GAO: Government unprepared for flu pandemic

By William Neikirk

The federal government's plan to respond to an influenza pandemic is itself ailing, according to a report issued by the Government Accountability Office, the watchdog arm of Congress.

The GAO's report had an infectious impact. Congressional critics from both parties had some heated responses. "Alarming," said Rep. Henry Waxman (D-Calif.). "We cannot afford to be unprepared," added Rep. Tom Davis (R-Va.).

To prepare for a pandemic, the GAO said, the government needs to do much more, including expanded testing of its plan and coordinating actions between government agencies. And the Department of Homeland Security agreed with most of the report.

Davis said that experts have said that it is only a matter of time before a flu pandemic strikes the United States. "Hurricane Katrina taught us that key officials often didn't understand their roles and responsibilities, which hindered efforts to get help where it was needed most."

In its report, the GAO found that the government's over-all strategy and emegency plan "do not specify how the leadership roles and responsibilities will work in addressing the unique characteristics of an influenza pandemic, which could occur simultaneously in multiple locations and over a long period."

The GAO said in case of a pandemic, the Department of Health and Human Services would lead the medical and health response and the Department of Homeland Security, non-medical response actions.

But, it said, the government's current plan "does not clearly address these simultaneous responsibilities or how these roles are to work together, particularly over an extended period and at multiple locations across the country."

The report indicated that a flu pandemic could have a more crippling effect than covered in the plan. "A pandemic could extend beyond health and medical boundaries, affecting critical infrastructure, the movement of goods across the nation and the globe, the economy and security," the GAO said.

More planning needs to be done on such possible eventualities, it said. The GAO also said testing had been limited and that more needed to be done at all levels of government.

"It is vital to resolve questions of turf, responsibility and performance in advance, rather than in the heat of an actual pandemic," said Waxman, chairman of the House Oversight and Government Reform Committee. "But the GAO observed that the only pandemic exercise involving cabinet members conducted to date took place nearly two years ago, in 2005."

In response to the report, the Department of Homeland Security's Norman Rabkin, managing director of Homeland Security and Justice Issues, said the report "offers an accurate depiction of the current pandemic prepardedness issues from a broad and strategic perspective." But, he added, it failed to address extensive planning efforts among federal, state, Tribal, and private-sector "stakeholders."

More than 150 presentations, workshops, and forums have been conducted among thousands of such stakeholders in the past year, he said. These included representatives from the health-care industry, banking and finance, retail, transportation, groceries and food suppliers, and "businesses of all types."

Rabkin said the department concurred with the recommendation that Homeland Security and Health and Human Services should work closely together on training, testing and exercises. More coordinated exercises are in the works, he said.