US Feds see problems with preparedness

Published by: wktd 2010-03-20

http://news.avian-influenza.info/linkout/o.php?out=http://us.rd.yahoo.

Bird Flu Readiness Problems

Feds see issues with bird flu plans.

Posted: Monday, September 10, 2007 at 6:46 p.m.
WASHINGTON, D.C. (AP) Federal investigators say the nation's preparedness for a potential influenza pandemic is hindered by a lack of training and testing. The Government Accountability Office says the Bush administration's bird flu plan provides a broad description of the responsibilities of federal agencies. But it says, there would undoubtedly be overlapping responsibilities that are not clearly defined. According to the GAO, national pandemic exercises involving multiple agencies have not been conducted since the plan was released in May 2006. The investigators say such exercises would show which agencies understand their responsibilities. Congressman Henry Waxman, one of the lawmakers to request the report, says he's alarmed that key federal leadership roles have not been adequately defined or tested.

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( 2007 by The Associated Press. .)

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Full report here:
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Conclusions

Although it is likely that an influenza pandemic will occur in the future, there is a high level of uncertainty about when a pandemic might occur and its level of severity. The administration has taken an active approach to this potential disaster by establishing an information clearinghouse for pandemic information; developing numerous planning guidelines for governments, businesses, nongovernmental organizations, and individuals; issuing the Strategy and Plan; completing many action items contained in the Plan; and continuing efforts to complete the remaining action items.

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A pandemic poses some unique challenges. Other disasters, such as hurricanes, earthquakes, or terrorist attacks, generally occur within a short period and the immediate effects are experienced in specific locations. By contrast, a pandemic would likely occur in multiple waves, each lasting weeks or months and affecting communities across the nation. Initial actions may help limit the spread of an influenza virus, reflecting the importance of a swift and effective response. Therefore, the effective exercise of shared leadership roles and responsibilities could have substantial consequences, both in the short and long term. However, these roles and responsibilities continue to evolve, leaving uncertainty about how the federal government would lead preparations for and response to a pandemic. Since the release of the Plan in May 2006, no national pandemic exercises of federal leadership roles and responsibilities have been conducted. Without rigorous testing, training, and exercising, the administration lacks information to determine whether current and evolving leadership roles and responsibilities are clear and clearly understood or if more changes are needed to ensure clarity.

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The Strategy and Plan are important because they broadly describe the federal government�s approach and planned actions to prepare for and respond to a pandemic, as well as expectations for states and communities, the private sector, and global partners. Although they contain a number of important characteristics, the documents lack several key elements. As a result, their usefulness as a management tool for ensuring accountability and achieving results is limited. For example, because the Strategy and Plan do not address the resources and investments needed to implement the actions called for, it is unclear what resources are needed to build capacity and whether they would be available. Further, because they did not include stakeholders that are expected to be the primary responders to a pandemic in the development of the Strategy and Plan, these documents may not fully reflect a national perspective on this critical national issue, and stakeholders and the public may not have a full understanding of their critical roles. In addition, the linkages among pandemic planning efforts and with all-hazards plans and initiatives need to be clear so that the numerous parties involved can operate in an integrated manner. Finally, because many of the performance measures do not provide information about the impacts of proposed actions, it will be difficult to assess the extent to which we are better prepared or to identify areas needing additional attention. Opportunities exist to improve the usefulness of the Plan because it is viewed as an evolving document and is intended to be updated on a regular basis to reflect ongoing policy decisions, as well as improvements in domestic preparedness. Currently, however, time frames or mechanisms for updating the Plan are undefined.

While the HSC publicly reported on the status of approximately 100 action items that were to have been completed by November 2006, the Plan lacks a prescribed process for monitoring and reporting on the progress of the action items or what has been accomplished as a result. Therefore, it is unclear when the next report will be issued or how much information will be released. In addition, some of the information reported was incorrect. This lack of transparency makes it difficult to inform a national dialogue on the progress made to date or what further steps are needed. It also inhibits congressional oversight of strategies, funding priorities, and critical efforts to enhance the nation�s level of preparedness.

DHS officials believe that their efforts to develop a Federal Concept Plan for Pandemic Influenza may help to more fully address some of the characteristics that we found the Strategy and Plan lack. According to those officials, the proposed Concept Plan may help, for example, better integrate the organizational roles, responsibilities, and coordination of interagency partners. They recognized, however, that the Concept Plan would not fully address all of the gaps we have identified. For example, they told us that the Concept Plan may not address actual or estimated costs or investments of the resources that will be required. Overall, they agreed that more needs to be done, especially in view of the long time requirements and challenging issues presented by a potential pandemic influenza.

Recommendations for Executive Action

To enhance preparedness efforts for a possible pandemic, we are making the following two recommendations:

We recommend that the Secretaries of Homeland Security and Health and Human Services work together to develop and conduct rigorous testing, training, and exercises for pandemic influenza to ensure that federal leadership roles are clearly defined and understood and that leaders are able to effectively execute shared responsibilities to address emerging challenges. Once the leadership roles have been clarified through testing, training, and exercising, the Secretaries of Homeland Security and Health and Human Services should ensure that these roles are clearly understood by state, local, and tribal governments; the private and nonprofit sectors; and the international community.

We also recommend that the Homeland Security Council establish a specific process and time frame for updating the Implementation Plan for the National Strategy for Pandemic Influenza. The process for updating the Plan should involve key nonfederal stakeholders and incorporate lessons learned from exercises and other sources. The Plan should also be improved by including the following information in the next update:

� the cost, sources, and types of resources and investments needed to complete the action items and where they should be targeted;
� a process and schedule for monitoring and publicly reporting on progress made on completing the actions;
� clearer linkages with other strategies and plans; and
� clearer descriptions of relationships or priorities among action items and greater use of outcome-focused performance measures.