Bush Seeks $1.5 Billion For Bioterrorism Drugs, Readiness

With the number of reported anthrax cases increasing and fears about the disease spreading, the Bush administration plans to ask Congress for an additional $1.5 billion in funding for counter-bioterrorism measures, the Wall Street Journal reports. Some $643 million of the $1.5 billion would go toward increasing the nation's stockpile of medications for the disease, and the remainder would go to hospitals and state and local governments to increase their "bioterrorism preparedness." About $345 million has already been allocated for bioterrorism initiatives for fiscal year 2002, but many members of Congress and health experts have said that the nation is not adequately prepared for a large-scale bioterrorist attack. The federal government currently has enough quantities of the antibiotic Cipro -- the only drug approved by the FDA to treat inhalation anthrax -- to treat 2.2 million people for 60 days (McGinley/McKinnon, Wall Street Journal, 10/15). Speaking on news programs yesterday, HHS Secretary Tommy Thompson said the administration wants to boost the supply to treat 12 million people (Pollack, New York Times, 10/15). He said that the federal government was prepared for a future anthrax attack. "I'm telling people you don't need to hoard Cipro," he said (Shenon, New York Times, 10/15).

Production Matters
The German drug maker Bayer, which manufactures Cipro, said last week that it would increase its production of the antibiotic by 25% to meet the rising demand. But because Cipro's annual worldwide sales total about $1.5 billion, a $643 million purchase by the United States government "might strain [Bayer's] capacity," the Times reports. At Bayer's average wholesale prices, $643 million could buy only 1.1 million 60-day treatments of Cipro, the Times reports. But health officials have said that penicillin and other antibiotics are also effective treatments for anthrax, and the Times reports that "it seems likely" that the administration would use the funding request to purchase these drugs (New York Times, 10/15). Sen. Max Cleland (D-Ga.) has called for a "Manhattan-style project" to upgrade the CDC, and wants to give the agency an additional $750 million in funding (McGinley, Wall Street Journal, 10/15).

Less is More?
Federal officials are also looking to take proactive measures against bioterrorism by expanding the availability of vaccines for anthrax and smallpox, which, unlike anthrax, has no treatment and is contagious. Thompson said yesterday that the government has 15.4 million doses of smallpox vaccines and has ordered an additional 40 million doses from the British company Acambis, to be delivered next year (New York Times, 10/15). Meanwhile, the NIH's National Institute of Allergy and Infectious Diseases is funding a study to determine whether the current smallpox vaccine stockpile can be diluted to increase the number of doses. Researchers at four institutions will test whether the vaccines are effective at one-fifth and one-tenth of their standard dosage. If so, the national smallpox vaccine stockpile would increase to 75 million and 150 million, respectively. The two-and-a-half month study of 684 adults younger than 32 who have never been vaccinated for the disease will test whether the diluted vaccines produce antibodies. The AP/Washington Times reports that a "pilot study" last year of 20 people found that vaccines diluted to one-tenth showed signs of working, while those at one-hundredth did not (Manning, AP/Washington Times, 10/15). In addition, NIAID this week will ask the FDA whether it can test the ability of the drug cidofovir to combat smallpox cases that could come as a side effect of the new smallpox vaccination trial, the Wall Street Journal reports. NIAID Director Dr. Anthony Fauci said that cidofovir, originally approved for an AIDS-related infection, has shown "interesting and potentially important activity" against smallpox viruses in animal and test-tube studies. Meanwhile, some lawmakers have proposed giving biotechnology and drug companies financial incentives for conducting research and development on vaccines and drugs to combat bioterrorism (Chase/Carroll, Wall Street Journal, 10/15).

The Cost of Preparations
As city and county officials look to increase their bioterrorism readiness, many are finding that the cost of purchasing new equipment may place a strain on their overall budgets. While the federal government will "likely" provide funding to municipalities for bioterrorism initiatives -- $184 million in federal anti-bioterrorism grant money is available to communities -- many local officials "expect much of the additional costs will come out of city coffers." In Virginia Beach, Va., for example, fire department officials want a new truck and gear for the city's hazardous-materials response team, at a cost of $1.2 million, plus an additional $800,000 a year for 16 new hazardous material firefighters specialized in hazardous materials. In addition, the city's search and rescue team needs $1.5 million to "fully equip" its 162 members to fight bioterrorism (Caffrey/Gold, Wall Street Journal, 10/15).