[Congressional Record (Bound Edition), Volume 150 (2004), Part 13]
[Senate]
[Pages 17983-17984]
[From the U.S. Government Publishing Office, www.gpo.gov]




         GLOBAL HEALTH AND PROTECTION AGAINST BIOTERROR ATTACKS

 Mr. AKAKA. Mr. President, I rise today to express my concern 
that we need to do much more and do it much sooner to address the 
threat posed by Avian influenza and other infectious diseases.
  The Avian influenza outbreaks that occurred in late June 2004 
indicate that the virus is becoming more pathogenic and more widespread 
according to World Health Organization, WHO, officials. In addition, 
this virus has crossed the species barrier, moving from infected 
chickens or ducks directly into humans in three documented outbreaks 
since 1997.
  I am most troubled, however, by a warning from WHO officials that the 
virus may acquire the ability to spread easily from human to human, and 
thus, trigger a global influenza pandemic. According to the Centers for 
Disease Control and Prevention, CDC, an influenza pandemic could cause 
an estimated 89,000 to 207,000 deaths, 314,000 to 733,000 
hospitalizations, and cost from $71-$167 billion in the United States 
alone. We cannot afford to take this threat lightly.
  The so-called bird flu is deadly to humans. It killed 24 out of 35 
people who contracted it from chickens in Thailand and Vietnam earlier 
this year. In July an additional three were killed in Vietnam. This 
fatality rate is in the same range as the Ebola virus which is 
considered one of the most virulent viral diseases known to man.
  Lack of effective treatment options for Avian flu contribute to its 
lethality. Creating an effective vaccine for the Avian influenza virus 
is extremely difficult. The virus is so deadly that a vaccine cannot 
easily be grown in eggs, the usual method of production. Other vaccine 
production methods are being studied, but the required extensive safety 
tests for a new vaccine mean that large scale vaccine distribution is 
not feasible in the near term.
  Equally disturbing is that only one drug is currently believed 
effective to treat Avian flu, an antiviral medicine called Tamiflu 
which helps only if taken within one to two days of developing symptoms 
of the disease.
  The WHO recently decided Tamiflu should be included in regional 
stockpiles to be distributed at the first sign of a new influenza virus 
spreading among humans. Unfortunately, if a pandemic of Avian flu were 
to occur now, the manufacturer of Tamiflu could not produce enough of 
the drug to meet the huge demand that would occur, and there is no 
generic substitute.
  In light of these very limited treatment options, we should heed the 
WHO's warning and take aggressive steps to prevent a pandemic from 
occurring while at the same time increasing our preparedness to respond 
to all public health emergencies by developing a global defense system 
against the outbreak of diseases, including those resulting from 
terrorist attacks.
  On July 31, 2003, I introduced S. Res. 208 to address this concern. 
The resolution seeks to improve American defenses against the spread of 
infectious diseases by calling for improvements in global disease 
surveillance capabilities because the early warning of a disease 
outbreak is key to its identification, the quick application of 
countermeasures, and the development a cure.
  The recent Presidential Directive 10, ``Biodefense for the 21st 
Century,'' observes that many bioterror attacks could initially mimic 
naturally occurring diseases and potentially delay recognition of an 
attack. This is another

[[Page 17984]]

