Congress eyes next avian flu payment

Congress is poised to provide the White House with the second of three installments of funding, totaling $7.1 billion, to prepare for a potential global influenza pandemic. But some fear the dribs-and-drabs approach to funding a key health initiative has complicated preparations.

Health and Human Services Secretary Michael Leavitt said last week his agency has managed to stick to its plan for preparing for a pandemic, even though it has received just over half of the money the administration has said it needed. Within the next week or so, using the first installment of flu money from Congress, the agency is expected to announce it has signed contracts with private companies for vaccine manufacturing, rapid diagnostics and stretching doses of antiviral drugs and other medications.

But Leavitt said future progress would be jeopardized if lawmakers don't follow through on plans to fund the $7.1 billion blueprint.

"If Congress would fail to act, it would inhibit our capacity," he told reporters. "But I expect Congress to respond."

The emergency supplemental spending bill Congress will take up this week likely will include $2.3 billion for pandemic flu preparedness efforts, bringing the total Congress will have appropriated to $6.1 billion. The remaining $1 billion is not needed until next year, HHS has told lawmakers, and probably will be included in either future appropriations bills or supplemental spending measures, aides say.

The $2.3 billion is contained in only the Senate version of the supplemental, which also includes funding for military operations and hurricane relief. But the flu money is expected to make it into the final version that Congress adopts.

Some observers say a congressional role in avian-flu preparedness will be curtailed until lawmakers provide all the money the White House requested.

"If Congress were to say the administration wasn't moving fast enough, the administration could say 'well, you haven't given us what we're looking for,'" said Jeff Levi, executive director of the Trust for America's Health, a disease-prevention advocacy group. "That would be a legitimate comeback."

And having all of the flu funding at once would make it easier for the government to entice private companies to enter into contracts, he said. "The government's biggest function is to try to change the market, and all the money should be on the table at once to do that," Levi said. "Those that are participating are trusting that the rest of the money is forthcoming."

Added one industry lobbyist, "It's always a concern, having the federal government as a partner and having the source of funding a bit unpredictable."

Meanwhile, key members of Congress, even those who say the administration has taken a slower pace than it should, say they are waiting to see the administration's plan fully funded before they contemplate further legislative moves.

"We'll have to see where we are at that point," said a spokeswoman for Senate Labor-HHS Appropriations Subcommittee ranking member Tom Harkin, D-Iowa. "The downpayment has to be made before we can determine whether it's enough."

Meanwhile, there are other initiatives for Congress not directly linked to the flu-preparation plan that lawmakers say will strengthen defense against a potential outbreak. Congress must reauthorize the Public Health Security and Bioterrorism Act, a task the Senate Health, Education, Labor and Pensions Committee has already taken up.

That law, enacted in 2002 following anthrax attacks, is aimed at improving coordination in the event of a public-health emergency. Reauthorization is a chance to incorporate pandemic preparations.

"Avian flu and other natural disasters have to be part of this," said HELP Bioterrorism Subcommittee Chairman Richard Burr, R-N.C.

There is also the prospect of using the congressional oversight function to keep tabs on the administration's plans for dealing with a potential outbreak. "Our hands are not tied," one GOP staffer said.