Policymakers plot next pandemic flu preparedness steps

Lisa Schnirring  Staff Writer

Sep 14, 2012 (CIDRAP News) – US influenza policy experts who gathered in Washington, DC, today called for better vaccines and other steps for improving pandemic and seasonal flu preparedness, themes echoed in an action plan released by the Infectious Diseases Society of America (IDSA).

The presentations and panel discussions were streamed live in a webinar cohosted by the IDSA and the American Medical Association (AMA). The IDSA posted its 22-page report, "Pandemic and Seasonal Influenza Principles for United States Action," on its Web site today.

Two of the main themes of the discussion centered around the need for better flu vaccines and treatments and a steady stream of funding to support the many preparedness activities, such as immunizing patients and conducting flu surveillance, that take place at the state and local public health levels.

Since 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA) has been the federal funding tool for filling gaps in the nation's preparedness against flu and other biologic threats. The legislation is up for reauthorization but has languished in the Senate for the past several months.

Rep. Mike Rogers, R-Mich., the lead House sponsor of the bill, told webinar participants today that the Senate's work on the bill is 90% complete, and while negotiations aren't contentious, consideration of the bill is competing with several other measures. He urged the group to give their Senators a friendly call as a nudge to send the bill to final passage.

Rogers, who also chairs the House intelligence committee, told attendees that bioterror attacks are still a threat, and that maintaining work on countermeasure development and the Strategic National Stockpile is crucial. "This is on our watch, and we've got to get it right," he said.

Nicole Lurie, MD, MPH, assistant secretary for preparedness and response (ASPR) at the Department of Health and Human Services (HHS), told participants that the next flu preparedness steps are based on several lessons that health officials learned during the 2009 H1N1 pandemic. She said the new mantra for pandemic and other flu vaccines isn't just faster production. "It's more vaccine, better vaccine, and faster vaccine."

The country still has a long way to go toward acquiring new antiviral and broad-spectrum antibiotics, she said, pointing out that during the 2009 H1N1 pandemic, 40% of children who died from pandemic flu infections were coinfected with methicillin-resistant Staphylococcus aureus (MRSA).

Another important gap that the 2009 pandemic response revealed was that the slow movement of federal funding to states in some instances limited the pace of local efforts and took away an important opportunity to do science-based research during the outbreak. Such research is crucial to help guide pandemic response and advance knowledge about the disease, Lurie said.

She said discussions are under way about how to speed research money to academic institutions so they can quickly launch key studies during biological events.

To boost the science-based nature of response to flu and other threats, Lurie said the ideas of an "incident commander for science" and a "science ready reserve" are options under consideration.

Andrew Pavia, MD, a pediatric infectious disease expert at the University of Utah and board member of the IDSA, said it will take an enormous effort and a great deal of coordination to support and develop a better, more adaptable, flu vaccine. However, he urged policymakers not to ignore the important distribution and dispensing steps that happens with flu vaccines and medications at the state and local levels where public health departments have been gutted by budget cuts and challenged by a lack of steady funding for preparedness activities.

Strengthening flu vaccine efforts is the lead principle in the IDSA's revised pandemic and seasonal flu action plan. The report said the society supports efforts to improve the effectiveness of flu vaccines, speed development and manufacturing, and broaden their use. It recommends that federal officials appoint a lead office and director within HHS to coordinate flu vaccine efforts.

The IDSA's action plan also addressed nine other steps regarding medical management of flu, diagnostic testing, communication strategies, surveillance, community mitigation, all-hazards response systems, protecting healthcare workers, international collaboration, and allocating significant and sustained funding. 

http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/sep1412fluprep.html