Address to the National Institutes of Health on Protecting Against Pandemic Influenza
November 1, 2005
Thank you all. Michael, thank you very much for your
introduction. And thanks for the warm reception here at the National
Institute of Health. It's good to be back here again.
For more than a century, the NIH has been at the forefront of this
country's efforts to prevent, detect and treat disease, and I appreciate
the good work you're doing here. This is an important facility, an
important complex, and the people who work here are really important to the
security of this nation. The scientists who have been supported by the
folks who work here have developed and improved vaccines for meningitis and
whooping cough and measles and mumps and rubella and chickenpox, and other
infectious diseases. Because of the revolutionary advances in medicine
pioneered with the help of the NIH, Americans no longer fear these dreaded
diseases -- many lives have been saved.
At this moment, the men and women of the NIH are working to protect the
American people from another danger -- the risk of avian and pandemic
influenza. Today, I have come to talk about our nation's efforts to
address this vital issue to the health and the safety of all Americans.
I'm here to discuss our strategy to prevent and protect the American people
from a possible outbreak.
I appreciate members of my Cabinet who are here. More importantly, I
appreciate the hard work you've done on this issue. Secretary Rice,
Secretary Johanns, Secretary Mineta, Secretary Nicholson, Secretary
Chertoff. I appreciate the fact that Dr. J.W. Lee, Director-General of the
World Health Organization has joined us. Dr. Lee, thank you for being
I want to recognize Dr. David Nabarro, the Senior United Nations System
Coordinator for Avian and Human Influenza. Thanks for being here. This is
-- you're about to hear me talk about an international scope of response
and detection necessary to protect not only our own people, but people
around the world. And the fact that these two gentlemen are here is an
I want to thank Dr. Elias Zerhouni, he's the Director of the NIH; doing a
fine job. I want to thank Julie Gerberding, who's the Director of the
Centers for Disease Control and Prevention. I appreciate Dr. Rich Carmona,
U.S. Surgeon General. Dr. Tony Fauci, Director of the National Institute
of Allergy and Infectious Diseases. I want to thank Dr. Bruce Gellin,
Director of the National Vaccine Program Office. I want to thank Dr. Andy
von Eschenbach, who is the Acting Director of the FDA and the Director of
the National Cancer Institute.
I appreciate all the members of the health care community who have joined
us today. I want to thank state and local officials who are here. I
particularly want to thank Senators Specter and Kennedy for coming, as well
as Congressmen Linder, Burgess and Price. I appreciate you all taking time
to be here.
Most Americans are familiar with the influenza or the "flu" as a
respiratory illness that makes hundreds of thousands of people sick every
year. This fall as the flu season approaches, millions of our fellow
citizens are once again visiting their doctors for their annual flu shot.
I had mine. For most, it's just simply a precautionary measure to avoid
the fever or a sore throat or muscle aches that come with the flu.
Seasonal flu is extremely dangerous for some -- people whose immune systems
have been weakened by age or illness. But it is not usually
life-threatening for most healthy people.
Pandemic flu is another matter. Pandemic flu occurs when a new strain of
influenza emerges that can be transmitted easily from person to person --
and for which there is little or no natural immunity. Unlike seasonal flu,
most people have not built up resistance to it. And unlike seasonal flu,
it can kill those who are young and the healthy as well as those who are
frail and sick.
At this moment, there is no pandemic influenza in the United States or the
world. But if history is our guide, there is reason to be concerned. In
the last century, our country and the world have been hit by three
influenza pandemics -- and viruses from birds contributed to all of them.
The first, which struck in 1918, killed over half-a-million Americans and
more than 20 million people across the globe. One-third of the U.S.
population was infected, and life expectancy in our country was reduced by
13 years. The 1918 pandemic was followed by pandemics in 1957 and 1968
which killed tens of thousands of Americans, and millions across the world.
Three years ago, the world had a preview of the disruption an influenza
pandemic can cause, when a previously unknown virus called SARS appeared in
rural China. When an infected doctor carried the virus out of China, it
spread to Vietnam and Singapore and Canada within a month. Before long,
the SARS virus had spread to nearly 30 countries on six continents. It
infected more than 8,000 people and killed nearly 800. One elderly woman
brought the virus from Hong Kong to Toronto, where it quickly spread to her
son and then to others. Eventually, four others arrived with the virus and
hundreds of Canadians fell ill with SARS, and dozens died.
