Flu Isn't a Spending Priority

Flu isn't a spending priority By Seth Borenstein Knight Ridder Newspapers December 22, 2003

WASHINGTON - The flu kills 36,000 Americans a year, but the federal government spends only about half as much money on research to fight it as it spends to attack boll weevils, which are cotton pests.

Other diseases that grab headlines or have advocacy groups or celebrity spokespeople - such as AIDS, Alzheimer's or Parkinson's disease - kill far fewer people than the inseparable duo of influenza and pneumonia.

But the National Institutes of Health spends between eight and 100 times more money researching those more prominent diseases than it spends for flu.

This year the federal government is spending about $50 million on flu research at NIH and on tracking and fighting the flu at the Centers for Disease Control and Prevention, according to the U.S. Department of Health and Human Services. That's $100 million less than it spends on persuading people to commute in nonpeak traffic hours.

The NIH spends on average about $700 per flu fatality. In contrast, it spends about $12,000 per Alzheimer's death, $14,000 per Parkinson's death and $158,000 per AIDS death.

NIH spends $25 million a year on flu research, but it spends $79 million a year researching anthrax, which killed five people in 2001. Flu spending is so modest that it isn't listed on the NIH budgetary breakdown for disease spending.

The Bush administration hopes to at least triple flu spending by adding $100 million, according to Health and Human Services Secretary Tommy Thompson.

"There's a battle out there over dollars. Certain diseases are not on the front burner because we're familiar with them," said University of Pennsylvania bioethics director Arthur Caplan. "We underspend on a variety of ailments that aren't glamorous, and flu is one of them."

"It's always been this way," bemoaned longtime influenza researcher Dr. Edwin D. Kilbourne, a retired professor of immunology at New York Medical College in Valhalla. "One of the chief reasons is that people forget (about how bad flu can be) between epidemics. It tends to get confused with the common cold and trivialized."

But the flu isn't the sniffles. It kills 36,000 people in the United States in an average year and in bad years - with this year predicted to be one - the U.S. death toll can reach 70,000.

When a global pandemic - a widespread outbreak of a new strain - hits, the worldwide death toll is in the millions. The 1918 Spanish flu pandemic, which started in Kansas, not Spain, killed at least 20 million people worldwide, including about half a million in the United States.

Deaths aren't the only toll, experts said. In an average year, flu also sends 114,000 people to the hospital, infects about 54 million Americans and costs the economy $12 billion. Flu is so prevalent and expensive that Medicare this year will spend $98.5 million on reimbursements to doctors and hospitals for flu-sick seniors.

"We need to continue to re-examine how NIH's priorities are set," said Rep. Ernest J. Istook, R-Okla., a member of the House Appropriations Subcommittee on Labor, Health and Human Services. "We need to help more Americans who suffer from terrible diseases, not just those diseases which receive the most political and media attention."

Dr. Martin Blaser, vice president of the Infectious Disease Society of America and chair of the department of medicine at the New York University School of Medicine, blames the media and the public for flu's paltry budget.

"The media pays attention to very dramatic sexy things like West Nile and anthrax," Blaser said. Flu needs star power, he said, such as actors Michael J. Fox for Parkinson's or Christopher Reeve for spinal-cord injuries.

"The way our system works, if somebody famous gets a disease, suddenly it's on our itinerary," Blaser said.

One reason flu spending is so low is that flu has been around so long that science has learned a lot about it, and there's less to learn compared with AIDS or West Nile, said William Pierce, spokesman for the Department of Health and Human Services. Because flu is so old, spending on it has shifted more to private companies for vaccines, anti-virals and symptom treatment, said Dr. Bruce Gellin, director of the federal National Vaccine Program Office.

And what's more money gonna do: Convince folks to wash their hands more often? Stay home when you're sick? Get a flu shot? A lot of this is common sense. Which was still free the last time I checked, though sadly lacking apparently.

Maybe this reporter knows some people with flu and got the idea to write an article about how little is spent by the public to combat the disease. The disease was especially bad in 1918, as I recall reading. So I don't think flu is going away -- nor is NIH and CDC for that matter. People believe in these federal programs to cure one and all.

Well, it is true that our spending on public health matters has grown very distorted. Inordinate sums are spent on politically correct diseases such as AIDS, and not enough on diseases like Lymes and Nile Fever. We should certainly be spending something on these diseases.

Although as I understand it the chief problem in the flu area is Hillarycare, which managed to put all the U.S. manufacturers of flu vaccine out of business, so we are now dependent on the French and will be in huge trouble if we suddenly find that we need a lot of flu vaccine in a hurry.

More people die of "Natural Causes" each year than flu and the CDC doesn't spend one penny on Natural Causes.

I read in the paper that 3 or 4 people each day die of Natural Causes. And it is 100% fatal. You never read that Mr. Jones has just recovered from Natural Causes, just that he died from NC.

It is a scandal, I'm telling you.

It's not just that, though. Over ten million doses were tossed out last year because no-one wanted them. The manufacturers reduced their production by about that amount this year. About the only thing the Feds could do would be to promise to buy up any unused vaccine. What would be even better is if folks who could would get vaccinated with available vaccine. All the vaccine in the world won't do any good if folks won't go get their shots.

The flu kills 36,000 Americans a year...

I'm not sure I believe this. I don't believe it kills even one sufferer unless in conjunction with some other malady such as a heart problem or old age or a sufferer that gets the flu and chooses to go play in the snow.

Hysteria over the flu is silly for those of us that have something of the fatalist in us. The flu virus has been with us since long before any CDC started counting cases. It's never killed me, although the half dozen times I have caught it, it made me wish I was dead. As an aside, the two times in my life I have had a flu shot, that made me much sicker than the flu ever did. Or maybe it was something in the hamburger by coincidence.

Oh, well. I live in the snow belt, and these days every time two clouds form in the same day between November 1st and April 1st, we are bombarded by hours of weather reports suggesting we are all surely going to die in the ensuing storm.

"The flu kills 36,000 Americans a year..."

"I'm not sure I believe this. "

With all the talk about how bad this flu season is, there have only been reports of a couple dozen deaths.

This is Bush's fault....

I'm not sure I believe this. I don't believe it kills even one sufferer unless in conjunction with some other malady such as a heart problem or old age or a sufferer that gets the flu and chooses to go play in the snow.

The CDC just came out with a report on 42 flu deaths in US children <18. 60% of the cases had no reported underlying condition.

The real number of deaths is probably quite a bit higher, since flu deaths are not reportable diseases.

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