National Strategy for

pandemic 

influenza

h o mel and security COUNCIL

november 2005
My fellow Americans, 

Once again, nature has presented us with a daunting challenge: the possibility of an influenza 

pandemic. 

Most of us are accustomed to seasonal influenza, or “the flu,” a viral infection that continues to 

be a significant public health challenge. From time to time, changes in the influenza virus result 

in a new strain to which people have never been exposed. These new strains have the potential 

to sweep the globe, causing millions of illnesses, in what is called a pandemic. 

A new strain of influenza virus has been found in birds in Asia, and has shown that it can infect 

humans. If this virus undergoes further change, it could very well result in the next human 

pandemic. 

We have an opportunity to prepare ourselves, our Nation, and our world to fight this potentially 

devastating outbreak of infectious disease. 

The National Strategy for Pandemic Influenza presents our approach to address the threat of 

pandemic influenza, whether it results from the strain currently in birds in Asia or another 

influenza virus. It outlines how we intend to prepare, detect, and respond to a pandemic. It also 

outlines the important roles to be played not only by the Federal government, but also by State 

and local governments, private industry, our international partners, and most importantly 

individual citizens, including you and your families. 

While your government will do much to prepare for a pandemic, individual action and individual 

responsibility are necessary for the success of any measures. Not only should you take action to 

protect yourself and your families, you should also take action to prevent the spread of influenza 

if you or anyone in your family becomes ill. 

Together we will confront this emerging threat and together, as Americans, we will be prepared 

to protect our families, our communities, this great Nation, and our world. 

GEORGE W. BUSH 

THE WHITE HOUSE 

November 1, 2005 
NATIONAL STRATEGY FOR PANDEMIC INFLUENZA

TABLE OF CONTENTS

INTRODUCTION................................................................................................................... 1 

THE PANDEMIC THREAT.................................................................................................... 1 

THE NATIONAL STRATEGY FOR PANDEMIC INFLUENZA ..................................................... 2 

PILLARS OF THE NATIONAL STRATEGY .............................................................................. 3 

IMPLEMENTATION OF THE NATIONAL STRATEGY .............................................................. 3 

PILLAR ONE: PREPAREDNESS AND COMMUNICATION...................................................... 4 

PILLAR TWO: SURVEILLANCE AND DETECTION ............................................................... 7 

PILLAR THREE: RESPONSE AND CONTAINMENT............................................................... 8 

ROLES AND RESPONSIBILITIES ........................................................................................ 10 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 
NATIONAL STRATEGY FOR PANDEMIC INFLUENZA

INTRODUCTION

Although remarkable advances have been 

made in science and medicine during the 

past century, we are constantly reminded 

that we live in a universe of microbes - 

viruses, bacteria, protozoa and fungi that are 

forever changing and adapting themselves to 

the human host and the defenses that 

humans create. 

Influenza viruses are notable for their 

resilience and adaptability. While science 

has been able to develop highly effective 

vaccines and treatments for many infectious 

diseases that threaten public health, 

acquiring these tools is an ongoing challenge 

with the influenza virus. Changes in the 

genetic makeup of the virus require us to 

develop new vaccines on an annual basis 

and forecast which strains are likely to 

predominate. 

As a result, and despite annual vaccinations, 

the U.S. faces a burden of influenza that 

results in approximately 36,000 deaths and 

more than 200,000 hospitalizations each 

year. In addition to this human toll, 

influenza is annually responsible for a total 

cost of over $10 billion in the U.S. 

A pandemic, or worldwide outbreak of a 

new influenza virus, could dwarf this impact 

by overwhelming our health and medical 

capabilities, potentially resulting in 

hundreds of thousands of deaths, millions of 

hospitalizations, and hundreds of billions of 

dollars in direct and indirect costs. This 

Strategy will guide our preparedness and 

response activities to mitigate that impact. 

THE PANDEMIC THREAT

Pandemics happen when a novel influenza 

virus emerges that infects and can be 

efficiently transmitted between humans. 

Animals are the most likely reservoir for 

these emerging viruses; avian viruses played 

a role in the last three influenza pandemics. 

Two of these pandemic-causing viruses 

remain in circulation and are responsible for 

the majority of influenza cases each year. 

