New Dollars and Critique Lobbed at Swine Flu Response

On the heels of the Obama Administration's request that Congress put aside nearly $12 billion to combat the swine flu outbreak if needed, a nonprofit health advocacy group has given the country mixed marks for its response to the novel H1N1 virus to date.

Trust for America’s Health, which is based in Washington, D.C., today issued a detailed critique, “Pandemic Flu Preparedness: Lessons from the Frontlines.” The report praises federal, state, and local governments for having invested in pandemic planning, including the stockpiling of drugs and training public health officials to respond appropriately. It specifically commends U.S. President Barack Obama and the health officials who work under him for “providing clear, straightforward information to the public,” which the report says has both allayed fears and built trust.

But the report says public health departments are underfunded and “stretched too thin,” leading to delays in identifying and containing infections. “The biggest vulnerability is layoffs in local and state public health departments have stretched capacity to the limit,” says Jeffrey Levi, a public health specialist who heads the Trust for America’s Health. “Had this gotten bigger quickly we would have been stuck. And if there are more layoffs in fall, there will be fewer people out there still.”

The 23-page report, which was written by a team from the Trust for America’s Health and the Center for Biosecurity of the University of Pittsburgh Medical Center, pays especially close attention to the development of a vaccine against the novel H1N1 virus. The country’s “current vaccine development and production capacity is severely lacking,” the report notes, adding that “the country has not developed or adequately tested a system that will ensure that all Americans would be able to be inoculated in a short period of time.” The report calls for the federal government to continue subsidizing the construction of new vaccine manufacturing plants and also for “an infusion of major resources” to oversee and coordinate vaccine delivery.

On the international front, the report notes that the World Health Organization’s pandemic alert system has caused much confusion, and it criticized some countries for instituting travel restrictions and bans on pork products. “These measures were not based on either science or reasonable public health practices and caused unnecessary economic losses,” the report says.

Levi says he hopes that some of the domestic problems identified in the report will receive help from the billions of dollars President Obama has requested, should a full-scale swine flu pandemic wallop the United States. On 2 June, Obama, out of “an abundance of caution,” asked House of Representatives Speaker Nancy Pelosi to add $2 billion of supplemental money to the 30 April request he made for $1.5 billion (upped to $2 billion by the House). Obama’s letter to Pelosi attached a detailed request from the Office of Management and Budget that asked Congress to make another nearly $8 billion more available, if Obama determines it is needed, by dipping into money set aside for the stimulus plan, Project BioShield, and the discretionary needs of the Department of Health and Human Services.

All told, Levi calculates that $11.6 billion in new money may be set aside to beef up the response to the swine flu outbreak. He expects Congress to vote on the various requests this week.