6. Pandemics and Biosecurity. Some estimates suggest that if H5N1 Avian Flu becomes a pandemic it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?

Obama

McCain

It's time for a comprehensive effort to tackle bio-terror. We know that the successful deployment of a biological weapon—whether it is sprayed into our cities or spread through our food supply—could kill tens of thousands of Americans and deal a crushing blow to our economy.

Overseas, I will launch a Shared Security Partnership that invests $5 billion over 3 years to forge an international intelligence and law enforcement infrastructure to take down terrorist networks. I will also strengthen U.S. intelligence collection overseas to identify and interdict would-be bioterrorists before they strike and expand the U.S. government’s bioforensics program for tracking the source of any biological weapon. I will work with the international community to make any use of disease as a weapon declared a crime against humanity.

And to ensure our country is prepared should such an event occur, we must provide our public health system across the country with the surge capacity to confront a crisis and improve our ability to cope with infectious diseases. I will invest in new vaccines and technology to detect attacks and to trace them to their origin, so that we can react in a timely fashion. I have pledged to invest $10 billion per year over the next 5 years in electronic health information systems to not only improve routine health care, but also ensure that these systems will give health officials the crucial information they need to deploy resources and save lives in an emergency. I will help hospitals form collaborative networks to deal with sudden surges in patients and will ensure that the U.S. has adequate supplies of medicines, vaccines, and diagnostic tests and can get these vital products into the hands of those who need them.

We also have to expand local and state programs to ensure that they have the resources to respond to these disasters. I will work to strengthen the federal government’s partnership with local and state governments on these issues by improving the mechanisms for clear communication, eliminating redundant programs, and building on the key strengths possessed by each level of government. I introduced legislation which would have provided funding for programs in order to enhance emergency care systems throughout the country.

I will build on America’s unparalleled talent and advantage in STEM fields and the powerful insights into biological systems that are emerging to create new drugs, vaccines, and diagnostic tests and to manufacture these vital products much more quickly and efficiently than is now possible. Unfortunately, the Bush administration has failed to take full advantage of the Bioshield initiative. Because of the unpredictability of the mode of biological attack, I will stress the need for broad-gauged vaccines and drugs and for more agile and responsive drug development and production systems. This effort will strengthen the U.S. biotech and pharmaceutical industry and create high-wage jobs.

It is impossible to know whether the H5N1 virus will cause a human pandemic. The widespread nature of H5N1 in birds, the high mortality rates in exposed humans, and the likelihood of mutations over time have illustrated, however, the potentially catastrophic consequences that could arise from a pandemic, whether it arises from the current H5N1 strain or a different strain of the virus. That awareness requires the international community, the federal government, state and local governments, the health care industry, research community and the business community to develop and implement strategies to address this threat. The positive news is that such efforts are underway. They need continued development and attention, however, because by their very nature pandemics have the potential to overwhelm society’s response capabilities.

There are many common elements to the strategies needed to address pandemics and biological attacks; however, elements of the strategies differ, because we must focus more on containment and response with respect to the former, and prevention and early detection with respect to the latter.

When faced with a global pandemic, the United States must have in place and implement a layered strategy to save lives and protect the continuity of a functioning society. First, we must limit the spread of disease to the United States. Second, we must limit the spread of disease within the United States. This must be accomplished at the community level with strategies that have worked in past pandemics and can be adapted to a current crisis. Third, we must mitigate symptoms of the disease and minimize suffering and death with effective treatments and countermeasures. And fourth, we must maintain a functioning economy, public service sector and community.

The strategy requires a focus on: preparedness (the activities that should be undertaken before a pandemic to ensure preparedness); communication (the roles and responsibilities of all levels of government and segments of society); surveillance and detection ( both domestic and international systems that provide continuous situational awareness to ensure the earliest warning possible to protect the population); and response and containment (actions to limit the spread of the outbreak and to mitigate the health, social and economic impacts of a pandemic). Similar response capabilities would be necessary if a deliberate biological attack were to occur; but the best defense is deterring the attack from the outset. We must focus on efforts to disrupt and prevent attacks by terrorist groups like al-Qaeda through robust intelligence and counter-terrorism capabilities. If an attack were to occur, we must be ready.

Medical surveillance and biological detection technology continues to advance rapidly, but it is not where we need it to be. Samples from currently-deployed detectors must be collected by hand and analyzed in laboratories. This can mean that up to 30 hours elapses between when a biological agent is released and when it is analyzed and identified in a lab. We need to continue to develop and facilitate the development of next generation automated detectors that can analyze as well as sample biological agents and feed information real-time to public heath and emergency management officials.

For both pandemics and biological attacks, our final and perhaps most important line of defense are effective medical countermeasures. We must fund research and development of new medicines and vaccines and make sure that we have adequate stockpiles of countermeasures and a robust and well thought out distribution plan in case crisis strikes.