Bird-brained plan needs revision

President George W. Bush introduced a plan last Tuesday intended to prevent the spread of avian influenza among humans. The $7.1 billion plan is well- intentioned, but not well-reasoned. It addresses the problem too generally and requires excessive monetary contribution from the states.

Concern about avian influenza or "bird flu" has mounted steadily since the H5N1 strain of the virus found its first human victims in Hong Kong in 1997. Indeed, H5N1 should elicit substantial concern: of the 122 humans who have contracted the virus since its origination, more than half have died. H5N1 mutates rapidly, and although it is not easily passed between humans, new mutations may soon change that. The virus holds potential to spawn an influenza pandemic, which epidemiologists estimate could kill more than 7 million people worldwide.

Most human infections have been confined to Southeast Asia thus far, but strains of the virus have been found in other parts of the world as well, including British Columbia just to our north. Past influenza pandemics -- Spanish flu of 1918, for example -- indicate that an outbreak of H5N1 anywhere could have a devastating worldwide scope. Despite this fact, troublingly, many Americans have remained oblivious to the threat.

Introduction of the Bush plan, then, was already a step in the right direction by calling the problem directly to public attention, and certainly also in its underlying motivation: "something needs to be done before it's too late." But the plan has several fundamental flaws that warrant thorough reconsideration of the plan as a whole.

First, Bush has called for a frenzied manufacturing and stockpiling of two existing flu vaccines -- oseltamavir and zanamavir -- which research suggests might prevent the onset of bird flu as it exists now. The target number of 40 million doses would not be obtained until 2009 though, and the virus could well have mutated into a form impervious to both vaccines by that time, if it hasn't already wrought its destruction.

Epidemiologists have suggested waiting to manufacture a vaccine until the form of the virus, which may finally become contagious among humans, is more precisely evolved, and therefore easier to precisely vaccinate against. This is standard procedure -- scientists always wait until it has become clear which forms of the annual flu virus pose the greatest threat before designing the annual flu vaccine. Bush's departure from this standard at the risk of producing a useless vaccine and wasting billions of dollars is unacceptable.

Second, and related directly to my last point of contention, Bush has designated the Department of Homeland Security as the coordinating organization should a pandemic occur -- not the Department of Health and Human Services. That's right, Bush has given politicians command over doctors and scientists in the event of a public health crisis. Let's see -- doctors specialize in helping people, and politicians specialize in, uh, what? Getting elected? Arguing? Lying? In all seriousness, this factor alone could be the country's undoing if a pandemic strikes -- politicians have not yet even outlined a competent plan for vaccine distribution.

Lastly, Bush has mandated in his plan that states, not the federal government, pay for much of the vaccine production. This is of course an absurd waste if the vaccine is ineffective anyway, but even supposing an effective vaccine is devised, it is still unreasonable to expect states to pay for it. The federal emergency resource pool dwarfs those of the states, and a bird flu pandemic would certainly constitute a federal emergency. The federal government is therefore responsible to pay.

Nobody questions that preventative action needs to be taken against the spread of avian influenza, and soon, but monetary and resource commitments should not be made until it becomes clearer how the virus is going to develop. If Bush will listen to the plea of public health experts and give them command of the situation, disaster may be averted. If not, you'd better stop hanging around poultry farmers and their friends.

source: the daily