Bush/Cheney Cut Health Budget
in Vaccine Crisis
by Paul Gallagher
While deploying Health Secretary Tommy Thompson across the country in the last pre-election week to reassure governors and state health officials that "there is no flu vaccine crisis," President George W. Bush was angrily contradicted by a growing chorus of health experts, and by events on the ground. Bush and Vice President Dick Cheney claimed that their government's health agencies were doing everything possible to solve the flu vaccine crisis, which their negligence had brought on, in the face of three years' expert warnings of disappearing vaccine production capabilities. But astonishingly, even as they spoke, the White House was proposing to cut the ongoing year's budget of the Centers for Disease Control and Prevention, the agency in charge of the flu response. The White House is doing this while preparing to ask for another $70 billion in funding for the military occupation of Iraq.
The same President Bush who ignored official warnings since 2001 about a collapse of vaccine production, and who then gloated in the last debate with Sen. John Kerry that he, personally, didn't need a flu shot, is now acting knowingly to perpetuate this vaccine crisis into next year. Vice President Cheney's home state has the lowest child-vaccination rates in America. Bush and Cheney are handling the public health crisis as they've handling Iraq—with gloating smugness and a refusal to admit mistakes or their consequences for human lives.
Experts Want Emergency Declaration
These were the leading developments in the crisis:
- The doctors who head the infectious diseases units at the University of Florida, the University of Miami, and the University of South Florida, on Oct. 27 called on the President to declare a national emergency. They voiced their "grave concern" over the shortage of the influenza vaccine in Florida. "Although it is claimed there is no crisis, we disagree," they wrote in a letter to the editor of the St. Petersburg Times. "We have received less than the 50% allotment expected. As experts in the field of infectious diseases, we know that if our high-risk patients are not vaccinated, the consequences could be grave. We ask the Administration to declare a national state of emergency and recall all available supplies of vaccine so that they can be redistributed immediately to those most in need of protection.... We recommend recall from all commercial vendors not affiliated with established health care delivery systems."
- As these experts spoke out, health officials in Jefferson County, Alabama, including the large city of Birmingham, announced that they had no flu shots remaining from a supply of 9,900, and did not expect to have any more for 4-6 weeks, deep into the flu season, which has now hit only about a dozen states. The governors of Illinois and Oregon were in daily confrontation with Health and Human Services Secretary Thompson over more than 200,000 flu shots they wanted to import from Canada and Germany, which the Food and Drug Administration (FDA) of HHS would not license.
- On Oct. 27, a U.S. District Court judge barred the Pentagon from continuing to compel all troops to receive the "investigatory" or experimental anthrax vaccine, because the FDA has been approving this mass vaccination of soldiers for two years without ever licensing the drug. This decision threw into bold relief the FDA's holdup of importation of flu vaccines, approved and in use in Canada or Europe, on grounds that it had not licensed them for use in the United States. The Bush-Cheney Administration fears importing flu vaccines would open the door to re-importation of other pharmaceuticals from Canada, which it—and the pharmaceutical lobby—opposes.
- Rep. Henry Waxman (D-Calif.) released a damning letter to FDA Commissioner Dr. Lester Crawford on Oct. 26, in which Waxman said he had evidence that Crawford was deliberately withholding from Congress—until after Election Day—documents on the Chiron Corp.'s flu vaccine production debacle, which had been gathered within FDA and sent to Crawford's office to fulfill a direct request of the House Committee on Government Reform. Waxman told Crawford that "a confidential communication from inside your agency" informed the Committee that Crawford had the documents—which the Committee had asked him for on Oct. 8—in his office before Oct. 22. On that date, Crawford claimed to the Committee that FDA was so busy looking for more flu vaccine, they could not collect the documents.
"These are serious allegations," Waxman wrote, and asked Crawford either to show that the incriminating internal FDA e-mails Waxman received were mistaken, or produce the documents immediately. Government Reform Committee Chairman Thomas Davis of Virginia, a Republican who had been trying to give the FDA maximum leeway, admitted when met by LaRouche organizers in his district on Oct. 26, "The FDA is stiff-arming us."
- In an act of criminal negligence during a full-blown national vaccine shortage crisis, the Bush-Cheney White House is trying to cut $262 million from the budget of the Centers for Disease Control and Prevention (CDC) in the budget for Fiscal 2005, which began on Oct. 1. That includes a $105 million cut from CDC's aid to state and local governments for public health preparedness—public health centers, hospitals, and testing laboratories.
And incredibly, in the tax bill Bush just signed, Bush, Rep. Tom DeLay (R-Tex.), and the Republican leadership have just put a 75¢ tax on every dose of vaccine administered in America!
