Medical Infrastructure - Defending The U.s. Against Bioterrorism

October 4, 2001. The day "bioterrorism" became reality in the United States. On this day the Palm Beach County Health Department, the Florida State Department of Health, and the Centers for Disease Control (CDC) reported that a 63-year old patient was hospitalized with inhalation anthrax. That patient later died. By December 2001, 22 cases of anthrax had been reported.

That same month, the Bush Administration asked for $1.5 billion in emergency funds for the Department of Health and Human Services (HHS) to help in their response to bioterrorism attacks. Much of the money was to go towards increasing the national supply of antibiotics to treat anthrax and increasing the national supply of the smallpox vaccine.

With the growing crisis of drug shortages in the United States (see previous panel), can America's drug companies manufacture millions of doses of antibiotics and vaccines in just one year?

In October 2001, HHS contracted with Bayer Corporation to provide the government with 100 million tablets of Cipro, an antibiotic used to treat anthrax cases. The $95 million agreement also calls for Bayer to rotate the government inventory to "assure the American public a continuously fresh supply of Cipro."⁴³ This increase in reserves would allow 12 million people to be treated for anthrax. The contract provides for two more orders of 100 million tablets if needed. Cipro makes up about 10% of the antibiotic reserves in the National Pharmaceutical Stockpile (NPS). Anthrax is treated with a combination of antibiotics. Cipro is used for the first 5 days in a 60-day antibiotic regimen.

In November 2001, HHS signed a $428 million fixed-price contract with Acambis Inc. (and its subcontractor Baxter International Inc.) to produce 155 million doses of the smallpox vaccine by the end of 2002. This is in addition to what was agreed upon in earlier contracts. In September 2000, the CDC contracted with Acambis to produce 40 million doses of the vaccine to be delivered by 2004. But, in September 2001, the contract was renegotiated and Acambis agreed to produce and deliver 54 million doses by late 2002. In addition to these efforts, National Institute of Allergy and Infectious Diseases studies indicate that diluting the existing supply of the vaccine (which has been stored since 1983) will create 77 million doses. All totaled, the NPS should have 286 million doses of the smallpox vaccine by the end of 2002. Nearly enough doses for everyone in the United States.⁴⁴

Sources: Butler, Mary Ellen. "HHS To Use Emergency Funds For Bioterrorism." U.S. Medicine, November 2001. Retrieved September 19, 2002 from http://www.usmedicine.com/. U.S. Department of Health and Human Services. "HHS, Bayer Agree to Cipro Purchase." and "HHS Awards $428 Million Contract to Produce Smallpox Vaccine." HHS News, various dates. Retrieved September 19, 2002 from http://www.hhs.gov. Philip K. Russell. "Vaccines in Civilian Defense Against Bioterrorism." Emerging Infectious Diseases, July-August 1999. Retrieved September 19, 2002 from http://www.cdc.gov/ncidod/EID/vol5no4/pdf/russell.pdf. Centers for Disease Control. "Ongoing Investigation of Anthrax-Florida, October 2001" and "Update: Investigation of Bioterrorism-Related Anthrax-Connecticut, 2001." MMWR, various dates. Retrieved September 19, 2002 from http://www.cdc.gov/mmwr/.