Publications

On November 1 and 2, 2005, the Bush Administration released two documents that describe what the federal government—and everyone else—should do to prepare and respond to a flu pandemic. National Strategy for Pandemic Influenza is a clear, 12-page overview of the conceptual categories or “pillars” that frame the government’s approach: “preparedness and communication,” “surveillance and detection,” and “response and containment.” The content of this document largely mirrors the speech given by President Bush at the NIH on November 1.

The second document, the long-awaited, 200-plus-page HHS Pandemic Influenza Plan (the “Plan”) was released by Secretary Leavitt the next day. It was expected to describe the priorities, roles and responsibilities, and operational details of the actual implementation of the national strategy in states, cities, towns, and hospitals across the nation. Unfortunately, the Plan does not meet those expectations.

Without question, the Plan is a significant document. It presents some of the federal government’s assumptions and provides detailed lists describing what should happen on the state or local levels and what could be done in areas such as “community disease control and prevention.” In truth, though, the federal “plan” is more reference document than plan, with its comprehensive checklist of the considerations, actions, authorities, and problems that might confront states, localities, hospitals, businesses, and citizens as they prepare for or deal with a flu pandemic.

Puzzlingly, some of the priorities emphasized by the President, such as “a crash program” to create large supplies of pandemic flu vaccine using cell culture technology, are given scant attention in the HHS plan. And key elements of the U.S. strategy that were announced by the President are not supported adequately. For example, efforts “to control and monitor flu in Asia” are allotted only $251 million—about equal to the cost of building a single bridge in Alaska.