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Letter to Secretary Michael O. Leavitt

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Letter to Secretary Michael O. Leavitt

August 9, 2005

The Honorable Michael O. Leavitt
Secretary of Health and Human Services
U.S. Department of Health and Human Services
Washington, DC 20510

Dear Secretary Leavitt:

I am writing to urge the Bush Administration to take immediate action to prepare for and respond to a potential avian flu pandemic.

Such a pandemic is becoming increasingly more likely given bird-to-human transmission of avian flu and the persistent and growing numbers of infected chickens and other birds around the world. The only remaining requirement for pandemic avian flu is efficient human-to-human transmission, and there is some concern that this may soon occur. Given the high mortality rate from avian flu among those who have contracted the virus thus far, the world would experience human suffering and death of cataclysmic proportions if immediate steps are not taken to prevent and mitigate its impact.

Unlike previous pandemics, these early warnings about a potential avian flu pandemic have provided the United States with a small window of opportunity to prepare for this eventuality. In particular, we must accelerate efforts to produce an effective vaccine against avian flu and stockpile enough doses of antivirals to prevent and treat avian flu. It has been estimated that with no vaccine or antiviral drugs, 93 million Americans would be infected with avian flu, and 164,000 would die. However, if an effective vaccine is provided to 80 percent of individuals younger than 19 years of age, the estimated numbers decrease to 6 million total cases and 15,000 total deaths. A sufficient supply of antivirals could have the same protective effect.

I was encouraged by this week's announcement that the latest clinical trials of the Sanofi Pasteur vaccine against avian flu were successful. However, the vaccine was only effective when given in high doses, which means that the 2 million vaccine doses already acquired by the government would protect only about 450,000 Americans. I understand from news accounts yesterday that the U.S. government is preparing to purchase additional doses from Sanofi.

Similarly, the current supply of the antiviral oseltamavir is grossly inadequate to protect or treat the U.S. population, let alone to assist efforts by our international partners. The World Health Organization recommends that countries maintain a stockpile of antivirals capable of treating 25% of their population. However, between the U.S. government's current stockpile and its plan to order additional doses, there are only enough treatments for 2% of the U.S. population. Roche, which manufactures the drug, has stated that it could supply 13 million more courses of treatment in 2006 and an additional 70 million in 2007, if ordered by the U.S. government.

But, vaccines and antivirals are not enough. More needs to be done to strengthen and expand our nation's public health infrastructure. Public health providers will play a pivotal role in training doctors and other health practitioners, delivering preventive and medical care, communicating with the public, and conducting continuous surveillance.

Since any avian flu pandemic would likely begin abroad, the U.S. should be working with international health organizations on assisting poor countries to purchase vaccines and antivirals and to develop a system for quickly distributing the drugs in the event of a pandemic.

Over the past six months, I have pushed for - and the Senate has appropriated - $35 million to assist in the fight against the avian flu. The Foreign Affairs Authorization Act (S. 600), which could pass the Senate this fall, would require the establishment of an interagency task force to design and implement a comprehensive, international strategy to prevent and respond to an outbreak of the avian flu. I also have introduced the AVIAN Act (S. 969) which would improve domestic and international preparedness against a potential pandemic, including procuring vaccines and antivirals for a strategic national stockpile and studying the creation of an international fund to support pandemic control.

To improve this country's preparedness for a potential avian flu pandemic, I urge the Administration to take a number of steps immediately:

1. The U.S. government should begin creating a national stockpile with sufficient doses of antivirals to protect 25% of the U.S. population.

2. If subsequent studies confirm the effectiveness of an avian flu vaccine, the U.S. government should begin creating a national stockpile with sufficient vaccine doses to protect 25% of the U.S. population.

3. The U.S. government should finalize its domestic preparedness plan to prevent and respond to an outbreak of the avian flu;

4. The U.S. government should establish an interagency task force to design and implement a comprehensive, international strategy to prevent and respond to an outbreak of the avian flu; and

5. The U.S. government should work with international health organizations to assist other countries in purchasing necessary vaccines and antivirals.

Please notify me by August 23, 2005, as to what, if any, steps the Administration is taking in these areas. Thank you.


Barack Obama
United States Senator

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