Pandemics have occurred intermittently over 

centuries. The last three pandemics, in 

1918, 1957 and 1968, killed approximately 

40 million, 2 million and 1 million people 

worldwide, respectively. Although the 

timing cannot be predicted, history and 

science suggest that we will face one or 

more pandemics in this century. 

The current pandemic threat stems from an 

unprecedented outbreak of avian influenza 

in Asia and Europe, caused by the H5N1 

strain of the Influenza A virus. To date, the 

virus has infected birds in 16 countries and 

has resulted in the deaths, through illness 

and culling, of approximately 200 million 

birds across Asia. While traditional control 

measures have been attempted, the virus is 

now endemic in Southeast Asia, present in 

long-range migratory birds, and unlikely to 

be eradicated soon. 

A notable and worrisome feature of the 

H5N1 virus is its ability to infect a wide 

range of hosts, including birds and humans. 

As of the date of this document, the virus is 

known to have infected 121 people in four 

countries, resulting in 62 deaths over the 

past two years. Although the virus has not 

yet shown an ability to transmit efficiently 

between humans, as is seen with the annual 

influenza virus, there is concern that it will 

acquire this capability through genetic 

mutation or exchange of genetic material 

with a human influenza virus. 

It is impossible to know whether the 

currently circulating H5N1 virus will cause 

a human pandemic. The widespread nature 

of H5N1 in birds and the likelihood of 

mutations over time raise our concerns that 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 1 - 
the virus will become transmissible between 

humans, with potentially catastrophic 

consequences. If this does not happen with 

the current H5N1 strain, history suggests 

that a different influenza virus will emerge 

and result in the next pandemic. 

THE NATIONAL STRATEGY FOR PANDEMIC 

INFLUENZA

Preparing for a pandemic requires the 

leveraging of all instruments of national 

power, and coordinated action by all 

segments of government and society. 

Influenza viruses do not respect the 

distinctions of race, sex, age, profession or 

nationality, and are not constrained by 

geographic boundaries. The next pandemic 

is likely to come in waves, each lasting 

months, and pass through communities of all 

size across the nation and world. While a 

pandemic will not damage power lines, 

banks or computer networks, it will 

ultimately threaten all critical infrastructure 

by removing essential personnel from the 

workplace for weeks or months. 

This makes a pandemic a unique 

circumstance necessitating a strategy that 

extends well beyond health and medical 

boundaries, to include the sustainment of 

critical infrastructure, private-sector 

activities, the movement of goods and 

services across the nation and the globe, and 

economic and security considerations. The 

uncertainties associated with influenza 

viruses require that our Strategy be versatile, 

to ensure that we are prepared for any virus 

with pandemic potential, as well as the 

annual burden of influenza that we know we 

will face. 

The National Strategy for Pandemic 

Influenza guides our preparedness and 

response to an influenza pandemic, with 

the intent of (1) stopping, slowing or 

otherwise limiting the spread of a 

pandemic to the United States; 

(2) limiting the domestic spread of a 

pandemic, and mitigating disease, 

suffering and death; and (3) sustaining 

infrastructure and mitigating impact to 

the economy and the functioning of 

society. 

The Strategy will provide a framework for 

future U.S. Government planning efforts 

that is consistent with The National Security 

Strategy and the National Strategy for 

Homeland Security. It recognizes that 

preparing for and responding to a pandemic 

cannot be viewed as a purely federal 

responsibility, and that the nation must have 

a system of plans at all levels of government 

and in all sectors outside of government that 

can be integrated to address the pandemic 

threat. It is guided by the following 

principles: 

• The federal government will use all 

instruments of national power to address 

the pandemic threat. 

• States and communities should have 

credible pandemic preparedness plans to 

respond to an outbreak within their 

jurisdictions. 

• The private sector should play an 

integral role in preparedness before a 

pandemic begins, and should be part of 

the national response. 

• Individual citizens should be prepared 

for an influenza pandemic, and be 

educated about individual responsibility 

to limit the spread of infection if they or 

their family members become ill. 

• Global partnerships will be leveraged to 

address the pandemic threat. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 2 - 
PILLARS OF THE NATIONAL STRATEGY

Our Strategy addresses the full spectrum of 

events that link a farmyard overseas to a 

living room in America. While the 

circumstances that connect these 

environments are very different, our 

strategic principles remain relevant. The 

pillars of our Strategy are: 

• Preparedness and Communication: 

Activities that should be undertaken 

before a pandemic to ensure 

preparedness, and the communication of 

roles and responsibilities to all levels of 

government, segments of society and 

individuals. 

