[Congressional Record (Bound Edition), Volume 151 (2005), Part 16]
[Senate]
[Pages 21689-21694]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               AVIAN FLU

  Mr. BAYH. Mr. President, let me begin by thanking our colleague, 
Senator Kennedy from Massachusetts. He is busy and has a lot on his 
agenda. He has graciously agreed to let me speak before giving his 
remarks. I thank him for his courtesy.
  I also commend Senator Harkin, our colleague from Iowa, and Minority 
Leader Harry Reid for putting this pressing issue squarely on the 
national agenda. The issue of avian flu is one of the critically 
important issues of our time. Second only to the potential for the 
existence of weapons of mass destruction in the hands of suicidal 
terrorists, this issue has the potential to be catastrophic to the 
national security interests of this country.
  I cannot imagine a more timely issue or one more appropriate to be 
brought up on this legislation than something that will protect the 
American people who are currently dreadfully exposed to the possibility 
of a global pandemic. We need a new sense of urgency in addressing this 
issue.
  People have died because of avian influenza: 115 people have 
contracted it in Asia; 59 of those people have died. Leading experts 
say it is only a matter of time before this deadly disease becomes more 
efficient in moving from person to person. We should not await that 
dreadful day, but act proactively to protect the national security 
interests and the health interests of the people of the United States 
of America.
  Previous influenza epidemics have been catastrophic, killing not 
hundreds of thousands, but millions of human beings. We cannot afford 
to wait for that kind of event to occur.
  We are currently woefully unprepared. The estimates are that we have 
in our stockpiles only enough vaccine to cover about 1 percent of the 
American people. There are about 2.3 million

[[Page 21690]]

doses of Tamiflu and 2 million doses of experimental pandemic flu 
vaccine in our stockpile. And another antiviral may have been 
compromised by the Chinese use on their poultry population, thereby 
imperiling its efficacy. We are way behind the curve in preparing for a 
potential outbreak or pandemic of this severity and potential 
magnitude. Other developed nations are way ahead of us in terms of 
compiling their stockpiles and preparing their public health agencies 
for a rapid response to this grave health threat.
  The final point I wish to make is I think more than anything else, 
the lesson of Hurricane Katrina has taught us this: When it is a matter 
of life and death for the American people, we better prepare for the 
worst, even as we hope for the best because then one of two things will 
happen: If the worst occurs, you are prepared to protect the life, the 
security, and the safety of those who place their confidence in us. 
That is the very least they should expect from their Government. And if 
the worst did not happen, then we will be pleasantly surprised.
  When it comes to dealing with avian influenza, let us not have a 
repeat of the mistakes of Hurricane Katrina. Let us be prepared so we 
may protect our citizens or so we may be pleasantly surprised. That is 
what Government is all about. That is why I am pleased to be a 
cosponsor of the Harkin amendment.
  I thank our leader Harry Reid and, once again, Senator Kennedy for a 
lifetime of leadership on these issues and for his courtesy to me 
today.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Coleman). The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, I first pay tribute to my friend, 
colleague, and the chairman of our HELP Committee, Senator Enzi, for 
his comments and his statements. We have worked very closely together 
and will continue to do so on a variety of different health-related 
issues. We are working together on the challenges that we are facing 
from Hurricane Katrina, and we are also working on health and 
education, as well as issues of pensions and higher education.
  We come at this with somewhat different viewpoints. First, I commend 
Secretary Leavitt for an excellent briefing and presentation yesterday. 
All of our colleagues have had the opportunity to read in our national 
newspapers the dangers associated with avian influenza, including the 
potential threat that it presents and why it is different from the 
seasonal flu that concerns families all over this country, particularly 
to the elderly.
  We have to be reminded that 36,000 people every year die from the 
flu, even when we work to make sure they have access to the appropriate 
flu vaccine. But that is the number that we lose, and that certainly is 
a tragedy.
  We heard an outstanding presentation by Secretary Leavitt, as well as 
an outstanding presentation by Dr. Julie Gerberding, who is the head of 
the CDC and who has been enormously perceptive in terms of looking at 
the avian flu that we are facing. We also heard from General Michael 
Hayden, Deputy Director of National Intelligence, and others. The one 
thing that came out of that meeting, that I think all of us were 
impressed by, is the sense of immediacy. I think that is what Senator 
Harkin is reacting to and responding to, the real potential danger 
which would be devastating to potentially tens of millions of 
Americans.