Remedial Legislation Stopped
Additional damning facts deal with legislation which could ameliorate this year's crisis and revive the vaccine production industry for future years.
- Bush/Cheney and the Congressional Republican leadership squelched a bill ten months ago which would have avoided the foreseeable vaccine shortage. The shortage had been forecast by Government Accountability Office and Congressional Budget Office reports since 2001, as the last pharmaceutical companies—Pfizer, Wyeth, King, and Monarch—pulled out of making flu vaccine. Sen. Evan Bayh (D-Ind.) and Rep. Rahm Emanuel (D-Ill.) introduced the Flu Prevention Act of 2004 in January, to stop the disappearance of vaccine manufacture in the United States and create new makers, with a small intervention of Federal funds. The legislation, based on proposals from medical experts, would have created a Federal buy-back program for unused vaccine, like a price-support for farmers. It would have regulated an area of vaccine production which is vital to public health, but which involves six months' production, is unpredictable in sales, and inexpensive in price. And it would have set aside funds to help get new producers into the market.
Bush, Cheney, and the Republican Congressional leadership didn't want it. It was re-introduced in early October, aimed at next year's season— and it appears nearly certain that California-based Chiron will again not be able to produce any flu vaccine in 2005—and they still don't want it.
- The Reed-Kennedy Flu Response Act of 2004 was introduced to mandate immediate licensing of vaccines approved for use in Europe, Canada, or Japan, so that state officials, like Governor Blagojevich of Illinois and Governor Junkoworski of Oregon, can import them. It would also give the government power to find out where all the scarce vaccine has been shipped, and direct its redistribution to the people who need it most. This would enable state and local governments to know what's now "proprietary information" of manufacturer Aventis Pasteur—exactly where that scarce vaccine has been delivered. It would overcome the present chaos and confusion, which led states like Michigan and New York, on Oct. 24-25, to suspend flu shots entirely because they did not know what their available supply was.
Bush and Cheney did not want this legislation either: it interferes with the "market" in flu vaccines—which is disappearing. Cheney's only comment was made in West Virginia on Oct. 18: "The problem is that producing flu vaccine is just not a very profitable business."
- As of Oct. 28, seven days after the CDC had first publicly promised the states an inventory estimation and redirection plan for the scarce vaccine supplies, none had been forthcoming. The CDC was simply continuing to list the priority groups for immunization—which total about 105 million, against perhaps 60 million shots available from now until January—and call on those people to remain calm and not wait in lines for shots. Michigan officials, for example, have repeatedly stressed that they do not know where the vaccine supplies in their state are, and they asked CDC to find out from the manufacturer.
- The American College of Emergency Physicians, since Oct. 19, has repeatedly asked the Bush White House to use Federal emergency public health funds to reopen as many emergency rooms or other closed sections of hospitals as possible, immediately, to prevent deaths from pneumonia, especially among older or sick citizens who get the flu. The White House has not responded.
Ten percent of all the emergency rooms in America have closed since 1993—from 4,998 down to 4,510 open and functioning ERs—while the number of ER visits has gone up from 92 million to more than 111 million, a 20% increase, because of such factors as increasing poverty and the rising number of Americans with no health insurance. This means that the patient workload on existing ERs increased by more than 33% from 1993-2003, making them extremely vulnerable to a severe flu outbreak with pneumonia complications among the elderly—especially if the health workers themselves are not vaccinated against flu.
- It's not just flu vaccine disappearing. On George W. Bush's "watch," American soldiers in large numbers at U.S. bases are coming down with adenovirus infection, the "boot camp virus," because the vaccine isn't produced at all any more. Some military leaders wanted this changed several years ago, but nothing was done by the Bush Administration. (The armed forces are short 65% of the flu vaccine they ordered for this year.) And almost all the childhood vaccines have been in shortage throughout Bush's term.
- The only increased funding for vaccines was mandated in a ten-year-old law pushed by President Bill Clinton, the Childhood Vaccination Act of 1993. That law is the sole reason Bush puffed up in the final Presidential debate on Oct. 13, and claimed that his Administration had increased funding to fight influenza. Bill Clinton made him do it!
Counting on Luck
The only actual policy coming from the White House, Thompson's HHS, or the CDC itself, since the crisis was revealed on Oct. 5, has been to forecast a mild flu season and scrape up a few million more doses from the same two manufacturers. At the end of October, influenza had appeared in a dozen states and did not, as yet, appear particularly severe. In the Southern Hemisphere, whose flu season has just ended, it was reported that a surprise strain of flu, A/Wellington, had appeared and predominated as the season went on—its appearance in America would put an even greater stress on general immunization levels, because this year's vaccine is not particularly tailored against it. But, on President Bush's watch, even an ordinary flu season finds the United States public health system unready.