http://dailynews.yahoo.com/h/nm/20011102/hl/smallpox_6.html
Friday November 2 1:14 PM ET
By Todd Zwillich
WASHINGTON (Reuters Health) - American vaccine makers are ''up to the
effort'' of manufacturing 300 million doses of smallpox vaccine by the middle
of next year, an industry representative told lawmakers on Friday.
But others are warning Congress to focus on shoring up the abilities of
local health departments to respond to a serious bioterror attack.
The Department of Health and Human Services (news
- web
sites) has pared down its list of potential contractors from 10 to 4, and
those companies are currently in negotiations to begin ramping up vaccine
production, said Dr. Michael Friedman, chief medical officer for biomedical
preparedness at the Pharmaceutical Research and Manufacturers of America, an
industry trade group.
``This is an extraordinary effort. We are up to this effort,'' he told
members of the Senate Appropriations Committee.
Moves to rapidly increase America's stores of smallpox vaccine are working
on two main fronts--one in drug company labs making new vaccine and another in
trials to see if existing stocks can be diluted while remaining effective.
The Bush administration has requested $509 million for procuring smallpox
vaccine, though Congress has not yet acted on the proposal.
The US currently has 15.4 million doses of smallpox vaccine in stock. None
has been manufactured over the last two decades.
Friedman said that Americans could expect 300 million vaccine doses--enough
for everyone in the US--by ``the middle third quarter'' of the 2002 calendar
year.
But that schedule was not fast enough for Sen. Arlen Specter (R-PA), who
told companies and federal officials to ``go back to the drawing board'' to try
to speed up vaccine production. ``The question is how fast can it be done...if
money is not object,'' said Specter, the ranking member of the Senate
Appropriations health subcommittee.
Public health officials argued that vaccine production is already working at
capacity.
``I think we have pushed this system absolutely as much as we can,'' said
Dr. James W. LeDuc, the head of the National Center for Infectious Diseases at
the Centers for Disease Control and Prevention (news
- web
sites) in Atlanta, Georgia.
In addition to vaccine manufacturing, researchers are also conducting
studies to see if antiviral drugs used to treat other infections might be
effective as second-line backups in the case of a smallpox emergency.
Scientists are testing cidofovir, a drug originally developed to treat
cytomegalovirus infectious in AIDS (news
- web
sites) patients, said Dr. Anthony Fauci, the director of the National
Institutes of Allergy and Infectious Diseases.
But local officials cautioned that Congress must also give high priority to
state and local health departments as it considers emergency spending of up to
$20 billion in the coming weeks.
``With smallpox, all the vaccine in the world isn't going to do any good
without the capacity to distribute and administer vaccine locally,'' said Dr.
Anita Barry, the communicable disease control director for the Boston Public (news
- Y!
TV) Health Commission in Massachusetts.
``And one thing is very clear: the current levels of staffing, planning and
preparedness at the local level are not enough, even in cities that have
initiated bioterrorism preparedness,'' she said.
Barry stressed that local departments [if not prepared to help doctors
identify smallpox, while few have plans for how they will handle the surveillance,
treatment and quarantine of potentially massive numbers of patients.
In Boston, ``we currently have one infectious disease physician and a few
nurses,'' said Barry, who called on Homeland Security Director Tom Ridge to
establish a commission of local health authorities to coordinate with federal
officials on bioterrorism preparedness.
Lawmakers were sympathetic, noting that their proposals will spend between
$2.3 billion and $3.1 billion on bioterrorism preparedness. Local health
departments represent the ``front lines'' of any future bioterrorist attack,
said Sen. Robert C. Byrd, a West Virginia Democrat who chairs the
Appropriations Committee.
``If you put it in military terms, our troops are poorly trained, our radar
is out of date, and we're low on ammunition,'' said Sen. Tom Harkin (D-IA), the
health subcommittee chairman.
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