Avian Flu

AVIAN FLU

BREAK IN TRANSCRIPT

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 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 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.

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