• Surveillance and Detection: Domestic 

and international systems that provide 

continuous “situational awareness,” to 

ensure the earliest warning possible to 

protect the population. 

• Response and Containment: Actions 

to limit the spread of the outbreak and to 

mitigate the health, social and economic 

impacts of a pandemic. 

IMPLEMENTATION OF THE NATIONAL 

STRATEGY

This Strategy reflects the federal 

government’s approach to the pandemic 

threat. While it provides strategic direction 

for the Departments and Agencies of the 

U.S. Government, it does not attempt to 

catalogue and assign all federal 

responsibilities. The implementation of this 

Strategy and specific responsibilities will be 

described separately.

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 3 - 
PILLAR ONE: PREPAREDNESS AND COMMUNICATION

Preparedness is the underpinning of the 

entire spectrum of activities, including 

surveillance, detection, containment and 

response efforts. We will support pandemic 

planning efforts, and clearly communicate 

expectations to individuals, communities 

and governments, whether overseas or in the 

United States, recognizing that all share the 

responsibility to limit the spread of infection 

in order to protect populations beyond their 

borders. 

Planning for a Pandemic 

To enhance preparedness, we will: 

• Develop federal implementation plans to 

support this Strategy, to include all 

components of the U.S. government and 

to address the full range of 

consequences of a pandemic, including 

human and animal health, security, 

transportation, economic, trade and 

infrastructure considerations. 

• Work through multilateral health 

organizations such as the World Health 

Organization (WHO), Food and 

Agriculture Organization (FAO), World 

Organization for Animal Health (OIE) 

and regional organizations such as the 

Asia-Pacific Economic Cooperation 

(APEC) forum, as well as through 

bilateral and multilateral contacts to: 

o Support the development and 

exercising of avian and 

pandemic response plans; 

o Expand in-country medical, 

veterinary and scientific 

capacity to respond to an 

outbreak; and 

o Educate populations at home 

and abroad about high-risk 

practices that increase the 

likelihood of virus transmission 

between species. 

• Continue to work with states and 

localities to: 

o Establish and exercise pandemic 

response plans; 

o Develop medical and veterinary 

surge capacity plans; and 

o Integrate non-health sectors, 

including the private sector and 

critical infrastructure entities, in 

these planning efforts. 

• Build upon existing domestic 

mechanisms to rapidly recruit and 

deploy large numbers of health, medical 

and veterinary providers within or 

across jurisdictions to match medical 

requirements with capabilities. 

Communicating Expectations and 

Responsibilities 

A critical element of pandemic planning is 

ensuring that people and entities not 

accustomed to responding to health crises 

understand the actions and priorities 

required to prepare for and respond to a 

pandemic. Those groups include political 

leadership at all levels of government, nonhealth components of government and 

members of the private sector. Essential 

planning also includes the coordination of 

efforts between human and animal health 

authorities. In order to accomplish this, we 

will:

• Work to ensure clear, effective and 

coordinated risk communication, 

domestically and internationally, before 

and during a pandemic. This includes 

identifying credible spokespersons at all 

levels of government to effectively 

coordinate and communicate helpful, 

informative messages in a timely 

manner. 

• Provide guidance to the private sector 

and critical infrastructure entities on 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 4 - 
their role in the pandemic response, and 

considerations necessary to maintain 

essential services and operations despite 

significant and sustained worker 

absenteeism. 

• Provide guidance to individuals on 

infection control behaviors they should 

adopt pre-pandemic, and the specific 

actions they will need to take during a 

severe influenza season or pandemic, 

such as self-isolation and protection of 

others if they themselves contract 

influenza. 

• Provide guidance and support to poultry, 

swine and related industries on their role 

in responding to an outbreak of avian 

influenza, including ensuring the 

protection of animal workers and 

initiating or strengthening public 

education campaigns to minimize the 

risks of infection from animal products. 

Producing and Stockpiling Vaccines, 

Antivirals and Medical Material 

In combination with traditional public health 

measures, vaccines and antiviral drugs form 

the foundation of our infection control 

strategy. Vaccination is the most important 

element of this strategy, but we 

acknowledge that a two-pronged strategy 

incorporating both vaccines and antivirals is 

essential. To establish production capacity 

and stockpiles in support of our containment 

and response strategies, we will: 

• Encourage nations to develop 

production capacity and stockpiles to 

support their response needs, to include 

pooling of efforts to create regional 

capacity. 

