle has already been lost -- after the disease has already reached this country. Preventive medicine is always the most effective, and the best way to protect the nation is not to let the virus get here.
In fact, allocating resources to combating the disease abroad kills two birds with one stone: It helps the United States and it helps the countries directly affected by an outbreak. In a time where each country is working to stockpile vaccines for itself, it's easy to forget that our nation has a humanitarian responsibility in the world. The countries where outbreaks occur need to have some responsibility too, but the ones in the greatest danger don't have anything close to the resources or the infrastructure of the United States.
It's possible that the danger posed by H5N1 may never be fully realized, and this will hopefully be the case. But the risks facing this country and the rest of the world are too great to ignore: A new pandemic could take a toll even greater than that of 1918. The president is headed in the right direction, but his plan still needs some work.
Matt Waring's column appears Fridays in The Cavalier Daily. He can be reached at mwaring@cavalierdaily.com.
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