  Perhaps we are being overly sensitive to this issue by adding this 
amendment to the Defense appropriations bill because of the recent 
tragedy of Hurricanes Katrina and Rita. Obviously Katrina has been 
particularly devastating, and Rita was certainly enormously harmful as 
well.
  There were several of us in that briefing who left saying if we are 
going to make a mistake, it will be on the side of taking too much 
action.
  The Secretary outlined a very vigorous program that he himself is 
involved in, working with the other agencies of Government and working 
with other members of the Cabinet. Avian flu is going to involve just 
about every kind of public policy issue, including transportation, 
health, commerce, and so many others. He gave us the assurance that he 
is going to have his own plan that will be released in the next few 
weeks.
  As Senator Harkin and others have pointed out, this particular 
legislation outlines the areas where funding should be directed, and 
also gives great flexibility to the administration in terms of its 
expenditures. Senator Harkin says that the funds will be available 
until spent. By passing this amendment today, we will not get caught at 
a time when either the Senate or the House is not in session. We now 
have an opportunity to make the necessary resources available, as well 
as direct the ways that it ought to be expended.
  During the presentation, the Secretary pointed out that their goal 
was to buy enough antiviral treatment to cover 80 million people, which 
is about one-quarter of the Nation's population. That was going to be 
at the cost of $20 a course of treatment. It was brought up by our 
colleagues that if this pandemic strikes the United States, there is 
not going to be a family that is not going to want to make sure that 
they have protections for their children and for themselves, for their 
spouses, for their parents, and for their grandparents.
  Every family is going to want to make sure they are able to afford 
and obtain that antiviral treatment. If one is affected by avian 
influenza and the antiviral treatment is taken immediately, the risk of 
death is diminished in a dramatic way. I think it is going to be very 
difficult to accept that this Nation will be satisfied with just one 
out of four Americans having access to this treatment. Even more so, 
when we already know the potential dangers of a pandemic by what we 
have seen in the places affected and impacted by avian flu.
  This legislation will only cover 50 percent of the population. It 
does not cover three out of four Americans. And, it does not cover the 
whole population. It costs $1.6 billion just to cover a quarter. We 
doubled that roughly to $3.2 billion, which puts us into the range 
suggested by experts.
  The point that was made very carefully by the Secretary is that we 
are going to have to deal with surge capacity, and that our hospitals 
do not have this capability at the present time. That is going to be 
very important.
  Previously, we have provided help and assistance to local communities 
and to State agencies to help them meet their surge capacity needs. 
Beyond that, it is going to be enormously important that we invest 
funds, as this legislation does, in surveillance--not only detection in 
this country but detection in foreign countries. That is the best way 
that we are going to be able to deal with this avian flu, to get the 
earliest possible detection.
  As a result of that briefing yesterday, I do not think any of us 
would feel that we have a full alert system working around the world. 
We had reports from various countries. A number of the countries, large 
countries as well as small, have effectively buried this health 
challenge and denied that they ever had it. We have to be very 
proactive if we are going to protect Americans. We have to be able to 
develop a system internationally where we can identify early warning 
signs of a pandemic. That kind of surveillance, is included in this 
legislation.
  We have to make sure we have the capability in our States to be able 
to detect this when it first affects a community. We have to set up a 
system for our health clinics and for our hospitals to make sure that 
the first indications of this kind of health challenge are going to be 
addressed. We need the detection and then we need the containment. To 
contain flu, we need to build our public health infrastructure in the 
local community. We are very far away from that kind of capability.
  A year ago, I think the Department submitted a public report about 
how many States actually had moved ahead in terms of developing their 
plans. About half of the states have yet to develop pandemic 
preparedness plans, and those with plans have yet to be evaluated for 
quality and feasibility.

[[Page 21691]]

  When I entered the Chamber, I was listening to my friend, Senator 
Enzi, talk about the BioShield Program which we put in place in 
preparation for the kind of challenge that we might face from 
bioterrorists. It focused on different bioterrorism agents that might 
pose a direct health threat, and allows the Secretary to put in place a 
system to respond quickly and effectively to those kinds of challenges.