• Encourage and subsidize the 

development of state-based antiviral 

stockpiles to support response activities. 

• Ensure that our national stockpile and 

stockpiles based in states and 

communities are properly configured to 

respond to the diversity of medical 

requirements presented by a pandemic, 

including personal protective 

equipment, antibiotics and general 

supplies. 

• Establish domestic production capacity 

and stockpiles of countermeasures to 

ensure: 

o Sufficient vaccine to vaccinate 

front-line personnel and at-risk 

populations, including military 

personnel; 

o Sufficient vaccine to vaccinate 

the entire U.S. population 

within six months of the 

emergence of a virus with 

pandemic potential; and 

o Antiviral treatment for those 

who contract a pandemic strain 

of influenza. 

• Facilitate appropriate coordination of 

efforts across the vaccine manufacturing 

sector. 

• Address regulatory and other legal 

barriers to the expansion of our 

domestic vaccine production capacity. 

• Expand the public health 

recommendations for domestic seasonal 

influenza vaccination and encourage the 

same practice internationally. 

• Expand the domestic supply of avian 

influenza vaccine to control a domestic 

outbreak of avian influenza in bird 

populations. 

Establishing Distribution Plans for 

Vaccines and Antivirals 

It is essential that we prioritize the allocation 

of countermeasures (vaccines and antivirals) 

that are in limited supply and define 

effective distribution modalities during a 

pandemic. We will: 

• Develop credible countermeasure 

distribution mechanisms for vaccine and 

antiviral agents prior to and during a 

pandemic. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 5 - 
• Prioritize countermeasure allocation 

before an outbreak, and update this 

prioritization immediately after the 

outbreak begins based on the at-risk 

populations, available supplies and the 

characteristics of the virus. 

Advancing Scientific Knowledge and 

Accelerating Development 

Research and development of vaccines, 

antivirals, adjuvants and diagnostics 

represents our best defense against a 

pandemic. To realize our goal of nextgeneration countermeasures against 

influenza, we must make significant and 

targeted investments in promising 

technologies. We will: 

• Ensure that there is maximal sharing of 

scientific information about influenza 

viruses between governments, scientific 

entities and the private sector. 

• Work with our international partners to 

ensure that we are all leveraging the 

most advanced technological approaches 

available for vaccine production. 

• Accelerate the development of cell 

culture technology for influenza vaccine 

production and establish a domestic 

production base to support vaccination 

demands. 

• Use novel investment strategies to 

advance the development of nextgeneration influenza diagnostics and 

countermeasures, including new 

antivirals, vaccines, adjuvant 

technologies, and countermeasures that 

provide protection across multiple 

strains and seasons of the influenza 

virus.

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 6 - 
PILLAR TWO: SURVEILLANCE AND DETECTION

Early warning of a pandemic and our ability 

to closely track the spread of avian influenza 

outbreak is critical to being able to rapidly 

employ resources to contain the spread of 

the virus. An effective surveillance and 

detection system will save lives by allowing 

us to activate our response plans before the 

arrival of a pandemic virus to the U.S., 

activate additional surveillance systems and 

initiate vaccine production and 

administration. 

Ensuring Rapid Reporting of Outbreaks 

To support our need for “situational 

awareness,” both domestically and 

internationally, we will: 

• Work through the International 

Partnership on Avian and Pandemic 

Influenza, as well as through other 

political and diplomatic channels such 

as the United Nations and the AsiaPacific Economic Cooperation forum, to 

ensure transparency, scientific 

cooperation and rapid reporting of avian 

and human influenza cases. 

• Support the development of the proper 

scientific and epidemiologic expertise in 

affected regions to ensure early 

recognition of changes in the pattern of 

avian or human outbreaks. 

• Support the development and 

sustainment of sufficient U.S. and host 

nation laboratory capacity and 

diagnostic reagents in affected regions 

and domestically, to provide rapid 

confirmation of cases in animals or 

humans. 

• Advance mechanisms for “real-time” 

clinical surveillance in domestic acute 

care settings such as emergency 

departments, intensive care units and 

laboratories to provide local, state and 

federal public health officials with 

continuous awareness of the profile of 

illness in communities, and leverage all 

federal medical capabilities, both 

domestic and international, in support of 

this objective. 