By one estimate, the SARS outbreak cost the Asian-Pacific region about $40
billion. The airline industry was hit particularly hard, with air travel
to Asia dropping 45 percent in the year after the outbreak. All this was
caused by a limited outbreak of a virus that infected thousands and lasted
about six months. A global influenza pandemic that infects millions and
lasts from one to three years could be far worse.
Scientists and doctors cannot tell us where or when the next pandemic will
strike, or how severe it will be, but most agree: at some point, we are
likely to face another pandemic. And the scientific community is
increasingly concerned by a new influenza virus known as H5N1 -- or avian
flu -- that is now spreading through bird populations across Asia, and has
recently reached Europe.
This new strain of influenza has infected domesticated birds like ducks and
chickens, as well as long-range migratory birds. In 1997, the first
recorded outbreak among people took place in Hong Kong, when 18 people
became infected and six died from the disease. Public health officials in
the region took aggressive action and successfully contained the spread of
the virus. Avian flu struck again in late 2003, and has infected over 120
people in Thailand, Cambodia, Vietnam and Indonesia, and killed more than
60 -- that's a fatality rate of about 50 percent.
At this point, we do not have evidence that a pandemic is imminent. Most
of the people in Southeast Asia who got sick were handling infected birds.
And while the avian flu virus has spread from Asia to Europe, there are no
reports of infected birds, animals, or people in the United States. Even
if the virus does eventually appear on our shores in birds, that does not
mean people in our country will be infected. Avian flu is still primarily
an animal disease. And as of now, unless people come into direct,
sustained contact with infected birds, it is unlikely they will come down
with avian flu.
While avian flu has not yet acquired the ability to spread easily from
human to human, there is still cause for vigilance. The virus has
developed some characteristics needed to cause a pandemic: It has
demonstrated the ability to infect human beings, and it has produced a
fatal illness in humans. If the virus were to develop the capacity for
sustained human-to-human transmission, it could spread quickly across the
Our country has been given fair warning of this danger to our homeland --
and time to prepare. It's my responsibility as President to take measures
now to protect the American people from the possibility that human-to-human
transmission may occur. So several months ago, I directed all relevant
departments and agencies in the federal government to take steps to address
the threat of avian and pandemic flu. Since that time, my administration
has developed a comprehensive national strategy, with concrete measures we
can take to prepare for an influenza pandemic.
Today, I am announcing key elements of that strategy. Our strategy is
designed to meet three critical goals: First, we must detect outbreaks
that occur anywhere in the world; second, we must protect the American
people by stockpiling vaccines and antiviral drugs, and improve our ability
to rapidly produce new vaccines against a pandemic strain; and, third, we
must be ready to respond at the federal, state and local levels in the
event that a pandemic reaches our shores.
To meet these three goals, our strategy will require the combined efforts
of government officials in public health, medical, veterinary and law
enforcement communities and the private sector. It will require the active
participation of the American people. And it will require the immediate
attention of the United States Congress so we can have the resources in
place to begin implementing this strategy right away.
The first part of our strategy is to detect outbreaks before they spread
across the world. In the fight against avian and pandemic flu, early
detection is our first line of defense. A pandemic is a lot like a forest
fire: if caught early, it might be extinguished with limited damage; if
allowed to smolder undetected, it can grow to an inferno that spreads
quickly beyond our ability to control it. So we're taking immediate steps
to ensure early warning of an avian or pandemic flu outbreak among animals
or humans anywhere in the world.
In September at the United Nations, I announced a new International
Partnership on Avian and Pandemic Influenza -- a global network of
surveillance and preparedness that will help us to detect and respond
quickly to any outbreaks of disease. The partnership requires
participating countries that face an outbreak to immediately share
information and provide samples to the World Health Organization. By
requiring transparency, we can respond more rapidly to dangerous outbreaks.
