U.S. readiness for pandemic needs improvement, GAO says

WASHINGTON, D.C. — The United States is not as prepared as it could be to handle an avian-influenza pandemic, reports a federal audit of USDA efforts.

While the nation has played a prominent role in global initiatives against a pandemic, "widespread preparedness weakness" exists here and worldwide, concludes a June report released by the Government Accountability Office (GAO).

While $377 million is committed to prevention efforts, including the stockpiling of protective equipment, pharmaceuticals, vaccines and the training of foreign animal-disease professionals to respond to outbreaks, continued efforts are needed, GAO says.

Despite criticism, "the United States should feel confident and comfortable with the nation's plan," says John Clifford, DVM and deputy administrator for veterinary services with USDA's Animal and Plant Health Inspection Service (APHIS).

Through the World Health Organization, USDA and other countries have developed teams to evaluate veterinary infrastructures and make improvements, while also providing training on lab diagnostics and epidemiology. A network of U.S. veterinarians is ready to take action in case of a pandemic, Clifford says.

"The role of veterinarians in private practice is critically important to early detection and diagnosis and to the education of their clients in what to look for. Their role is important for producers and bird owners in general," he says.

Quick avian-flu recognition and treatment have helped put the United States among countries in the top tier of preparedness, on level with standards in Canada, Australia, New Zealand and many European countries, Clifford says. "I don't want to say we are better than anybody else, but our preparedness is very good. The United States does a tremendous amount of surveillance."

While worldwide avian-flu research continues and vaccines exist for some current strains, it takes up to six months to develop a vaccine for a new strain. "Therefore, a pandemic will likely be well under way before a vaccine that is specifically formulated to counteract the pandemic strain becomes available," says the report.

The GAO report offers reasonable insight, both positively and negatively, into USDA efforts, but leaves out of its assessment the organization's development of a National Animal Health Lab network, with 51 affiliate labs across the country, Clifford says. Partnering state, university and federal lab systems has strengthened the country's ability to address avian flu and other pandemics. And preparedness marches on, starting with 9/11 and a 2002, low-path avian-flu scare in Virginia that spurred unified state and federal response efforts.

The GAO's conclusion remains ominous: "Pandemic influenza poses a grave threat to global public health. It is not possible to predict when or where the next influenza pandemic will begin," says the report, noting the Spanish influenza pandemic of 1918-19 killed 50-million humans worldwide, including about 675,000 Americans.

The report urges continued USDA planning for a pandemic by communicating expectations and responsibilities, producing and stockpiling vaccines, establishing supply-distribution plans and advancing scientific knowledge about vaccines.

But Clifford remains confident in national preparedness to date and the opportunity for continued growth. "I think the USDA and the United States are well-prepared for an avian-influenza outbreak," he says. "I think there is always room for improvement, and that is often what an audit shows."