  Our colleague, Senator Burr from North Carolina, has held an 
extraordinary number of hearings in these areas. I know he has been 
preparing legislation to deal with a number of these items that I am 
mentioning today. He has done a magnificent job in the development of 
those hearings. But that still does not mean that with the kind of 
challenge avian flu presents, which can be so devastating, that we 
should not be alert and ready to go.
  We can point out that our whole system of vaccines is woefully 
lagging in the United States for a variety of different reasons. Today, 
we do not have the direct capability and capacity to develop the kind 
of avian flu countermeasures we need, including vaccines or producing 
enough antiviral medication. The best estimate is even if we were to 
give all the contracts out today, it would be well into the year 2007 
before we were able to provide important coverage for all Americans. So 
we are talking years into the future before we can even provide 
Tamiflu, something that we know can make a difference.
  It does seem to me that we do not have a day to waste. This is 
something that is very dangerous.
  Finally, one could ask, Is it appropriate to be on a Defense 
appropriations bill? Well, if we were talking about something like 
nuclear weapons, I would say, yes, because we are concerned about the 
dangers of nuclear proliferation. I, quite frankly, believe avian flu 
presents a much greater threat, because it is imminent, highly lethal, 
and we have few countermeasures.
  I do not see a great difference myself--certainly it will not be much 
of a difference to the families who are affected, whether it is 
terrorism or the fact that this kind of influenza has spread to this 
country and their family is infected with a deadly virus. That is why I 
believe that action is necessary.
  Very quickly, we have seen reductions in two very important agencies. 
One is HRSA, which provides grants to help hospitals in the area of 
preparedness so that they can develop a response plan, get clearance 
with the State and HHS. Hospitals have begun working on plans, but they 
are woefully far behind, and this program was cut again this year.
  Then we have the Centers for Disease Control that will be certainly a 
lead agency--I would hope that it would be a lead agency--and we know 
that their public health expenditures have been reduced. I think this 
is tragic myself. It is a jewel of an organization in terms of American 
public health, and it has done extraordinarily well. It is extremely 
well led at the present time, and it does not seem appropriate to me 
that we ought to be reducing the CDC budget, when the agency has such 
great responsibility in this area at this time.
  Yesterday, when I asked Secretary Leavitt whether we could actually 
use the BioShield money--I think we have close to $6 billion in that--
he said that it was set up and structured so that the funds are not 
applicable to this particular kind of challenge.
  I think the amounts we are talking about are appropriate, given the 
essential nature of the potential disaster. The new flu strain poses a 
deadly threat. One of the important points made by Secretary Leavitt 
yesterday is that even this very deadly strain they are most concerned 
about can mutate further. It is always somewhat difficult to develop 
the vaccines and antivirals because these strains can alter and change, 
making the vaccines no longer effective. But having said that, they 
believe the treatments they have developed can have an important impact 
on saving the lives of those infected with avian flu. In the areas 
already affected with avian flu, we see a death rate of 44 percent in 
Vietnam, 71 percent in Thailand, almost 100 percent in Cambodia--and an 
average of 50 percent for all of Asia.
  The great challenge, as we heard yesterday, occurs when it moves from 
the birds into human beings. That is a big leap. I will come back and 
make a longer talk about how that comes about and how rare that process 
is, but that has happened.
  Then, the next leap is whether it is easily spread from person to 
person. For example, if one member of the family--if a child has it, is 
it easily communicable to the child's siblings? There is only one 
recorded instance, as we were told yesterday, where that has taken 
place. But it has taken place. That is a very important warning sign 
because it suggests that this influenza has the potential to become a 
pandemic and be absolutely devastating.
  We were reminded yesterday, during the briefing, there are usually 
three pandemics every 100 years. They talked about what happened in the 
immediate postwar period of 1918, when soldiers had been at the front 
and they contracted dangerous influenza. In the US, over 500,000 people 
died from that pandemic flu, and another 50 million worldwide died.
  We do not want to be unduly alarmist, but we have to be serious about 
it. This meeting we had was in S-407. It was going to be top secret, 
evidently. I said to the Secretary, now that we have heard all this 
news, it seems to me the public ought to know about it, they ought to 
understand it, and it ought to be explained by the top health officials 
in the country so we get accurate information. We have a number of 
those--Secretary Leavitt, Dr. Tony Fauci, Dr. Julie Gerberding--who are 
enormously competent, thoughtful scientists, researchers, who have a 
lifetime of commitment trying to understand these dangers. The more 
Americans listen to them and read the information on this and the 
authentic science, the better off they are going to be.
