Preparing for the worst

CYNICS MIGHT HAVE DETECTED a whiff of desperation coming from President Bush on Tuesday as he announced his flu-preparedness plan. The president is coming off a truly awful week during which he had to withdraw his Supreme Court nominee and watch as a key aide in his administration was indicted on charges of perjury. What better way to seize control of the front pages and regain his footing as a war president than by declaring war on the flu?

Senate Democrats are already impatient with the president’s attempt to change the subject, as they showed with their temper tantrum on Tuesday, calling for a closed session to discuss intelligence failures in the run-up to the Iraq war. But there are less political reasons to be skeptical. Any new spending program, particularly one calling for $7.1 billion to prepare for a disease outbreak that is potentially catastrophic but purely theoretical, faces an uphill battle in Congress.

It won’t hurt Bush politically if Congress turns him down, but it may hurt the country as a whole.

In that sense, it’s a shame that Bush chose to announce his flu plan while he is at the nadir of his political power. Easily dismissed as an attempt to distract the media, the administration’s pandemic-flu strategy is something more: It’s an attempt to fend off a very real threat that has the potential to kill far more Americans than any terrorist attack.

Public health experts generally support the plan, though it’s possible to quibble with some of its details. It is overreliant on the states to purchase antiviral medications, always risky because some will be unwilling or unable to meet their responsibilities. Probably its greatest flaw is the way it neglects efforts to monitor outbreaks overseas.

Bush’s proposal calls for a relatively low $251 million to pay for surveillance and training of medical personnel in foreign countries, yet this is probably the most important single aspect of controlling a flu pandemic. It is vital that measures be put in place to detect and monitor flu outbreaks, particularly in countries where the avian flu is now running rampant but where the healthcare infrastructure is primitive.

At the same time, the plan calls for $2.8 billion to accelerate the development of cell-culture technology, which would speed the production of new vaccines. It’s debatable whether pharmaceutical companies really need this much government assistance, but at least Bush can’t be accused of supporting corporate welfare; most of the recipients of the money would be European companies.

It’s unusual for a U.S. president to ask for so much money to prepare for a disaster that isn’t likely to occur during his administration. There is no avian flu in the United States, and there may never be; even if it arrives, it may never become a severe public health menace. Same with any other flu pandemic -- we may not get another one for decades.

But you wouldn’t want to bet your life on that. Bush is right to try to address the problem now.