• Develop and deploy rapid diagnostics 

with greater sensitivity and 

reproducibility to allow onsite diagnosis 

of pandemic strains of influenza at home 

and abroad, in animals and humans, to 

facilitate early warning, outbreak control 

and targeting of antiviral therapy. 

• Expand our domestic livestock and 

wildlife surveillance activities to ensure 

early warning of the spread of an 

outbreak to our shores. 

Using Surveillance to Limit Spread 

Although influenza does not respect 

geographic or political borders, entry to and 

egress from affected areas represent 

opportunities to control or at the very least 

slow the spread of infection. In parallel to 

our containment measures, we will: 

• Develop mechanisms to rapidly share 

information on travelers who may be 

carrying or may have been exposed to a 

pandemic strain of influenza, for the 

purposes of contact tracing and outbreak 

investigation. 

• Develop and exercise mechanisms to 

provide active and passive surveillance 

during an outbreak, both within and 

beyond our borders. 

• Expand and enhance mechanisms for 

screening and monitoring animals that 

may harbor viruses with pandemic 

potential. 

• Develop screening and monitoring 

mechanisms and agreements to 

appropriately control travel and shipping 

of potentially infected products to and 

from affected regions if necessary, and 

to protect unaffected populations. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 7 - 
PILLAR THREE: RESPONSE AND CONTAINMENT

We recognize that a virus with pandemic 

potential anywhere represents a risk to 

populations everywhere. Once health 

authorities have signaled sustained and 

efficient human-to-human spread of the 

virus has occurred, a cascade of response 

mechanisms will be initiated, from the site 

of the documented transmission to locations 

around the globe. 

Containing Outbreaks 

The most effective way to protect the 

American population is to contain an 

outbreak beyond the borders of the U.S. 

While we work to prevent a pandemic from 

reaching our shores, we recognize that 

slowing or limiting the spread of the 

outbreak is a more realistic outcome and can 

save many lives. In support of our 

containment strategy, we will: 

• Work through the International 

Partnership to develop a coalition of 

strong partners to coordinate actions to 

limit the spread of a virus with 

pandemic potential beyond the location 

where it is first recognized in order to 

protect U.S. interests abroad. 

• Where appropriate, offer and coordinate 

assistance from the United States and 

other members of the International 

Partnership. 

• Encourage all levels of government, 

domestically and globally, to take 

appropriate and lawful action to contain 

an outbreak within the borders of their 

community, province, state or nation. 

• Where appropriate, use governmental 

authorities to limit non-essential 

movement of people, goods and services 

into and out of areas where an outbreak 

occurs. 

• Provide guidance to all levels of 

government on the range of options for 

infection-control and containment, 

including those circumstances where 

social distancing measures, limitations 

on gatherings, or quarantine authority 

may be an appropriate public health 

intervention. 

• Emphasize the roles and responsibilities 

of the individual in preventing the 

spread of an outbreak, and the risk to 

others if infection-control practices are 

not followed. 

• Provide guidance for states, localities 

and industry on best practices to prevent 

the spread of avian influenza in 

commercial, domestic and wild birds, 

and other animals. 

Leveraging National Medical and Public 

Health Surge Capacity 

Rather than generating a focal point of 

casualties, the medical burden of a pandemic 

is likely to be distributed in communities 

across the nation for an extended period of 

time. In order to save lives and limit 

suffering, we will: 

• Implement state and local public health 

and medical surge plans, and leverage 

all federal medical facilities, personnel 

and response capabilities to support the 

national surge requirement. 

• Activate plans to distribute medical 

countermeasures, including non-medical 

equipment and other material, from the 

Strategic National Stockpile and other 

distribution centers to federal, state and 

local authorities. 

• Address barriers to the flow of public 

health, medical and veterinary personnel 

across state and local jurisdictions to 

meet local shortfalls in public health, 

medical and veterinary capacity. 

• Determine the spectrum of public 

health, medical and veterinary surge 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 8 - 
capacity activities that the U.S. military 

and other government entities may be 

able to support during a pandemic, 

contingent upon primary mission 

requirements, and develop mechanisms 

to activate them. 

Sustaining Infrastructure, Essential 

Services and the Economy 

Movement of essential personnel, goods and 

services, and maintenance of critical 

infrastructure are necessary during an event 

that spans months in any given community. 

