PUBLIC POLICY CASE STUDY

A review of the case study on 2004/05 U.S. Influenza Vaccine Shortage

The case is intended solely as a vehicle for classroom discussion

Public Policy & Management classCarnegie Mellon University – Adelaide

Jan 2012

OUTLINE An overview

Underlying Issues

Possible Solutions

Recommendations

1

2

3

4

OVERVIEW

Concerns raised about the fragile US vaccine situation

FLU:36,000 deaths 200,000 hospitalizations

$11-18 billion

2004-2005, US FLU VACCINE SHORTAGE

Vaccine manufacturer was suspended by England

US couldn't get half of expected 100 mil doses90mil at high risk

Pricing gaugingDistribution issues

Government's actions: InvestigationHigh risk areas were set priority

Started to search for additional vaccine supplyImported costly flu shots

High lack of vaccine supply remained Health threat remained

What if this was a flu pandemic?

FDA

Vaccine Manufacturers

People

(including) Media/ Public Relations Plan

CDC MHRA

Private hospitals

Media

High risk population

•High FDA quality standards;•Poor analytical tools;•Weak M&E system;•Disconnect between public and private sectors;•Feeble intra/inter governmental cooperation;•Poor communication

ISSUES UNDERLYING

• Production plants take time to set up

• Vaccine production is time consuming

• High-risk market• High long-term production

costs• Low profit margins

VACCINE PRODUCTION

• Media frenzy;• Public health threat;• Public agitation;• Vaccine smuggling and theft;• Movement to Canada for flu vaccine shots;• Additional costs

FLU VACCINE CRISIS

PUBLIC ADMINISTRATION SYSTEM

CRISIS RESPONSE• CDC recommended that vaccines be reserved for high risk patients (it

however lacked the authority to enforce it).

• A panel to investigate the ethics of distribution was established by CDC.

• A flu vaccine task force was assembled to help manage the distribution

and control price.

• Hospitals started sharing vaccines and doses from federal employees were

diverted to high-risk civilians.

• US government (Federal and State) went international to source vaccines

(efforts were restrained by FDA standards and procedures).

• Delayed supplies led to excess unutilized stock of vaccines.

POSSIBLE SOLUTIONS

1. Timely information management on public health issues.

2. Closer cooperation & alignment with other countries/international bodies (the Medicines and Healthcare Products Regulatory Agency in Britain and the US National Vaccine Advisory Committee/Federal Drug Administration).

3. Develop a more cohesive and coherent crisis management plan among the federal, state government and private agencies focused on resilience and continuity.

4. Review FDA approval/quality assurance procedures to ensure timeliness without compromising standards.

5. Develop Monitoring and Evaluation system to track problems identified as well as facilitate prompt implementation of proposed solutions.

6. Public-Private Partnerships to ensure timely production and distribution of adequate flu vaccines.

RECOMMENDATIONS

Public-Private Partnerships to ensure timely production and distribution of adequate flu vaccines.

RECOMMENDATIONS

Develop Monitoring and Evaluation system to track problems identified as well as facilitate prompt implementation of proposed solutions.

RECOMMENDATIONS

Develop a more cohesive and coherent crisis management plan among the federal, state government and private agencies focused on resilience and continuity. End.

RECOMMENDATION SUMMARY

Vaccine Production

Industry

Public Administration

SystemFlu Situation

Monitoring &Evaluation System Q&A ?

THANK YOU !

The case is intended solely as a vehicle for classroom discussionFlu Virus: Deccanherald

Images on the Newspaper page: Washington Post, AFP, Getty Images

Other photos : unknown authors on Google Images, thank you.

Group members:

Do Thi Thien-huong

Nguyen Thi Huyen

Linh

Oteng Karikari

Chikezie Isiguzo

Stephen Kihato