Since we announced this global initiative, the response from across the
world has been very positive. Already, 88 countries and nine international
organizations have joined the effort. Senior officials from participating
governments recently convened the partnership's first meeting here in
Together, we're working to control and monitor avian flu in Asia, and to
ensure that all nations have structures in place to recognize and report
outbreaks before they spread beyond human control. I've requested $251
million from Congress to help our foreign partners train local medical
personnel, expand their surveillance and testing capacity, draw up
preparedness plans, and take other vital actions to detect and contain
A flu pandemic would have global consequences, so no nation can afford to
ignore this threat, and every nation has responsibilities to detect and
stop its spread.
Here in the United States, we're doing our part. To strengthen domestic
surveillance, my administration is launching the National Bio-surveillance
Initiative. This initiative will help us rapidly detect, quantify and
respond to outbreaks of disease in humans and animals, and deliver
information quickly to state, and local, and national and international
public health officials. By creating systems that provide continuous
situational awareness, we're more likely to be able to stop, slow, or limit
the spread of the pandemic and save American lives.
The second part of our strategy is to protect the American people by
stockpiling vaccines and antiviral drugs, and accelerating development of
new vaccine technologies. One of the challenges presented by a pandemic is
that scientists need a sample of the new strain before they can produce a
vaccine against it. This means it is difficult to produce a pandemic
vaccine before the pandemic actually appears -- and so there may not be a
vaccine capable of fully immunizing our citizens from the new influenza
virus during the first several months of a pandemic.
To help protect our citizens during these early months when a fully
effective vaccine would not be available, we're taking a number of
immediate steps. Researchers here at the NIH have developed a vaccine
based on the current strain of the avian flu virus; the vaccine is already
in clinical trials. And I am asking that the Congress fund $1.2 billion
for the Department of Health and Human Services to purchase enough doses of
this vaccine from manufacturers to vaccinate 20 million people.
This vaccine would not be a perfect match to pandemic flu because the
pandemic strain would probably differ somewhat from the avian flu virus it
grew from. But a vaccine against the current avian flu virus would likely
offer some protection against a pandemic strain, and possibly save many
lives in the first critical months of an outbreak.
We're also increasing stockpiles of antiviral drugs such as Tamiflu and
Relenza. Antiviral drugs cannot prevent people from contracting the flu.
It can -- but they can reduce the severity of the illness when taken within
48 hours of getting sick. So in addition to vaccines, which are the
foundation of our pandemic response, I am asking Congress for a billion
dollars to stockpile additional antiviral medications, so that we have
enough on hand to help treat first responders and those on the front lines,
as well as populations most at risk in the first stages of a pandemic.
To protect the greatest possible number of Americans during a pandemic, the
cornerstone of our strategy is to develop new technologies that will allow
us to produce new vaccines rapidly. If a pandemic strikes our country -- if
a pandemic strikes, our country must have a surge capacity in place that
will allow us to bring a new vaccine online quickly and manufacture enough
to immunize every American against the pandemic strain.
I recently met with leaders of the vaccine industry. They assured me that
they will work with the federal government to expand the vaccine industry,
so that our country is better prepared for any pandemic. Today, the NIH is
working with vaccine makers to develop new cell-culture techniques that
will help us bring a pandemic flu vaccine to the American people faster in
the event of an outbreak. Right now, most vaccines are still produced with
1950's technology using chicken eggs that are infected with the influenza
virus and then used to develop and produce vaccines. In the event of a
pandemic, this antiquated process would take many, many months to produce a
vaccine, and it would not allow us to produce enough vaccine for every
American in time.
Since American lives depend on rapid advances in vaccine production
technology, we must fund a crash program to help our best scientists bring
the next generation of technology online rapidly. I'm asking Congress for
$2.8 billion to accelerate development of cell-culture technology. By
bringing cell-culture technology from the research laboratory into the
production line, we should be able to produce enough vaccine for every
American within six months of the start of a pandemic.
I'm also asking Congress to remove one of the greatest obstacles to
domestic vaccine production: the growing burden of litigation. In the
past three decades, the number of vaccine manufacturers in America has
plummeted, as the industry has been flooded with lawsuits. Today, there is
only one manufacturer in the United States that can produce influenza
vaccine. That leaves our nation vulnerable in the event of a pandemic.
We must increase the number of vaccine manufacturers in our country, and
improve our domestic production capacity. So Congress must pass liability
protection for the makers of life-saving vaccines.
