Your federal government in action: Active policy development to protect you from pandemic influenza

The Federal Government sometimes is characterized as static, routine, unimaginative, or uninspiring. Pandemic influenza preparedness, particularly due to its shared responsibility and transparency, provides clear evidence that this is a misperception. While Congress writes laws, the Executive Branch develops and implements policy – exercising discretion as appropriate within the bounds of law. The Federal Government made key policy decisions and exercised thoughtful stewardship of Congressionally-appropriated funds to assist states in preparing for an influenza pandemic.

Specifically, the government made policy decision in three important areas: antiviral drugs (resources), plans (instructions), and exercises (practice). The government not only utilized a $170M appropriation to provide a subsidy for state purchased antiviral drugs but further negotiated a contract price below any other price available to states and developed a policy to maximize use of the subsidy. In partnership with the private sector, the government created a model contract for state antiviral drug distribution planning. As expected, the government provided guidance to states regarding pandemic influenza plan content; however, it also critiqued state plan excerpts, provided technical assistance and recommendations, and directed funds and the involvement of all sectors for plan improvement. Plans are not effective unless exercised and improved. Policies to develop exercises that tested multiple objectives and were coordinated in an intricate schema across all levels of government were established to maximize synergies, increase cost efficiency and challenged assumptions. Public health in general and pandemic influenza preparedness specifically benefited from these policies. Development of these complex policies required imagination, foresight, action, and inclusion.