The private sector and critical infrastructure 

entities must respond in a manner that 

allows them to maintain the essential 

elements of their operations for a prolonged 

period of time, in order to prevent severe 

disruption of life in our communities. To 

ensure this, we will: 

• Encourage the development of 

coordination mechanisms across 

American industries to support the 

above activities during a pandemic. 

• Provide guidance to activate 

contingency plans to ensure that 

personnel are protected, that the delivery 

of essential goods and services is 

maintained, and that sectors remain 

functional despite significant and 

sustained worker absenteeism. 

• Determine the spectrum of 

infrastructure-sustainment activities that 

the U.S. military and other government 

entities may be able to support during a 

pandemic, contingent upon primary 

mission requirements, and develop 

mechanisms to activate them. 

Ensuring Effective Risk Communication 

Effective risk communication is essential to 

inform the public and mitigate panic. We 

will: 

• Ensure that timely, clear, coordinated 

messages are delivered to the American 

public from trained spokespersons at all 

levels of government and assist the 

governments of affected nations to do 

the same. 

• Work with state and local governments 

to develop guidelines to assure the 

public of the safety of the food supply 

and mitigate the risk of exposure from 

wildlife. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 9 - 
ROLES AND RESPONSIBILITIES

Because of its unique nature, responsibility 

for preparedness and response to a pandemic 

extends across all levels of government and 

all segments of society. No single entity 

alone can prevent or mitigate the impact of a 

pandemic. 

The Federal Government 

While the Federal government plays a 

critical role in elements of preparedness and 

response to a pandemic, the success of these 

measures is predicated on actions taken at 

the individual level and in states and 

communities. Federal responsibilities 

include the following: 

• Advancing international preparedness, 

surveillance, response and containment 

activities. 

• Supporting the establishment of 

countermeasure stockpiles and 

production capacity by: 

o Facilitating the development of 

sufficient domestic production 

capacity for vaccines, antivirals, 

diagnostics and personal 

protective equipment to support 

domestic needs, and 

encouraging the development of 

production capacity around the 

world; 

o Advancing the science 

necessary to produce effective 

vaccines, therapeutics and 

diagnostics; and 

o Stockpiling and coordinating the 

distribution of necessary 

countermeasures, in concert 

with states and other entities. 

• Ensuring that federal departments and 

agencies, including federal health care 

systems, have developed and exercised 

preparedness and response plans that 

take into account the potential impact of 

a pandemic on the federal workforce, 

and are configured to support state, local 

and private sector efforts as appropriate. 

• Facilitating state and local planning 

through funding and guidance. 

• Providing guidance to the private sector 

and public on preparedness and response 

planning, in conjunction with states and 

communities. 

Lead departments have been identified for 

the medical response (Department of Health 

and Human Services), veterinary response 

(Department of Agriculture), international 

activities (Department of State) and the 

overall domestic incident management and 

Federal coordination (Department of 

Homeland Security). Each department is 

responsible for coordination of all efforts 

within its authorized mission, and 

departments are responsible for developing 

plans to implement this Strategy. 

States and Localities 

Our communities are on the front lines of a 

pandemic and will face many challenges in 

maintaining continuity of society in the face 

of widespread illness and increased demand 

on most essential government services. State 

and local responsibilities include the 

following: 

• Ensuring that all reasonable measures 

are taken to limit the spread of an 

outbreak within and beyond the 

community’s borders. 

• Establishing comprehensive and 

credible preparedness and response 

plans that are exercised on a regular 

basis. 

• Integrating non-health entities in the 

planning for a pandemic, including law 

enforcement, utilities, city services and 

political leadership. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 10 - 
• Establishing state and community-based 

stockpiles and distribution systems to 

support a comprehensive pandemic 

response. 

• Identifying key spokespersons for the 

community, ensuring that they are 

educated in risk communication, and 

have coordinated crisis communications 

plans. 

• Providing public education campaigns 

on pandemic influenza and public and 

private interventions. 

The Private Sector and Critical 

Infrastructure Entities 

The private sector represents an essential 

pillar of our society because of the essential 

goods and services that it provides. 

Moreover, it touches the majority of our 

population on a daily basis, through an 

employer-employee or vendor-customer 

relationship. For these reasons, it is 

essential that the U.S. private sector be 

engaged in all preparedness and response 

activities for a pandemic. 

