ASSOCIATED PRESS / JUNE 2005 The Hawaii Legislature has received an emergency request for funds to prepare for a possible flu pandemic. Here, an official in protective gear pulls out live chickens from cages to slaughter them at a chicken farm in Mitsukaido, Japan, where bird flu had been detected.

State seeks $15M to fund bird flu emergency plan

The unusual request would allow Hawaii to secure antivirals

The Legislature has received an unusual $15 million emergency appropriation request from the state administration to prepare for a possible flu pandemic.

Emergency appropriations normally are requested to cover budget shortfalls, not provide for new programs.

Dr. Linda Rosen, state Department of Health deputy director, acknowledged that the $15 million emergency request is unusual, noting it has some language to prevent the funds from lapsing until the end of the next fiscal year.

Gov. Linda Lingle announced in November she would ask the Legislature for $15 million to stockpile antiviral medications and develop a data management and information system to track and monitor illnesses here.

But the flu preparedness situation was "constantly evolving" when the state budget package was being prepared, Rosen said. The method by which states would participate in purchase of antiviral medications with the federal government was not known, she said.

Hawaii's Pandemic Influenza Preparedness & Response Plan, published in November, generally conforms to the National Pandemic Flu Plan, which recommends that states stockpile enough antiviral pills in states to treat 25 percent of their population.

States hoped to get a share of federal bird flu money, but it was cut by the U.S. House from the 2006 health spending bill. Republican leaders said they would try to provide money for antiviral drugs in separate legislation.

Rosen said manufacturers need to produce more antivirals for a potential pandemic. "Should that occur, there were not enough medicines to go around."

Countries and states would have to purchase medicines ahead of time to have a supply and for companies to increase production, she said.

The Department of Health requested an emergency appropriation because of concern that it would have to contract with a drug company for antiviral medications, and it would not be able to do that if money was not available, Rosen said.

The Department of Health sent letters of intent to two different companies for antivirals, following U.S. Centers for Disease Control and Prevention recommendations, she said.

The two medications are Tamiflu and Relenza, but 90 percent of the request is for Tamiflu, Rosen said.

There is no drug specific for the H5N1 avian influenza, but health officials said the medications available can help in treating flu and that it is safer to have them than nothing.

Dr. Sarah Park, deputy chief of the Disease Outbreak and Control Division, said the drug companies instructed all states and entities putting in a bid or order for the antivirals to tell them now and how much.

"It's a nonbinding bid right now but sort of a price holder, not something we could hedge on," Park said. "They said it would be first come, first serves, and if we didn't put in our bid, we'd be out later. ... When faced with a dying patient, or a patient with significant complications, you're going to try anything you can to help the patient."

The H5N1 avian influenza has infected poultry in Asia and some parts of Europe, but so far it has not mutated into a form easily transmittable from human to human, Park said.

Dr. Linda Rosen, state Department of Health deputy director,* said about $8.5 million of the emergency funding request is anticipated for medications. The rest of the money would be used for laboratory equipment and supplies to diagnose cases and an information system to integrate laboratory results.