HEALTH Despite flu's threat, other diseases get more financial help

One reason for low spending is that flu is a familiar ailment, an official said.
KNIGHT RIDDER NEWSPAPERS
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 the boll weevil, a pest that eats cotton.
Other diseases that grab headlines or have advocacy groups or celebrity spokesmen -- 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.
Too familiar
The problem, experts say, is that flu isn't new or sexy.
"There's a battle out there over dollars. Certain diseases are not on the front burner because we're familiar with them," said bioethics director Arthur Caplan of the University of Pennsylvania. "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.
Re-evaluating priorities
"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 chairman 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."
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. And because flu is so old, spending on it has shifted more to private companies for vaccines, antivirals and symptom treatment, said Dr. Bruce Gellin, director of the federal National Vaccine Program Office.