Pandemic and Seasonal Influenza
To complement U.S. pandemic and seasonal influenza efforts, IDSA has developed a set of Pandemic and Seasonal Influenza Principles for U.S. Action (PDF). The U.S. federal government and state governments, private industry, and other U.S. and international stakeholders have made great strides to develop new systems, advance technologies, and build infrastructure to plan and prepare for an influenza pandemic.
What Action Does IDSA Recommend?
IDSA strongly believes that much work remains ahead of us, and overall responses to seasonal influenza and pandemic preparedness must be closely interrelated. The Society calls for:
a U.S. led multinational public and private effort to develop a pandemic influenza vaccine (“Master Program”)
leveraging pandemic preparedness efforts off of annual flu season
sustainable, long-term funding for federal, state, and local efforts
IDSA has been working diligently:
to obtain appropriate funding for preparedness, not only for pandemic influenza but also for bioterrorism threats including “All-Hazards” funding that can be used flexibly by local health departments
with federal agencies to improve guidance on how to manage and prevent influenza
to promote an adequate overall federal response, and
to improve the role of infectious diseases specialists in local preparedness efforts
IDSA’s Pandemic and Seasonal Influenza Principles for U.S. Action outlines 12 principles with detailed, action-oriented recommendations. These include:
Establish a Pandemic Influenza Vaccine Master Program. An effective vaccine will be the best protection against the next pandemic. The United States needs to lead a large, coordinated, multinational, public-private program on the scale of the Apollo space project. IDSA is calling for an investment of at least $2.8 billion for 2007 alone.
Boost R&D and stockpiling of antiinfectives. Public health authorities should have enough medicines to respond to a pandemic on hand ahead of time. New drugs need to be developed. Currently available antivirals are only moderately effective, and resistance to them is emerging.
Improve diagnostic tools. Influenza shares symptoms with many other illnesses. Better tools are needed to distinguish flu from other diseases quickly and affordably. Such tools need to be used even in small medical centers with limited resources.
Improve the financial, legal, and regulatory environment for developing anti-flu products. New funding for drug development authorized under the Pandemic and All-Hazards Preparedness Act will need to be targeted to the right products based on the advice of infectious diseases experts. The pharmaceutical industry will likely need additional incentives such as tax credits for R&D and manufacturing, and enhanced intellectual property rights to entice companies back into the anti-infectives field. The regulatory approvals process needs to be streamlined and standardized among international partners.
Update plans for distributing and prioritizing anti-flu supplies. During a pandemic, there may not be enough flu-fighting supplies for everyone who is sick or at risk. If so, who should receive them? This question needs to be answered in a transparent and ethical way well before a pandemic hits. (
See IDSA’s comment letter.)
Improve seasonal influenza response. Use seasonal flu to prepare for a pandemic. Health care workers should be required to get annual flu shots or decline in writing. New policies to increase flu vaccination among the public should be adopted. These measures will improve the market for flu vaccine and make it more attractive to industry. Each flu season should also be used to test vaccine distribution plans and procedures.
Protect Health Care Workers During a Pandemic. Health care workers and other first responders are the community’s first line of defense in any public health emergency. Their work also puts them at high risk of illness. They should be prioritized to receive anti-flu drugs and vaccines.
Build health care systems capable of responding to mass casualty events. National, regional, and local health systems must be able to take care of sudden surges of patients. The federal government should help train public health and medical personnel, and develop guidelines on allocation of scarce resources, liability protection, modified standards of care during an emergency, and other key issues.
Develop and test “community mitigation” measures: closing schools, sending workers home, isolation and quarantine, and so on. In the absence of enough vaccine or antivirals, these may be the only measures available to protect the public. But how well would they work? And how should they be used? National guidance on these issues needs to be worked out in consultation with experts.
Improve and coordinate surveillance. A viable, global early warning system is needed to detect an outbreak of pandemic influenza.
Continue to strengthen leadership, international collaboration, and communication. Continue clarifying lines of authority, holding tabletop exercises, issuing national standards and guidance, and involving experts and stakeholders in discussions and decision-making.
Commit funding for the long term. Influenza is a yearly hazard. An influenza pandemic could strike at any time. Although recent infusions of funding have been beneficial, a sustained, long-term commitment is needed.