By making wise investments in technology and breaking down barriers to
vaccine production, we're working toward a clear goal: In the event of a
pandemic, we must have enough vaccine for every American.
The third part of our strategy is to ensure that we are ready to respond to
a pandemic outbreak. A pandemic is unlike other natural disasters;
outbreaks can happen simultaneously in hundreds, or even thousands, of
locations at the same time. And unlike storms or floods, which strike in
an instant and then recede, a pandemic can continue spreading destruction
in repeated waves that can last for a year or more.
To respond to a pandemic, we must have emergency plans in place in all 50
states and every local community. We must ensure that all levels of
government are ready to act to contain an outbreak. We must be able to
deliver vaccines and other treatments to frontline responders and at-risk
So my administration is working with public health officials in the medical
community to develop -- to develop effective pandemic emergency plans.
We're working at the federal level. We're looking at ways and options to
coordinate our response with state and local leaders. I've asked Mike
Leavitt -- Secretary Leavitt -- to bring together state and local public
health officials from across the nation to discuss their plans for a
pandemic, and to help them improve pandemic planning at the community
level. I'm asking Congress to provide $583 million for pandemic
preparedness, including $100 million to help states complete and exercise
their pandemic plans now, before a pandemic strikes.
If an influenza pandemic strikes, every nation, every state in this Union,
and every community in these states, must be ready.
To respond to a pandemic, we need medical personnel and adequate supplies
of equipment. In a pandemic, everything from syringes to hospital beds,
respirators, masks and protective equipment would be in short supply. So
the federal government is stockpiling critical supplies in locations across
America as part of the Strategic National Stockpile. The Department of
Health and Human Services is helping states create rosters of medical
personnel who are willing to help alleviate local shortfalls during a
pandemic. And every federal department involved in health care is
expanding plans to ensure that all federal medical facilities, personnel,
and response capabilities are available to support local communities in the
event of a pandemic crisis.
To respond to a pandemic, the American people need to have information to
protect themselves and others. In a pandemic, an infection carried by one
person can be transmitted to many other people, and so every American must
take personal responsibility for stopping the spread of the virus. To
provide Americans with more information about pandemics, we're launching a
new website, pandemicflu.gov. That ought to be easy for people to
remember: pandemicflu.gov. The website will keep our citizens informed
about the preparations underway, steps they can take now to prepare for a
pandemic, and what every American can do to decrease their risk of
contracting and spreading the disease in the event of an outbreak.
To respond to a pandemic, members of the international community will
continue to work together. An influenza pandemic would be an event with
global consequences, and therefore we're continuing to meet to develop a
global response. We've called nations together in the past, and will
continue to call nations together to work with public health experts to
better coordinate our efforts to deal with a disaster.
Now, all the steps I've outlined today require immediate resources.
Because a pandemic could strike at any time, we can't waste time in
preparing. So to meet all our goals, I'm requesting a total of $7.1
billion in emergency funding from the United States Congress. By making
critical investments today, we'll strengthen our ability to safeguard the
American people in the awful event of a devastating global pandemic, and at
the same time will bring our nation's public health and medical
infrastructure more squarely in the 21st century.
The steps I have outlined will also help our nation in other critical ways.
By perfecting cell-based technologies now, we will be able to produce
vaccines for a range of illnesses and save countless lives. By
strengthening our domestic vaccine industry, we can help ensure that our
nation will never again have a shortage of vaccine for seasonal -- seasonal
flu. And by putting in place and exercising pandemic emergency plans
across the nation, we can help our nation prepare for other dangers -- such
as a terrorist attack using chemical or biological weapons.
Leaders at every level of government have a responsibility to confront
dangers before they appear, and engage the American people on the best
course of action. It is vital that our nation discuss and address the
threat of pandemic flu now. There is no pandemic flu in our country or in
the world at this time -- but if we wait for a pandemic to appear, it will
be too late to prepare, and one day many lives could be needlessly lost
because we failed to act today.
By preparing now, we can give our citizens some peace of mind knowing that
our nation is ready to act at the first sign of danger, and that we have
the plans in place to prevent and, if necessary, withstand an influenza
Thank you for coming today to let me outline my strategy. Thank the United
States Congress for considering this measure. May God bless you all.
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