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Suggested Citation:"Appendix D: Meeting Two Agenda." Institute of Medicine. 2008. Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program. Washington, DC: The National Academies Press. doi: 10.17226/12170.
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Page 113
Suggested Citation:"Appendix D: Meeting Two Agenda." Institute of Medicine. 2008. Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program. Washington, DC: The National Academies Press. doi: 10.17226/12170.
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Page 114
Suggested Citation:"Appendix D: Meeting Two Agenda." Institute of Medicine. 2008. Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program. Washington, DC: The National Academies Press. doi: 10.17226/12170.
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Page 115
Suggested Citation:"Appendix D: Meeting Two Agenda." Institute of Medicine. 2008. Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program. Washington, DC: The National Academies Press. doi: 10.17226/12170.
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Page 116

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Appendix D Meeting Two Agenda Committee on Implementation of Antiviral Medication Strategies for an Influenza Pandemic Meeting 2 January 7, 2008 Keck Center of The National Academies 500 Fifth Street, NW Room 110 Washington, DC 20001 (live audio/video feed provided in Room 105) 10:00 am Influenza Antivirals and Their Use: Effectiveness, Resistance, Surveillance Alexander Klimov Chief, Virus Surveillance and Diagnosis Branch Influenza Division Centers for Disease Control and Prevention 10:20 am Mathematical Modeling of Resistance in a Pandemic Marc Lipsitch Professor of Epidemiology Department of Epidemiology Department of Immunology and Infectious Diseases Harvard School of Public Health 10:40 am Committee Questions and Discussion 113

114 ANTIVIRALS FOR PANDEMIC INFLUENZA 11:00 am Antiviral Distribution Planning: More from State Public Health Agencies Paul Jarris Executive Director Association of State and Territorial Health Officials 11:15 am Committee Questions and Discussion 11:30 am Lessons from Past Public Health Drug or Vaccine Distribution Campaigns: Swine Flu Immunization Program, Vaccine Shortage, Antibiotic Distribution After Anthrax Attacks Swine Flu Walter Dowdle Senior Consultant to World Health Organization Polio Eradication Program Task Force on Child Survival and Development 11:45 am Lunch 12:45 pm Lessons from Past Public Health Drug or Vaccine Distribution Campaigns (continued) Influenza Vaccine Shortage Claire Hannan Executive Director Association of Immunization Managers Anthrax Eddy Bresnitz Deputy Health Commissioner State Epidemiologist New Jersey Mary Mahoney Bioterrorism Coordinator North Shore–Long Island Jewish Health System New York 1:30 pm Committee Questions and Discussion

APPENDIX D 115 1:50 pm Decision Analysis for Antiviral Distribution Sinan Khan Epidemiology Analyst Los Angeles County Emergency Preparedness and Response Program Telephone and Web-Based Decision Support and Triage Barry Wolcott Associate Professor Uniformed Services University of Health Sciences 2:30 pm Questions from the Committee and Discussion 2:45 pm Break 3:00 pm Antiviral Stockpiling: Stakeholders’ Perspectives Lisa Koonin Associate Director, Business Partnerships Division of Private and Public Partnerships National Center for Health Marketing/CoCHIS Centers for Disease Control and Prevention Antiviral Distribution Planning: The Public–Private-Sector Interface Rex Archer Director Kansas City Health Department Missouri Perspectives from the Private Sector Katherine B. Andrus Assistant General Counsel Air Transport Association of America, Inc. Stephen Jones Cluster Occupational Health Manager Downstream and Chemicals ExxonMobil Corporation Michael McGuire Vice President Roche Laboratories, Inc. 4:00 pm Committee Questions and Discussion

116 ANTIVIRALS FOR PANDEMIC INFLUENZA 4:15 pm Ethical Principles in Planning for the Distribution of Antiviral Medication Nancy Kass Phoebe R. Berman Professor of Bioethics and Public Health Johns Hopkins University Ethical Framework in Minnesota’s Plans for Distribution of Antiviral Medication Dorothy Vawter Associate Director Center for Health Care Ethics Minnesota 4:45 pm Committee Questions and Discussion 5:00 pm Antiviral Distribution Planning (continued) In a Publicly Funded Health Care System Victoria Davey Deputy Chief, Public Health and Environmental Hazards Officer Veterans Health Administration Department of Veterans Affairs In a Private Health Care System Skip Skivington Vice President of Supply Chain and Director of Operations, Procurement and Supply Program Offices Kaiser Permanente Eric Koscove Chief Emergency Department Kaiser Permanente Medical Center Santa Clara, CA 5:35 pm Committee Questions and Discussion 5:50 pm Public Comment (if time allows) 6:00 pm Adjourn

Next: Appendix E: Committee Member Biographies »
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Planning for an influenza pandemic, whether it occurs in the near or distant future, will need to take into account many constantly evolving factors. The Institute of Medicine (IOM) Committee on Implementation of Antiviral Medication Strategies for an Influenza Pandemic was asked by the Department of Health and Human Services, (DHHS) to consider best practices and policies for providing antiviral treatment and prophylaxis during a pandemic event. The committee's report, entitled Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program, calls for a national and public process of creating an ethical framework for antiviral use within the context of uncertainty and scarcity. It is unclear whether antivirals will work against a pandemic strain as well as they work against seasonal influenza. Also, government stockpiles may not be sufficient for all possible uses in part because antivirals are costly and public health agencies must invest in other important activities, including other medical resources for pandemic influenza. Furthermore, the report identifies the lack of a science-based advisory body to guide decision making during the pandemic, including guidance on all dimensions of antiviral dispensing (for example, prioritization, drug safety, and antiviral resistance). The report also acknowledges the need for diverse methods and sites of dispensing, and discusses their advantages and disadvantages.

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