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GAO Report Calls for Continued Federal Involvement in Pandemic Flu Planning

By Matthew Watson, July 28, 2008

The U.S. Government Accountability Office (GAO) recently released a report, about the status of state and local planning for pandemic influenza.¹ The report looks at improvements in pandemic planning which have been facilitated by U.S. Centers for Disease Control and Prevention (CDC) and Department of Homeland Security (DHS) grants and supplemented by the FY2006 influenza pandemic supplemental appropriation of $600 million. To assess progress achieved thus far, GAO officials conducted site visits to the five most populous states in the nation (California, Florida, Illinois, New York, and Texas) and conducted interviews and systems analysis at an urban and rural locality within each state.¹

Progress in Influenza Pandemic Planning Has Been Made
According to the report, CDC verified that all 50 states have developed pandemic influenza plans in compliance with CDC’s grant requirements. All plans that were examined included key partners in pandemic response: the federal government, state and local agencies, tribal nations, nonprofit organizations, and private industry. Plans also complied with other requirements in each of three phases of the grant funding cycles. Each phase corresponded with development of specific plans and capabilities, such as countermeasure distribution and dispensing, surveillance, communications and collaboration.

Cooperative Exercises at the State and Local Level
The GAO report recognizes the importance of building capability to respond to a pandemic threat; however, there are limited options with which to test those capabilities. Exercises, if conducted appropriately, are a strong performance measure of a preparedness system, and are required by grant guidance. CDC officials confirmed that pandemic exercises were conducted in all localities that received grant funding.

Further, incorporating lessons learned into updated plans is a critical action following an exercise. GAO confirmed with CDC that exercise after-action reports were being integrated into revised plans in all grantee locations.

The Federal Government’s Role in Closing Preparedness Gaps
Despite the measureable progress being made toward pandemic preparedness, the GAO reported that “many major gaps” remain in 16 of 22 priority areas (see Table 1 in the GAO document). Three priority areas where states have expressed the need for additional federal guidance are: implementing community interventions, fatality management, and facilitating medical surge.

In response to these gaps, GAO recommends that HHS and DHS convene additional workshops in each of the five federal pandemic planning regions and generate guidance specific to the concerns raised by communities.¹

References

1. U.S. Government Accountability Office. Federal agencies should continue to assist states to address gaps in pandemic planning. June 2008. http://www.gao.gov/new.items/d08539.pdf. Accessed June 24, 2008.