Stung by the continuing struggle to make a vaccine against the swine flu pandemic, Health and Human Services Secretary Kathleen Sebelius said on Tuesday her department would review its approach to disaster preparedness.
The goal, Sebelius said, will be streamlined regulations that will speed the approval of new technologies that are promoted through government contracts with private companies.
The administration of President Barack Obama has been worried that H1N1 flu would be the equivalent of Hurricane Katrina -- the 2005 disaster that flooded New Orleans, left much of the city still devastated and was seen as a failure of his predecessor George W. Bush's presidency.
Sebelius said about 70 million swine flu vaccine doses are available or have been ordered and administered -- far short of the goal which was to have all priority groups vaccinated by this week, a total of 160 million people.
A large part of the problem has come from difficulties making the vaccine using 1950s era egg-based technology.
There are gaps at every stage in the process, from labor to factory floor, that are stalling our development of key countermeasures, Sebelius told a meeting of the American Medical Association.
We don't know what's coming -- the next public health emergency we face could be much worse.
HHS has been forced in the past decade to respond to a range of health emergencies and potential disasters from Katrina to the September 11, 2001 attacks and the anthrax poisonings in 2001 that killed five people.
Sebelius said Dr. Nicki Lurie, assistant secretary for preparedness and response, would review the department's countermeasures, which include vaccine development and contracts, drug development and stockpiling of supplies such as medical masks and ventilators.
We're going to look at how our policies affect every step of countermeasure development and production and then ask, 'how can we do better?' Sebelius said.
That could mean more contracts for small companies such as Meriden, Connecticut-based Protein Sciences Corp, which failed last month to convince an advisory Food and Drug Administration panel that it had proved its experimental influenza vaccine was safe.
Sebelius did not name the privately held company but described its technology, which uses pieces of engineered virus grown in caterpillar cells, as promising to be even faster and more dependable.
Under the review I've announced today, we'll look for the fastest ways to move to new technologies that will let us quickly produce countermeasures that are more dependable and more robust, not just for flu and not just for infectious diseases, but for all the public health threats we face today, Sebelius said.
We also need 21st Century financial, legal, and regulatory frameworks that create incentives for companies to build these advanced countermeasures. When a vaccine is delayed on the production line, it's easy to see and get upset. But we pay the same price when a life-saving discovery never makes it to the factory in the first place.
Companies also need better incentives to make drugs or vaccines on a large scale, Sebelius said. As a pharmaceutical company, you can usually count on the (U.S. Centers for Disease Control and Prevention) to buy some of a countermeasure to replenish its stockpile. But in many cases, that's an insufficient market, she said.