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Bush's Flu Pandemic Plan Leans Heavily on Agencies Already Strained

November 03, 2005|Ricardo Alonso-Zaldivar and Charles Piller | Times Staff Writers

WASHINGTON — The Bush administration's $7.1-billion flu pandemic plan cannot succeed without the cooperation of many players, from local health departments to foreign governments in remote corners of the world. And in most cases, they are already spread thin.

"You have to have public health people available to identify the cases, put them on antivirals and track down their contacts" with other people, said Dr. Warner Hudson, a flu expert at UC Davis Medical Center. "All those basics require a certain infrastructure that has to be able to click together like a race car.... It doesn't typically click together now."

Health and Human Services Secretary Mike Leavitt said Wednesday that governments at all levels needed to take responsibility for their own preparedness because the job was too big for the federal government alone.

"We want to make certain that they are buying into pandemic preparation and not just looking for a check from the federal government," he said.

The Bush plan, unveiled Tuesday, proposes $100 million for state and local preparedness efforts. Most of the $7.1 billion in the plan is devoted to developing and stockpiling vaccines and drugs.

On Capitol Hill, lawmakers were presented Wednesday with a detailed, 396-page version of Bush's plan. Members of both parties predicted that the states would have a hard time finding the funds to fulfill their side of the plan.

Health officers agreed.

An antiviral "treatment course costs about $50 to $60, and they're expecting the states to pay [much] of that," said Dr. Eddy A. Bresnitz, New Jersey state epidemiologist. "That's a lot of change."

Dr. Linda Rosenstock, dean of the UCLA School of Public Health, said the costs were being heaped onto health systems already under pressure to meet daily needs.

"We have had evidence for decades of erosion of the public health infrastructure," including labs, training and communication systems, she said.

Some local officials have begun to look at existing programs that could partly support preparations for a pandemic.

"We do have money for bioterrorism, and we have the ability to use that money to help us with pandemic flu" because the two require similar responses, said Los Angeles County Public Health Director Jonathan Fielding.

The Bush plan was created in response to growing fears that the lethal H5N1 bird flu, which has spread from Asia to Europe, could eventually mutate into a strain easily passed between people. Currently, the virus is rarely transmitted to humans.

In a severe pandemic, about 90 million Americans would fall ill and 1.9 million would die, according to the Department of Health and Human Services.

The Bush plan includes $251 million to help poor countries track and contain the disease in Asia, the epicenter of the outbreak.

Some public health experts said more money was needed. A lack of funds and scientific expertise have made some Southeast Asian countries slow and ineffective in controlling bird flu.

"We are thinking very small for what is a global problem. We are thinking very U.S.-centric," said UCLA's Rosenstock.

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Times staff writer Karen Kaplan contributed to this report.

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