The 9/11 disaster caused President Bush to turn our foreign policy and our Bill of Rights upside down. The flu disaster has barely gotten his attention. Both are the result of failed presidential leadership.

There have been so many revelations about presidential ineptitude on so many fronts in the past week that the flu story already seems like yesterday's news. But in fact it is tomorrow's news.

There could be a much bigger flu crisis next year as the next menace, avian flu, spreads. Unlike the typical winter flu, which is not fatal in most people, avian flu (which begins in birds) is easily transmitted from person to person and is usually fatal. So far, it hasn't hit the United States, but it could be the public health nightmare experts have long feared.

Here's the background to this year's flu mess. Every year, the flu virus mutates. So the US Centers for Disease Control, scientists, and manufacturers have only a few months to devise and make new vaccines that protect against this year's strain.

The administration is a close ally of the super-profitable pharmaceutical industry. It trusts private enterprise to deliver public health and has reduced regulation. Meanwhile, the industry has become ever more profitable and more interested in making blockbuster, copycat drugs for ills like indigestion, arthritis, and male impotence (Do we really need Cialis, and Levitra and Viagra?) rather than low-profit, one-shot items like vaccines. As a result, fewer companies make vaccines.

This year the vaccines made by one of the two large US producers, Chiron, turned out to be contaminated. That left a shortfall of about 58 million doses. The government didn't even step in with an allocation plan.

What should the administration be doing? First, it should require several drug makers to work with the CDC to develop flu vaccines. The industry is profitable thanks to extended patent protection, publicly funded basic research, and FDA seals of approval. It should gladly make vaccines at only a normal profit as a civic thank-you for all it gets from government.

Second, Congress should pass a law, as it did in the swine flu crisis of 1976 indemnifying manufacturers and physicians against lawsuits. If the FDA approves a vaccine, that should be sufficient assurance. Government could set up a public compensation fund for the rare victim of a faulty vaccination.

Third, government should be the purchaser and distributor of the vaccines. That would both guarantee manufacturers a market and would create a rational plan for priority distribution. And these vaccines should never be patented. As Dr. Jonas Salk, creator of the polio vaccine, famously said: "Who owns my vaccine? The people! Could you patent the sun?"

We can't set up this system until the next flu season, but Bush should be doing one thing right now: As Dr. Marcia Angell, author of the book "The Truth About the Drug Companies," urges, "The government should declare an emergency, purchase all available doses, and create an allocation plan." Instead, preposterously, the Bush administration has called on healthy people to forgo shots voluntarily, leaving older Americans, clinics, and doctors to fend for themselves.

Oh, and the administration has also decided that it's OK to go to Canada. Somehow we can trust the Canadians (who have no vaccine shortages thanks to their national health system) to distribute safe vaccines but not prescription drugs.

Chiron has been described as a British company. In fact it is a US company based in California. The offending Chiron plant happens to be in Liverpool, England. Aventis Pasteur, the other producer of this vaccine, makes doses in the United States but it is owned by the French. (Does Bush know this?)

The whole controversy about Canadian-sourced drugs is idiotic, because the whole drug industry is globalized. But I digress. The last time I checked, Florida was a swing state with a lot of elderly people. Right now, they should be getting flu shots, but millions will be turned away and put at risk. They should be very angry and be aware of who is responsible. It's a perfect example of how George W. Bush's coziness with special interests and his contempt for government endanger the public health. The Kerry campaign should be reminding Floridians -- and other older voters -- of how the Bush administration has needlessly jeopardized the lives of America's elderly.

© 2004 Boston Globe

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