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Mike Leavitt, Secretary of Health and Human Services


The National Academy of Sciences


Monday, April 4, 2005

"Preparing Against Pandemic Influenza"

Thank you, Harvey, for that kind introduction (Harvey Fineberg, President of the Institute of Medicine).

This meeting is a tribute to a man who was a friend to many in this room, Dr. John La Montagne. You all know how his brilliant work helped save people from many diseases. While working on one of these projects, he told a colleague, "It's good that we're doing this. But if anything is going to get us, it will be the flu."

I am also especially pleased to have the opportunity to share the podium with Dr. Fineberg this morning. Because, as he knows, I have learned many lessons from his excellent book: The Epidemic that Never Was: Policymaking and the Swine Flu Scare.

I know that many of you have dedicated your careers to this field. In the short time that I have been Secretary of Health and Human Services, I have become acutely aware of the disastrous public health impact that an influenza pandemic could have throughout the world. This is one of the most urgent health challenges we face, and I've made it a top HHS priority. Recently, I increased my briefing frequency on the flu to daily.

While much of our attention is focused on the H5N1 virus in Asia, I know very well that it is not the only flu threat we face. Many of the lessons that we learn from it will prepare us for annual influenza as well as for other potentially pandemic influenza viruses that may emerge in the future.

President Bush also understands the gravity of our situation. In fact, the United States government has made significant progress on pandemic influenza since he took office. We have increased spending on influenza tenfold over the past 5 years. We have added flu vaccine and flu drugs to the stockpile and made influenza part of regular public health discussions.

In order to increase our readiness against a pandemic strain of influenza, last Friday, on my recommendation, President Bush added pandemic influenza to the list of quarantinable events. This gives HHS the authority to take steps to prevent people with a new or reemerging influenza virus from infecting others by stopping them at our borders.

As we learned from CDC in last week's Morbidity and Mortality Weekly Report, there was a silver lining in last season's influenza vaccine situation. Despite the fact that we lost nearly half of our expected influenza vaccine supply, careful management of the available supply allowed this vaccine to be directed to the most vulnerable members of our population. We also sought out additional vaccine produced by foreign manufacturers and made arrangements to use it if needed. I applaud the remarkable effort that this took, and the close working relationship between our agencies, the vaccine companies, state and local health officials, and healthcare providers that made it possible.

In spite of such challenges as that one, we've made great progress on influenza preparedness over the past few years. Flu preparation is an international responsibility, and I know many of you are involved in projects around the world.

My study of this matter has been short in duration by intensive, and the best in the world. Flu virus is a networked enemy. We must fight it with a networked army.

The United States will take precautions necessary to protect this country but we know our success is dependent on others protecting their own countries.

When you fight a networked enemy, a mainframe response will not do. Let me just mention a few steps we've taken here in the United States:

  • HHS is working to bring more influenza vaccine manufacturers into the domestic market through the joint efforts of CDC, FDA, NIH, our National Vaccine Program Office (NVPO), and the Office of Public Health Emergency Preparedness.
  • We're working to accelerate the development of new influenza vaccine formulation and production techniques that will allow us to have a flexible surge capacity to make the doses of vaccine that we would need in a pandemic.
  • We're devoting an unprecedented amount of resources to vaccine research, development, and procurement, and we want to increase the routine seasonal use of influenza vaccine for all who would benefit from it.
  • On Friday, I was delighted to announce a contract with Sanofi Pasteur for the development of an influenza vaccine produced in cell culture rather than eggs.

We're doing all we can to ensure that Americans are healthy and protected against the flu. And everything we do to improve our approach to seasonal influenza prepares us to respond to an influenza pandemic.

In the past century, the world experienced three global outbreaks, or pandemics, of influenza. The recent emergence and persistence of a new influenza virus in birds in Asia and its infection of a limited number of humans with a high mortality rate has raised concern among scientists and public health professionals about the possibility of another pandemic influenza.

Dr. Julie Gerberding will talk more about this situation later this morning.

I am sure that most of you have seen the HHS draft Pandemic Influenza Preparedness and Response Plan we released last August, and I know that many of you have submitted comments. We're grateful for all of your input. I expect we will have the next revision out in the next few months. I am hopeful that the discussions and deliberations at this important meeting will feed into this effort.

And as part of our commitment to preparedness against the possibility of a pandemic, I am pleased to report that NIH has very recently begun clinical trials of a vaccine specifically designed against the H5N1 strain of avian influenza that is currently circulating in Asia. We have also gone ahead and produced 2 million doses of this vaccine in bulk. You will hear more about these efforts from Dr. Fauci later this morning.

Since we don't know where or when a pandemic may originate, we have enhanced our surveillance network across the globe, but especially in east and southeast Asia, where we at HHS have people on the ground who are working with local researchers, clinicians, and governments. We are also in daily contact with the World Health Organization Secretariat in Geneva and its regional offices in Manila and New Delhi. We at HHS have experts on short- and long-term assignments to W.H.O. headquarters and the W.H.O. Country Office in Vietnam.

I've begun meeting with health ministers and ambassadors from affected countries, and soon I will begin to visit their countries. In May, I will also travel to the World Health Assembly, where pandemic influenza preparedness is on the agenda; I am convening a special meeting of health ministers from affected and donor countries to coordinate planning on influenza, followed by a technical meeting of experts the next day. Influenza will continue to be an important topic in all my discussions with my counterparts.

Needless to say, I've gained a much greater appreciation for how important your work is. We have learned so much in recent years about how to assess and respond to flu outbreaks, but we also have much more work to do. I am glad that all of you are engaged in these research and public health activities, and glad that you've come together today to compare notes and help us reexamine and reset the direction of our collective efforts.

While pandemics have happened several times in the past, never before have we had all of the tools of today. Never before have we possessed the wealth of knowledge on the problem and the ability to prepare. The challenge is immense, but so is our will to protect and preserve.

The outcome of this conference will be extremely important and will help guide us all in our work toward improving our ability to prepare ourselves. I look forward to being able to present a brief report on this symposium to my fellow health ministers when we meet at the World Health assembly next month.

Last revised: April 4, 2005


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