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Politics : PRESIDENT GEORGE W. BUSH -- Ignore unavailable to you. Want to Upgrade?

To: Kenneth E. Phillipps who wrote (694591)	7/31/2005 10:14:49 AM
From: Hope Praytochange	Read Replies (2) \| Respond to of 769670

kennybirdflu:Theoretically, antiviral drugs could slow an outbreak and buy time. The problem is only one licensed drug, oseltamivir, appears to work against bird flu. At the moment, there is not enough stockpiled for widespread use. Nor is there a plan to deploy the small amount that exists in ways that would have the best chance of slowing the disease. The public, conditioned to believe in the power of modern medicine, has heard little of how poorly prepared the world is to confront a flu pandemic, which is an epidemic that strikes several continents simultaneously and infects a substantial portion of the population. Since the current wave of avian flu began sweeping through poultry in Southeast Asia more than 18 months ago, international and U.S. health authorities have been warning of the danger and trying to mobilize. Research on vaccines has accelerated, efforts to build up drug supplies are underway, and discussions take place regularly on developing a coordinated global response. The U.S. Department of Health and Human Services will spend $419 million in pandemic planning this year. The National Institutes of Health's influenza research budget has quintupled in the past five years. "The secretary or the chief of staff -- we have a discussion about flu almost every day," said Bruce Gellin, head of HHS's National Vaccine Program Office. This week, a committee is scheduled to deliver to HHS Secretary Mike Leavitt an updated plan for confronting a pandemic. Despite these efforts, the world's lack of readiness to meet the threat is huge, experts say. "The only reason nobody's concerned the emperor has no clothes is that he hasn't shown up yet," Harvey V. Fineberg, president of the National Academy of Sciences' Institute of Medicine, said recently of the world's efforts to prepare for pandemic flu. "When he appears, people will see he's naked." Other scientists are sounding the alarm as well. The most outspoken is Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. In writing and in speeches, Osterholm reminds his audience that after public calamities, the United States usually convenes blue-ribbon commissions to pass judgment. There will be one after a flu pandemic, he believes. washingtonpost.com

To: Kenneth E. Phillipps who wrote (694591)	7/31/2005 10:20:05 AM
From: Hope Praytochange	Read Replies (3) \| Respond to of 769670

When a slightly different strain of the virus surfaced in Hong Kong in 1997, killing thousands of chickens and a half-dozen people, researchers used viruses from birds and people to make experimental vaccines. But neither offered much protection in lab tests, and nobody knows why. Instead of working on the problem, researchers dropped it. First SARS (severe acute respiratory syndrome), and then a different avian flu strain that arose in Europe (H7N7), took their attention. "The urgency around this issue kind of dissipated," said John Treanor, a physician at the University of Rochester and one of the leaders of the vaccine project. "I think it's an example of how unpredictable things are. We got distracted." The urgency is back. As the first, small hedge against disaster, the government last fall ordered 2 million doses of H5N1 vaccine from Sanofi Pasteur, one of the country's three flu vaccine makers, even though nobody yet knows whether it works. A half-dozen other countries are also working on pandemic vaccines. But making enough to fight an outbreak is a tall order. About 300 million flu shots are made worldwide each year. The vaccine protects against three flu strains. If the global production capacity were directed to make only H5N1 vaccine, the output could be 900 million shots. Unfortunately, virologists are almost certain people will need two doses about a month apart to mount a successful immune response against a wholly new strain such as H5N1. That would cut the theoretical number of recipients worldwide to 450 million. If each shot requires a larger-than-usual amount of vaccine to work, the number will be even smaller. Can the world produce more flu shots? Not easily. Only One Drug -------------------------------------------------------------------------------- In the absence of a vaccine, the only pharmaceutical bulwark against H5N1 is oseltamivir. It can shorten the illness's duration, and if taken immediately after exposure, it can even prevent infection. But the world's supply of the drug is limited. Sold as Tamiflu, it is manufactured by just one company, the Swiss giant Roche, in a laborious, expensive process that takes eight months. Twenty-five countries have ordered oseltamivir to stockpile, and five others have expressed interest, a Roche spokesman, Terence J. Hurley, said recently. The United States already has a stockpile, but it is enough to treat less than 1 percent of the population. The government has ordered enough to treat 3 million more people, or about 2 percent total. At a congressional hearing in late May, the company's medical director, Dominick A. Iacuzio, said it will begin producing oseltamivir in the United States soon. The company says it could supply 13 million more courses of treatment in 2006 and an additional 70 million in 2007 -- provided the government orders them. Would having lots of vaccine or oseltamivir make a difference? In a study published last year, Ira M. Longini Jr. of Emory University ran a mathematical model of what might happen if a pandemic such as the 1957 Asian flu, which was caused by a virus far milder than bird flu, hit the United States. He and his colleagues estimated that with no vaccine or antiviral drugs, there would be 93 million cases and 164,000 deaths. Vaccinating 80 percent of people younger than 19 -- the group most responsible for spreading the virus -- "would reduce the epidemic to just 6 million total cases and 15,000 total deaths in the country." Giving that group eight weeks of oseltamivir would have the same effect, at least temporarily. But it would take the equivalent of 190 million courses of treatment -- more than anyone thinks the country will have in the next few years. Somewhat more realistic is deploying the drug to where the outbreak begins. One researcher, Neil M. Ferguson of Imperial College in London, said in an interview that results of his not-yet-published mathematical modeling "are encouraging." But unless antiviral drugs squelch a pandemic at the outset, their ultimate usefulness will be small. Without widespread immunity through vaccination or infection, the virus will simply move into a population when the drugs run out.