important reason why I believe that the United States must strengthen 
its ability to detect diseases before they cross our borders. To pursue 
this initiative, I along with Senators Bingaman, Dodd, Durbin, 
Feinstein, Inouye, Leahy, Levin, Lieberman, Murray, and Sarbanes sent a 
letter to President Bush urging his support for global health issues at 
the 2004 Group of Eight, G-8, Summit. Our letter underscored the need 
for better disease surveillance and reporting systems which are 
inclusive of all public health emergencies of international concern.
  I am pleased that the G-8 committed to take steps to expand and 
initiate new biosurveillance capabilities to detect bioterror against 
humans, animals, and crops; improve bioterrorism prevention and 
response capabilities; increase protection of the global food supply; 
and respond to, investigate, and mitigate the effects of alleged uses 
of biological weapons or suspicious outbreaks of disease.
  The administration followed the G-8 summit with the August release an 
updated draft of the 1978 Pandemic Influenza Response and Preparedness 
Plan for 60 days of public comment. This plan outlines the 
administration's proposed national strategy for preparing and 
responding to an influenza pandemic. Developing a strategy is good and 
the administration is to be commended for its concern, but far better 
would be committing more resources now to programs that have already 
been identified as critical to our preparedness.
  For example, the administration's fiscal year 2005 budget request, 
which cuts public health preparedness for State and local governments 
by more than $105 million and hospital preparedness funding at the 
Health Resources and Services Administration by $39 million, seriously 
calls into question the administration's commitment to ensuring that 
U.S. citizens are protected from bioterrorist events and other public 
health emergencies.
  I commend the President and the G-8 for expressing support for global 
health issues, but words and plans are not enough. We need action and 
we need action now. We must act together to reduce the grave threat 
that biological weapons and naturally occurring infectious diseases 
pose to the safety and security of the world.
  Adoption of S. 427, the Agriculture Security Assistance Act, and S. 
430, the Agriculture Security Preparedness Act, which I introduced in 
2003 to help protect our Nation from an agroterror attack, would be a 
good first step for the United States as we strive to live up to the 
promises made to our G-8 partners. S. 427 would assist states and 
communities in responding to threats to the agriculture industry by 
providing funding for biosecurity grants to farmers and community 
planning activities. S. 430 would enable better interagency 
coordination within the federal government as it works to plan and 
respond to a threat to American agriculture.
  We should also ensure that the National Security Council, and the 
Departments of State, Homeland Security, and Health and Human Services 
have the funding and support they need to fully implement the 
commitments made at the 2004 G-8 summit. CDC's fiscal year 2005 budget 
request for global disease detection shows an increase of $27.5 million 
over the fiscal year 2004 budget. However, this funding increase comes 
at the expense of other important public health initiatives. We should 
not be robbing Peter to pay Paul when it comes to the health and safety 
of our Nation.
  We must take action to increase WHO's global disease surveillance 
capability, including supporting their effort to revise the 
International Health Regulations by expanding the scope of required 
disease reporting to include all public health emergencies of 
international concern. An April 2004 Government Accountability Office, 
GAO, report on emerging infectious diseases, ``Asian SARS Outbreak 
Challenged International and National Responses,'' GAO-04-564, noted 
that the response by governments in SARS-affected countries was 
hindered by inadequate disease surveillance systems, poor 
communication, ineffective leadership, insufficient public health 
capacity, and limited resources.
  While the International Health Regulations provide the legal 
framework for global infectious disease control, WHO's Global Outbreak 
Alert and Response Network, GOARN, is the primary mechanism by which 
WHO mobilizes technical resources for the investigation of and response 
to disease outbreaks of international importance. The SARS outbreak was 
the first time that the GOARN network was activated on such a large 
scale for an international outbreak of an unknown emerging infectious 
disease. During the SARS outbreak, GOARN's human resources were 
stretched to capacity. GOARN experienced difficulty in sustaining the 
response to SARS over time and getting the appropriate experts out into 
the field.
  These difficulties in responding to and containing the SARS outbreak 
demonstrate the urgent need to strengthen our ability to respond to 
global health emergencies. For example, the CDC reported that if the 
United States had experienced many SARS cases during the global 
outbreak, CDC might not have been able to make as many of their staff 
available to assist GOARN. In light of this, the implications of a 
bioterror event or an influenza pandemic are chilling. The SARS 
outbreak sickened 8,089 people causing 774 deaths in 2003, and an 
influenza pandemic is estimated by CDC to affect 10 times as many 
people.
  CDC's fiscal year 2005 budget request for global disease detection is 
$50 million. This figure is not adequate when one considers that the 
SARS outbreak alone cost Asian economies $11 billion to $18 billion and 
resulted in losses of 0.5 percent to 2 percent of total output. If we 
multiply that by 10 for an influenza pandemic, the numbers are 
staggering. If we act now to increase funding for these programs, we 
have a chance to help prevent such a tragic situation from happening. 
By helping the world cope with infectious disease outbreaks we not only 
increase global public health, but help ensure the health and safety of 
the American people as well.

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