[Public Papers of the Presidents of the United States: George W. Bush (2005, Book II)]
[November 1, 2005]
[Pages 1630-1636]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks on the National Strategy for Pandemic Influenza Preparedness and 
Response in Bethesda, Maryland
November 1, 2005

    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 chicken pox 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 been 
saved.
    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 being here. 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 the 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, the 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

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coming, as well as Congressmen Linder, 
Burgess, and Price.NM/ 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 the 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 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 a 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 the world.
    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 6 months. A global influenza pandemic that 
infects millions and lasts from 1 to 3 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 6 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

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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. My responsibility as the President is 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 our shores.
    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 the 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 9 
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

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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'm 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 the 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 
frontlines, 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 must have a surge capacity in place that will allow 
us to bring a new vaccine on line 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

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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 on line 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 6 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 lifesaving 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 
more.
    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 populations.
    So my administration is working with public health officials in the 
medical community 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 
strikes.
    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

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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 web site, pandemicflu.gov. That ought 
to be easy for people to remember: pandemicflu.gov. The web site 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 outbreak.
    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'll continue 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've 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 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 today.
    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 pandemic.
    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.

Note: The President spoke at 10:04 a.m. in the William H. Natcher 
Conference Center at the National Institutes of Health. The Office of 
the Press Secretary also released a Spanish language transcript of these 
remarks.

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