Updated: Swine Influenza & Recent Assessments of US Bio-Preparedness Priorities

In 2006, the Trust for America's Health organization's Germs Go Global report said the US was ill-prepared for bioterror, bird flu and other health disasters five years out from 9-11. Last year ABP warned the incoming Obama Administration not to ignore bio-incident counter-measures, citing the ease with which economic target fixation could catch the U.S. flatfooted in a pandemic.

By 2004 the US had enacted Project BioShield, authorizing 5.6 billion dollars in funding over ten years. It was supposed to support rapid development and deployment of health countermeasures to microbiologic threats. According to the report, the Health and Human Services Administration (HHS) was to form the Biomedical Advanced Research and Development Authority (BARDA) under the Pandemic and All Hazards Preparedness Act of 2006. In theory, BARDA would prioritize funds for advanced biomedical research into bio-incident countermeasures and support project BioShield. 

For fiscal years 2006-2008 Congress authorized 1.07 billion for BioShield, but only 102 million was appropriated in 2008 (Scroll to p. 21 of the report). 

While hundreds of billions have been spent propping up financial institutions after the financial sector meltdown of 2008-09, the survival of the nation's working population itself has rated scarcely over 100 million dollars during the same period.

Adding to HHS efforts, the U.S. Department of Homeland Security (DHS) was tasked with building a comprehensive national bio-surveillance system. DHS added some of its own acronyms to the effort: BioWatch and the National Biosurveillance Integration Center (NBIC).

By 2006, tens of billions had been spent on bio-terror research and development. This prompted a bipartisan group from Congress to request that the GAO study anti-biowarfare spending priorities. The GAO published these relevant reports in 2007-08:

Biosurveillance: Preliminary Observations on the Department of Homeland Security's Biosurveillance Initiatives 

Chemical and Biological Defense: Updated Intelligence, Clear Guidance and Consistent Priorities Needed to Guide Investments in Collective Protection.

DHS had apparently made progress toward making NBIC fully operational by September 2008, however, by the 2007 report still had not finalized all agreements with coordinating agencies, had not defined its own official capabilities, and was planning the purchase of new bioweapon detection technology.

In other words, five years after its mandate, DHS was 'making progress but still wading through government red tape and paperwork without a clear understanding of its capabilities.

By 2007, the Department of Defense still lacked coordination, consistency and efficiency in its anti-biological and chemical warfare upgrades, many of which were exposed when harsh desert conditions in Iraq made NBC protective gear prohibitive because of heat, mobility and functionality issues. The GAO report called for greater force protection coordination within DoD.

The US must boost emergency funding for BARDA and Bioshield to the levels originally authorized and immediately expand authorization and appropriations for comprehensive countermeasures against infectious disease pandemics. It should also implement the best recommendations of the Trust for America's Health October 2008 Germs Go Global report.

Some compare the 2009 swine flu now hitting Mexico to the Spanish flu of 1918-19 because both seem to hit young adults the hardest. Those killed by the current Mexican bug had respiratory system damage some attributed to possible overactive immune responses triggered by the virus. The short spike in swine flu cases and variable severities are not fully explained yet. The virus's morphology is not well understood yet. The fewer swine flu cases in the US have been milder. Some speculate that it is the season's weather change that has mitigated the flu's effects. Others credit a superior medical infrastructure. However, what will happen in the next flu season?

The world would do well with concerted action to avert another Spanish flu experience. The Spanish flu killed an estimated 20-40 million people worldwide and began with a short spike in cases at the end of one season, only to become a full-on breakout the next. The U.S. CDC says it has already gathered viral genetic material for the preparation of a vaccine.

It would be wiser for the CDC, governments, media and the general population to keep the flu pandemic story alive in analytic and editorial pieces. Critical mass precedes action. Preparations for next flu season should be intense and start now. A full investigation into the swine flu's source, whether there is more than one virus, and to rule out bio-terrorism should be underway now.

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[ABP Analyst]

Novartis reports vaccine production.