  But I believe this Harkin amendment is saying we have been put on 
notice. If there is an avian flu outbreak, they will say, Didn't you go 
to the briefing upstairs in 407 where they laid this out to you? You 
are on the HELP committee. You know the dangers. You worked with 
Senator Frist when we passed BioShield. Senator Burr, when he was in 
the House, was a principal sponsor--even before 9/11. The elements of 
preparedness, detection, and containment that are in this amendment 
were included in BioShield as well. These are thoughtful ideas. There 
is strong support for them in the HELP Committee. Today, we have an 
opportunity to take action on the floor. The administration is going to 
be responsible for that when this amendment is passed.
  I join with my colleague and friend, Senator Enzi, and with Senator 
Burr, our other colleague who has provided great leadership in the 
committee, to get legislation on preparedness out as early as possible.
  My chairman, Senator Enzi, likes to do it the old-fashioned way. He 
likes to listen to witnesses make the presentations, mark up the bill 
and get it to the floor, and he does it with extraordinary success. I 
would say, on this particular occasion, we ought to get the resources 
out there now.
  Senator Harkin has outlined the general areas which I think are 
justifiable, where the resources should be spent. I would also like to 
see the Secretary bring together all the major drug companies, which I 
think he intends to do, and go over this and get a plan from them about 
how we can maximize the safety and security for all Americans. This is 
what this amendment is all about.
  I thank my colleague from Wyoming for his comments and statements 
about avian flu. I look forward to working with him on this issue. Our 
only real difference is whether we move ahead now, trying to at least 
provide those essential resources for the Secretary, the President, and 
the administration, to act now and prepare us for the threat of avian 
flu or wait until it's too late.
  We can work with our colleagues within our committee to try to 
develop

[[Page 21692]]

additional legislation to further improve our preparedness and develop 
effective treatments for avian flu. That is certainly a responsibility 
that we have. I welcome the opportunity to do that with my friend from 
Wyoming and also the Senator from North Carolina.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the order for 
the quorum call be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. Mr. President, reflect for a moment on what America went 
through with Hurricane Katrina, reflect on what it has meant to our 
country and what it has meant to our Government. That was the greatest 
natural disaster of modern time. Americans were shaken to the core 
watching television night after night to see victims of Hurricane 
Katrina and what they were living through. Many of those scenes we 
witnessed did not look like America. It just doesn't seem like our 
great Nation where people would be in such a helpless and almost 
hopeless state--to find people struggling just to survive the 
floodwaters and the hurricane damage, to see Americans begging for 
water and food, to see what appeared to be refugees--in fact, 
evacuees--trying to bring their children across interstate bridges to 
dry land, to see people thrown in many different directions, families 
divided and still not united. To see all of that occur day in and day 
out 24-7 was a startling scene. It was an indication to all of us that 
we needed to take a step back and take a look at America from a 
different angle.
  Perhaps too many of us had been lulled into the belief that this sort 
of thing could never happen, that leaders in America would never let us 
reach this terrible point, whether it is a natural disaster or a 
terrorist disaster, that someone somewhere in Washington or in a State 
capital or in a city hall had not made preparations and plans to deal 
with it. It is that concern that has led so many people to call for an 
honest appraisal of what happened with Hurricane Katrina and Hurricane 
Rita and what we need to do in America to be better and stronger and 
better prepared.
  I don't think the people of this country expect the Senate or their 
Government to look at the world through the rearview mirror. We can't 
spend our time looking back and reliving every moment and pointing a 
finger of blame here and there or some place for some satisfaction, 
personal or political. But it is critically important that we review 
that scenario, that we don't repeat the same mistake, so that the next 
time, we are better prepared. That is what we need.
  That is why we need an independent, nonpartisan commission--people 
without allegiance to the President or to the Democratic Party or to 
the Republican Party but people who are truly Americans first who will 
come together in a commission and ask those questions so that we can be 
better prepared for our future. Unfortunately, there has been 
resistance to this idea, but that is nothing new.