Critical infrastructure entities also must be 

engaged in planning for a pandemic because 

of our society’s dependence upon their 

services. Both the private sector and critical 

infrastructure entities represent essential 

underpinnings for the functioning of 

American society. Responsibilities of the 

U.S. private sector and critical infrastructure 

entities include the following: 

• Establishing an ethic of infection control 

in the workplace that is reinforced 

during the annual influenza season, to 

include, if possible, options for working 

offsite while ill, systems to reduce 

infection transmission, and worker 

education. 

• Establishing contingency systems to 

maintain delivery of essential goods and 

services during times of significant and 

sustained worker absenteeism. 

• Where possible, establishing 

mechanisms to allow workers to provide 

services from home if public health 

officials advise against non-essential 

travel outside the home. 

• Establishing partnerships with other 

members of the sector to provide mutual 

support and maintenance of essential 

services during a pandemic. 

Individuals and Families 

The critical role of individuals and families 

in controlling a pandemic cannot be 

overstated. Modeling of the transmission of 

influenza vividly illustrates the impact of 

one individual’s behavior on the spread of 

disease, by showing that an infection carried 

by one person can be transmitted to tens or 

hundreds of others. For this reason, 

individual action is perhaps the most 

important element of pandemic preparedness 

and response. 

Education on pandemic preparedness for the 

population should begin before a pandemic, 

should be provided by all levels of 

government and the private sector, and 

should occur in the context of preventing the 

transmission of any infection, such as the 

annual influenza or the common cold. 

Responsibilities of the individual and 

families include: 

• Taking precautions to prevent the spread 

of infection to others if an individual or 

a family member has symptoms of 

influenza. 

• Being prepared to follow public health 

guidance that may include limitation of 

attendance at public gatherings and nonessential travel for several days or 

weeks. 

• Keeping supplies of materials at home, 

as recommended by authorities, to 

support essential needs of the household 

for several days if necessary. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 11 - 
International Partners 

We rely upon our international partnerships, 

with the United Nations, international 

organizations and private non-profit 

organizations, to amplify our efforts, and 

will engage them on a multilateral and 

bilateral basis. Our international effort to 

contain and mitigate the effects of an 

outbreak of pandemic influenza is a central 

component of our overall strategy. In many 

ways, the character and quality of the U.S. 

response and that of our international 

partners may play a determining role in the 

severity of a pandemic. 

The International Partnership on Avian and 

Pandemic Influenza stands in support of 

multinational organizations. Members of 

the Partnership have agreed that the 

following 10 principles will guide their 

efforts:

1. International cooperation to protect the 

lives and health of our people; 

2. Timely and sustained high-level global 

political leadership to combat avian and 

pandemic influenza; 

3. Transparency in reporting of influenza 

cases in humans and in animals caused 

by virus strains that have pandemic 

potential, to increase understanding and 

preparedness and especially to ensure 

rapid and timely response to potential 

outbreaks; 

4. Immediate sharing of epidemiological 

data and samples with the World Health 

Organization (WHO) and the 

international community to detect and 

characterize the nature and evolution of 

any outbreaks as quickly as possible, by 

utilizing, where appropriate, existing 

networks and mechanisms; 

5. Rapid reaction to address the first signs 

of accelerated transmission of H5N1 and 

other highly pathogenic influenza strains 

so that appropriate international and 

national resources can be brought to 

bear; 

6. Prevent and contain an incipient 

epidemic through capacity building and 

in-country collaboration with 

international partners; 

7. Work in a manner complementary to 

and supportive of expanded cooperation 

with and appropriate support of key 

multilateral organizations (including the 

WHO, Food and Agriculture 

Organization and World Organization 

for Animal Health); 

8. Timely coordination of bilateral and 

multilateral resource allocations; 

dedication of domestic resources 

(human and financial); improvements in 

public awareness; and development of 

economic and trade contingency plans; 

9. Increased coordination and 

harmonization of preparedness, 

prevention, response and containment 

activities among nations, 

complementing domestic and regional 

preparedness initiatives, and 

encouraging where appropriate the 

development of strategic regional 

initiatives; and 

10. Actions based on the best available 

science. 

Through the Partnership and other bilateral 

and multilateral initiatives, we will promote 

these principles and support the 

development of an international capacity to 

prepare, detect and respond to an influenza 

pandemic. 

NATIONAL STRATEGY FOR PANDEMIC INFLUENZA 

- 12 -