Intervention on United States National Strategy
and HHS Pandemic Influenza Plan

By Bruce Gellin, MD
Director, National Vaccine Program Office
U.S. Department of Health and Human Services

Thank you for convening this meeting and for allowing me to share the U.S. perspective and our recently released pandemic plans. The threat of a global disease outbreak called a pandemic is the most important public health issue we face today. We do not know whether the H5N1 influenza virus in birds will be the virus that sets off a pandemic. It is still primarily a disease among animals not people. But the signs are worrisome, and we must be prepared.

Last week was a historic one for U.S. pandemic influenza preparedness. On Tuesday, November 1 st, President George Bush released the first comprehensive National Strategy for Pandemic Influenza, and asked our Congress for $7.1 billion in emergency funding to support its implementation. He also announced a new, Federal government-wide web site, www.pandemicflu.gov which provides access to all of the government’s pandemic influenza information and materials. This was followed on Wednesday, November 2, by the release of the HHS Pandemic Influenza Plan –the medical and public health component of the National Strategy that provides guidance to national, state, and local policy makers and health departments. The goal is for all involved to achieve a state of readiness and quick response on the public health issues that will be the first and most overwhelming elements of a pandemic. Major components of the HHS plan include:

• Intensifying surveillance and collaborating on containment measures – both internationally and domestically;
• Stockpiling of antivirals and vaccines and working with industry to expand capacity for production of these medical countermeasures;
• Creating a seamless network of Federal, state and local preparedness, to include expansion of our health care surge capacity; and
• Developing the clear and consistent public education and communications necessary to keep the public informed.

We have also developed the following principles which will guide our strategic planning.

• Preparedness will require coordination among Federal, state and local government and partners in the private sector.
• An informed and responsive public is essential to minimizing the health effects of a pandemic and the resulting economic and social consequences to society.
• Domestic vaccine and production capacity sufficient to provide vaccine for the entire U. S. population is essential.
• The Federal government will stockpile antiviral drugs sufficient to treat 50 million persons, and will provide subsidies to our states to purchase and stockpile additional treatment courses, to collectively cover 25% of the U.S. population.
• Sustained human-to-human transmission anywhere in the world will be the triggering event to initiate a pandemic response by the U.S. government along with our international partners.
• Federal, state, and local authorities will employ basic public health measures to reduce person-to-person viral transmission and prevent or delay influenza outbreaks.
• At the onset of a pandemic, the Federal government will procure and distribute vaccine to state and local health departments for immunization of predetermined priority groups.
• At the onset of a pandemic, the Federal government will distribute antiviral drugs from public stockpiles for use by predetermined priority groups.

Our plan challenges all parts of society—individuals, families, communities, businesses, States, Federal agencies, and international partners to plan and prepare. If a pandemic occurs, it will affect more than just our health care system. It will affect almost every segment of our society, and have considerable social and economic impact. Preparing for a pandemic requires the leveraging of all instruments of national power, and coordinated action by all segments of government and society. While an influenza pandemic will not itself damage power lines, banks or computer networks, it will ultimately threaten all critical infrastructure by removing essential personnel from the workplace for weeks or months.

This makes an influenza pandemic a unique circumstance that requires a strategy that extends well beyond health and medical boundaries, to include critical infrastructure, private-sector activities, the movement of goods and services across the nation and the globe, and economic and security considerations. We have incorporated much in our planning that recognizes that our Nation’s businesses and employees are critical partners for pandemic preparedness, and we are enlisting their support in our Nation’s preparedness efforts. We are encouraging every employer to have a pandemic preparedness plan that includes: taking steps to protect their employees from influenza; coping with a reduced workforce; ensuring continued business operations; and communicating with employees and other community stakeholders.

We are also emphasizing that every community, every family, and even every individual has a responsibility to prepare. We will educate the American public on the steps that individuals and families should take in advance of an influenza pandemic, and to educate them about the basic hygiene measures they should observe during a pandemic to help keep themselves well or reduce the impact of illness.

Over the next months every sector of the US government will be developing its own plans on how they will prepare. We believe that this comprehensive National plan will be essential for a well-coordinated response.

Lastly, I want to underscore the importance of international collaboration and the need for transparency in everything that we are all doing in this area. The plans take note of our many bilateral and multilateral activities. On September 14 President Bush announced the International Partnership on Avian and Pandemic Influenza in his remarks to the High-Level Plenary Meeting of the United Nations General Assembly. We are pleased with the progress of the International Partnership. To date, 88 other countries and 9 international organizations have agreed to support its principles of rapid reporting, scientific cooperation and transparency. I want to thank the representatives of the governments here today that have joined the Partnership. You will be hearing more about this very important activity from us tomorrow.

We hope that our National Strategy and HHS plan will encourage all levels of government, the private sector, and individuals --domestically and globally-- to take appropriate action to contain an outbreak within the borders of their community, province, state or nation. Pandemic influenza is a threat not just to our individual nations but to the globe and it is critical that we all continue to build on our collaborative efforts. Thank you.