President Bush announced a broad plan to
prepare for the possible emergence of a human influenza
pandemic November 1, calling on the U.S. Congress to support
his proposals for $7.1 billion in emergency funding to bolster
national and international safeguards.
President George W. Bush delivers remarks outlining his National Strategy for Pandemic Influenza Preparedness Tuesday, November 1 at the U.S. National Institutes of Health. Bush calls for $7.1 billion in emergency spending to stockpile reserves of medicines and to press ahead with the development of a new vaccine.. (© AP/WWP)
Bush outlined three primary goals of the
plan, the first of which is to create the capability to
detect outbreaks of dangerous influenza viruses anywhere
in the world. The White House plan calls for more than $250
million to help other nations train personnel, expand disease
surveillance and testing, heighten planning activities and
prepare to respond to outbreaks. (See White House fact
The proposal announced in a speech at the
National Institutes of Health in Bethesda, Maryland, outside
Washington follows on the International Partnership on Avian
and Pandemic Influenza, which has attracted the involvement
of 88 governments and international organizations since
its first announcement in September. (See related
The second goal of the president’s
plan focuses on stockpiling antiviral medications and developing
vaccines. Bush is also requesting congressional approval
of an almost $3 billion plan for the expansion of a new
vaccine production technology that will create a greater
capability for manufacturers to supply effective and adequate
vaccines in the event of a pandemic.
Current vaccine production relies on the
use of billions of eggs, which serve as incubators for the
growth of virus, which is then used in vaccine. Bush called
this an “antiquated process,” inadequate to
provide the proper response in the face of a pandemic brought
on by a virulent virus to which humans may have no immunity.
“We must fund a crash program to help
our best scientists bring the next generation of technology
on line rapidly,” Bush said. The more advanced cell
technology is a process that allows more rapid production
of the appropriate virus, which is then killed for use in
vaccines. (See “Bird
Flu Needs Better, Modern Vaccine Production Methods.”)
The third goal of the pandemic preparedness
plan is to ensure that governments and agencies at all levels
are ready to respond to disease outbreaks that could occur
in thousands of places at once.
Bush also cautioned against panic and emphasized
that there is no evidence that a human pandemic is imminent.
A deadly and contagious strain of influenza
has stricken nations across Southeast Asia, and now spread
to animal populations in Europe. According to international
health officials, about 120 people have been infected, and
62 have died. These cases stem from direct human contact
with birds, and the disease has not yet become contagious
For more information on U.S. and international
efforts to combat avian influenza, see Bird
Flu (Avian Influenza).
The transcript of the president’s
THE WHITE HOUSE
Office of the Press Secretary
November 1, 2005
REMARKS BY THE PRESIDENT ON THE ADMINISTRATION'S
FOR PANDEMIC INFLUENZA PREPAREDNESS AND
William Natcher Center
National Naval Medical Center
10:04 A.M. EST
THE PRESIDENT: 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
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
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 important signal.
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
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 globe.
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
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 Washington.
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 outbreaks.
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
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
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
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
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. (Applause.)
END 10:30 A.M. EST