  After 9/11, many of us called for the creation of a commission to 
find out why our intelligence sources failed so miserably and what we 
could have done to avoid that terrible disaster of 9/11. At that time, 
the White House opposed the creation of the 9/11 Commission, and many 
members of the President's party also said it is premature, we don't 
need it. But good sense prevailed. More than that, the 9/11 survivors' 
families prevailed--those widows and widowers, those children and 
spouses who came forward and demanded the creation of this independent 
Commission. They were the political force. They were an irresistible 
force. They created this Commission with two extremely talented 
individuals: Governor Kean of New Jersey, a Republican, and Congressman 
Lee Hamilton of Indiana, a Democrat. They came together with others of 
like mind and did a great national service.
  The 9/11 Commission not only analyzed what went wrong, which you 
almost have to start with, but then they said: Here is how we could do 
better. They produced a proposal for reforming the intelligence 
agencies of America--there are many of them--so that they would be 
better coordinated, share information, and be there to protect America. 
The first line of defense against any terrorism is not our military. 
The first line of defense is intelligence. We need to see the danger 
coming before it strikes and stop it. That is what good intelligence 
can bring you.
  With their suggestions, on a bipartisan basis with the support the 9/
11 families, we moved forward. Credit should go where it is due. In the 
Senate, Susan Collins, Republican of Maine, and Senator Joe Lieberman, 
Democrat of Connecticut, took the proposals of the 9/11 Commission, 
working with the Members of the House of Representatives, and crafted a 
piece of legislation which I was honored to be part of, and we worked 
literally for months to get that done. We gave up a valuable commodity 
around here: we gave up our time with our families. We came back during 
the August recess and held hearings. We pushed the bill, and it was 
signed by the President.
  Good things happened. Why? Because we had the right leaders in place. 
These Commission leaders were in place. They pointed to weaknesses, and 
they told us how we could overcome. They called for reform. They stayed 
with the agenda until it was accomplished. It was a model for all of us 
and one we should look to when it comes to Hurricane Katrina and 
Hurricane Rita. That is why I believe an independent, nonpartisan 
commission is so necessary.
  The House of Representatives had a hearing earlier this week. They 
brought in Michael Brown. He pointed a finger of blame in every 
direction, including his own administration. When it was all said and 
done, people said: Well, at least he was brought before this committee 
and the members that did appear and was held accountable. That is a 
good thing. It is an important thing. But it isn't going to bring us to 
the point we ought to be in this country. We want to find out what went 
wrong. Why didn't we think ahead if we had been warned so many times 
about the dangers in New Orleans? Why didn't we plan ahead when it came 
to positioning forces, positioning food and supplies? Why didn't we 
have a communications network that could survive a natural disaster? 
Why didn't we have better cooperation at all levels of government? 
Where do we need to change the law so that at some given moment, it is 
clear who is in charge? What could we have done to save those lives we 
lost in those disasters? What should we do now to reunite these 
families and put their lives back in order? These are all valid points.
  The reason I have reflected on these circumstances, 9/11 and the 
hurricanes, is because the amendment that is pending right now on this 
Department of Defense appropriations bill gives this Senate an 
opportunity to step forward right now at an early moment to avert the 
next tragedy. Let me tell you what I mean. We need a wake-up call in 
America. Most public health officials here and around the world agree 
that an outbreak of a new pandemic is virtually inevitable. I use the 
words ``virtually inevitable'' with some care. Those are the words of 
Dr. Gerberding, who is the head of the Centers for Disease Control.
  You have to be a student of history to remember the great flu 
pandemic of 1918 that claimed so many innocent lives in America. What 
Dr. Gerberding and other health officials are telling us is that unless 
we aggressively monitor and immediately contain this avian flu, it is 
likely to be a global pandemic.
  The difference, of course, is the world of 2005 is so much different 
from the world of 1918. In the world of 2005, an infected person is 12 
hours away from your doorstep. That is about as long as it takes to fly 
from one part of the world to another.
  We have to prepare and we have to start now, no excuses. That is why 
the Harkin amendment, which I am happy

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to cosponsor, is so important. People say: Why would you bring up an 
amendment about a national pandemic of avian flu on a Department of 
Defense appropriations? Don't you have health appropriations or other 
things? It is true. And Senator Harkin and I happen to be on the 
subcommittee that would more naturally be the place to bring up this 
amendment. However, he is doing it because we have relatively few 
opportunities in this Senate to act. We believe, in supporting this 
amendment, we need to act, and to act now.
