How U.S. policy choices increase avian flu threat

WASHINGTON – Policy choices by U.S. officials have made the nation more vulnerable to an avian flu pandemic and other infectious diseases, say health experts.

"Today we face a double jeopardy from both chronic and infectious diseases, but because we forgot the public health lessons of the past, we tore down the infrastructure" that could help counter the avian flu, Dr. Susan Blumenthal, a former U.S. assistant surgeon general, told Cardiovascular Device Liability Week.

The trouble began back in the 1960s, say Blumenthal and others, when health officials in Washington all but declared total victory over communicable diseases such as smallpox, tuberculosis and polio.

U.S. Surgeon General William Stewart told Congress in 1969 it was time to "close the books on infectious diseases."

What followed was a drastic decrease in public health research, funding and manpower, especially at the U.S. National Institutes of Health as funds were shifted from infectious diseases to cancer, heart disease and stroke.

"We're not even staffed at even half the level we need to manage our day-to-day outbreaks and events in this country, let alone a challenge like pandemic flu," said Dr. Rex Archer, the director of health for Kansas City, Mo., and the president of the U.S. National Association of County Health Officials.

Health officials say it was shortsighted 40 years ago to assume the nation's troubles with infectious diseases were over. In fact, since 1973, at least 34 new infectious microbes have emerged.

They also suggest that President's Bush's call for $7.1 billion is not enough to offset the effects of policy choices made four decades ago.

"What we're failing to understand is that we need consistent long-term funding that maintains a flexible, adaptable (public health system) that can respond to all health threats," said Laurie Garrett, the Pulitzer Prize-winning author of "The Coming Plague." "We just haven't been able to hold a thought in our head long enough to look at this the right way."

Some health officials suggest the avian flu might actually present an opportunity to refocus the priorities of government.

"There's a wave here and we should ride it," said Georges Benjamin, executive director of the American Public Health Association. "It's a terrible tragedy that's potentially there, but we should use it as an opportunity to address what we believe are long-standing areas of neglect in rebuilding the public health infrastructure."

Department of Health & Human Services Secretary Mike Leavitt has convened senior state and local officials to establish an integrated federal-state influenza-pandemic planning process. Addressing the first meeting, Homeland Security Secretary Michael Chertoff put the threat in perspective.

"The avian flu bears the potential for societal disruption of unprecedented proportion," he said. "Strong partnerships and smart planning will be our best protection against this threat. At the president's direction, we are tapping every capability and expertise within the federal government and among first responders and public health officials to maximize our nation's preparedness."

As the new year gets under way, health officials remind the public that January, February and March represent the peak season for all forms of influenza.

The U.S. flu cases are not believed to be related to the avian flu that officially has killed at least 73 people in Asia. Most of the Asian victims were in close contact with birds. Millions of birds have died after contracting the flu, and millions others have been slaughtered in an effort to contain its spread.

Last month the Congressional Budget Office reported a severe pandemic of avian flu hitting the U.S. would kill 2 million Americans and throw the country into a major recession.

The CBO report predicted about 90 million Americans would get sick, health-care facilities would be overwhelmed, schools closed, with the retail sector hard hit and air travel falling by two-thirds.

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