9 March 2009

GAO reports on sustaining pandem= ic flu preparedness: 10 of 23 recommendations remain

On Friday, March 6 the U.S. Government Pandemic Influenza website (www.pandemicflu.gov) posted a Gove= rnment Accounting Office (GAO) 58-page pdf. document titled: “Influenza Pandemic: Sustaining Focus on the Nation’s Planning and Preparedness Efforts”. This report did not contain any new recommendations. The GAO did note, however, that in its previous reports on pandemic flu preparednes= s a total of 23 recommendations had been made. Of these, 10 “remain outstanding” (summarized in Appendix I, page 42-25), while the other = 13 recommendations have been implemented (Appendix II).

Examples (3) of the prior GAO recommendations that remain outstanding include:<= /o:p>

1.&n= bsp; Finalizing guidance on how to prioritize target groups for pre-pandemic vaccine.

2.&n= bsp; “The Homeland Security Council shou= ld establish a specific process and time frame for updating the National Pande= mic Implementation Plan...” (This GAO report states that “HSC did n= ot comment on the recommendation and has not indicated if it plans to implement it”.

3.&n= bsp; The US Department of Agriculture (USDA) Secretary should determine the amount of antiviral USDA would need to prote= ct animal health responders…and determine how to obtain and provide supp= lies within 24 hours of an outbreak. (This GAO report stated that USDA now has an antiviral stockpile to “protect 30,000 animal health responders for 40 days. However, USDA has yet to determine the number of individuals that wou= ld need medicine based on a calculation of those exposed to the virus under a specific scenario. Further, USDA officials told us that a contract for additional medication for the stockpile has not yet been secured…R= 21;

Examples of the 13 prior GAO recommendations that have been implemented include:

1.&n= bsp; The Secretary of the Department of Defense (DOD) should specify via the chain-of-command that U.S. Northern Command has the role and responsibilities as “global synchronizer” for pand= emic influenza planning within the DOD.

2.&n= bsp; “The Chairman, Federal Reserve, the Comptroller of the Currency, and the Chairman, Securities and Exchange Commission, should consider taking additional actions to ensure that market participants adequately prepare for an outbreak, including issuing formal expectations that business continuity plans for a pandemic should include measures likely to be effective even during severe outbreaks…”<= o:p>

Clearly, progress has been made over the past 5 or more years in the USA on pandemic influenza preparedness.

As this report discusses, however, sustaining this trajectory of progress is essential given that, as the GAO one-page summary states, “an influen= za pandemic remains a real threat to our nation and the world”.

Daniel R. Lucey, MD, MPH

EROne Institutes, Department of Emergency Medicine

Washington Hospital Center

Georgetown University Medical Center, Washington, D.C.

Website for this posting (requires Internet Explorer):www.BePast.org

Email: DRL23@Georgetown.edu