  I am told what makes the avian flu so dangerous is that humans have 
no natural immunity to this strain of flu. We remember the flu shots 
and all the warnings we have received over the years. For the most 
part, those flu shots are increasing our already natural resistance to 
flu. When it comes to the new strain of avian flu, we have no 
resistance. We have no immunity. It is not a question of children and 
sick people and the elderly being vulnerable, we are all vulnerable. 
That is what happened in 1918. The healthiest looking people on the 
street could be dead in 24 hours. That was the nature of that flu and 
could be the nature of this flu challenge.
  The Centers for Disease Control has suggested that an avian flu 
outbreak in the United States could claim the lives of 200,000 people--
a conservative estimate. Compare that to 36,000 lives lost each flu 
season to typical, normal flu. It is not just that the CDC that is 
anticipating a flu pandemic. Yesterday, Senator Frist asked the 
Secretary of Health and Human Services, Mr. Leavitt, to ensure that 
there are U.S. antiviral drugs in the national stockpile to provide 
treatment for 50 percent of the American population in the event of an 
outbreak. I fully support Senator Frist's recommendation. As most 
everyone knows, he is a medical doctor, in addition to being the 
majority leader of the Senate.
  I am pleased to join in offering this amendment which provides the 
Department of Health and Human Services with the money it needs to 
purchase those drugs. That recommendation alone will require about $3 
billion.
  What is the antiviral drug? The one most commonly referred to is 
called Tamiflu. If a person has flu-like symptoms and calls the doctor 
as soon as they feel them coming on, that doctor might prescribe 
Tamiflu, which if taken quickly, could lessen the severity of the 
influenza. The notion is, we should be prepared as a nation with this 
antiviral Tamiflu in the stockpile, or something like it, so that if we 
do see this flu coming toward America, we are prepared to provide some 
treatment for people as they start to exhibit symptoms.
  This amendment that Senator Harkin has offered, with my support and 
others, provides funding to the Department of Health and Human Services 
so it can enter into a contract to buy those drugs now. Until the 
Department of Health and Human Services has that money on hand, all of 
our conversations are just theoretical.
  Remember last year when we talked about running out of flu vaccine, 
and the flu had already hit? It was a little late. That is what we are 
trying to avoid. Step in early for the virtually inevitable pandemic 
and have a stockpile of medicine available for America. Be prepared. 
That is what this amendment has as its watchword.
  The Department of Health and Human Services cannot add antiviral 
drugs to the stockpile until it has the money to purchase them. This 
amendment provides the money to the Department of Health and Human 
Services so they can purchase drugs to treat up to 50 percent of the 
U.S. population.
  I asked yesterday in one of the briefings, why did you pick a number 
like 40 or 50 percent? The public health experts, such as Dr. Fauci and 
others, say that is the percentage of the population we think may be 
exposed. Let's not revisit the scenario of last year's flu season when 
there was not enough medicine and we had to make decisions about 
rationing the medicine. There came a time when we said there is not 
enough flu vaccine. I said, well, I feel pretty healthy, I will get to 
the end of the line. And when it was all over we ended up with more 
than we needed. It was not good management of flu vaccine in our 
country.
  Baruch Fischoff of Carnegie Mellon University, an expert on the 
public perception of risk, says telling people they cannot get flu 
treatment ``isn't the American way.'' ``That is rationed health care. 
We just do not accept that.''
  We have to prepare for developing something else which is going to 
take a lot of energy, a lot of resource and ingenuity. We have to 
prepare and develop a vaccine to deal with this flu that prevents the 
infection from ever setting in. Right now, that vaccine does not exist. 
Even if it did, we do not have the manufacturing capacity in the United 
States to produce vaccines at the rate we need them.
  Senator Harkin's amendment, now pending, doubles our commitment to 
research and development, the manufacture of, even the purchase of an 
effective avian flu vaccine.
  Remember last year when one of two flu vaccine manufacturers for a 
typical flu season had to close its European facility? The United 
States could not turn to any domestic supplier to make up for the loss 
of those doses of vaccine because we did not have that capacity.
  We talk a lot about the U.S. dependence on foreign suppliers for oil. 
We shouldn't have to depend on other countries for the medicines we 
need during a global health crisis.
  Another lesson from last year's flu vaccine shortage, we have to have 
a plan. In the face of the vaccine shortage, prices for a dose of flu 
vaccine in Kansas at one point went as high as $600. In Colorado, 600 
doses of flu vaccine were stolen from a doctor's office.
  Despite these images of chaos, State and local health officials 
worked long and hard to maintain calm and also figure out how many 
doses there were, where they were, and how to get them to the people 
who needed them the most.
  If we intend to rely on good work, long hours, and a public health 
workforce that does not get sick, we may be in trouble. This amendment 
restores cuts to State and local public health agencies so they will 
have the money to be prepared. It includes enough money for communities 
to figure out where we will take care of people who are sick when the 
hospitals and clinics reach capacity, which could happen.
  Again, the people who turned New Orleans airport into a hospital 
showed bravery and grace under pressure. But we can do better than 
airport lounges and convention centers as makeshift clinics in 
America--only if we think ahead; only if we are prepared. Let's give 
our State and local agencies the resources and timeline to prepare for 
a pandemic flu outbreak.
  This time, we are virtually certain it is going to hit. This time, no 
excuses. We should be prepared. We need to begin now to prepare, and do 
it aggressively. The best possible outcome would be an early detection 
of the outbreak, quick containment and treatment, and then development 
of a vaccine to prevent its spread. This amendment doubles the 
investment of the Centers for Disease Control in global disease 
detection in an effort to find, stop, and prevent the spread of the 
avian flu as soon as it mutates into a strain that can move 
efficiently, in the words of the medical community, ``from person to 
person.''
  I heard one of the public health leaders the other day say it might 
not be this winter, it might be next winter, but it is going to happen. 
If we know that, and we do not act to prepare for what President Bush 
says could become the first pandemic of the 21st century, we are 
failing in leadership. We will have failed as much as any official who 
did not respond to the catastrophe of Hurricane Katrina.
  The funding we propose to add to this bill to prepare for a virtually 
inevitable, probably global public health crisis is less than we spend 
on the war in Iraq in 1 month. That is what it will take to get America 
ready so this avian flu does not claim so many lives.
  This investment will, in fact, save lives. Hundreds of thousands of 
American lives could be spared, by the most conservative estimates. It 
could be as many as 1.7 million American lives

[[Page 21694]]

that are at risk in this pandemic, according to an adviser to the 
Department of Homeland Security. Understand, this amendment does not 
create any new programs or start any new initiatives. It simply 
accelerates the work of the CDC in preparing for the outbreak of this 
deadly flu. The preparation will take time. There is not much we can do 
about that. Avian flu could begin to spread at any time.
  Currently, they have reported 115 cases of avian flu around the 
world. Where humans were affected by it, over half of them have died. 
There isn't anything we can do about the current situation, but there 
is something we can do about the threat to America. What we can do is 
step up to this challenge, purchase the antiviral drugs we need now, 
invest in domestic capabilities for vaccine protection for America, and 
prepare for emergency care during a flu pandemic.
  We talk a lot about national security in the Department of Defense 
bill, but a strong America begins at home. We found that out. We found 
it out on the gulf coast. We were not prepared. We did not do our job. 
No one stood up soon enough and early enough and said it is time to 
hold people accountable. It is time to think ahead, think beyond the 
moment, think to what we need.
  What if I am wrong? What if this flu pandemic does not occur? What if 
this money is invested in things that, frankly, do not become 
necessary? That could happen. And I pray that it does. If we could 
spare Americans and people around the world the suffering that could be 
associated with that pandemic, I wish that happily. I would be glad to 
stand and say, well, perhaps we did too much too soon. But I would much 
rather stand here and apologize for doing too much too soon than to 
stand here and make excuses for not doing enough when we had to.
  The Harkin amendment is an important amendment for the strength of 
America, for the health of America, and for the protection of America. 
I look forward to supporting it. It would be wonderful if we had a 
strong bipartisan rollcall to say that we will start with this national 
challenge, coming together in a bipartisan fashion, both the 
administration and Congress dedicated to making certain that we learned 
a lesson from Hurricane Katrina.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida.

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