There are new concerns in the Senate over whether the United States is prepared for the mysterious and deadly avian flu.
The avian flu virus is spread by chickens, ducks and other birds and has been a problem in Southeast Asia for years. Since late 2003, it has killed at least 65 people in four Asian countries and has also been found in birds in Russia and Europe.
With strains of the virus found in humans, there has been growing concern among U.S. officials about the possibility of a pandemic and whether the United States is prepared to combat the disease.
"Experts warn that a global, cataclysmic pandemic is not a question of 'if' but 'when,' " said Sen. Bill Frist, R-Tenn.
The draft report of the federal government's emergency plan predicts that as many as 200 million Americans could be infected and 200,000 could die within a few months if the avian flu came to the United States. Right now, there is no vaccine to stop the flu.
"The first thing is, everybody in America's going to say, 'Where's a vaccine?' And they're going to find out that it's really darned hard to make a vaccine," said Laurie Garrett, senior fellow for global health at the Council on Foreign Relations. "It takes a really long time."
Although there is no avian flu vaccine, there is one medicine to treat it: Tamiflu. Tamiflu is made by the Roche pharmaceutical company with its plant in Switzerland. Roche says it has been selling Tamiflu for years. Scientists, however, have only recently realized that it is the sole medicine proven effective against avian flu. This has sparked a huge demand for Tamiflu and a shortage of the medicine.
"Our current stockpile is around 2 ½ million courses of treatment," Garrett said. "[It] Looks like we have a shortage."
Roche has set up a first-come, first-served waiting list for Tamiflu and sources told ABC News that the United States is nowhere near the top of that list. U.S. officials say they are working to obtain Tamiflu quickly.
"Do we wish we had ordered it sooner and more of it? I suspect one could say yes," said Health and Human Services Secretary Michael Leavitt. "Are we moving rapidly to assure that we have it? The answer is also yes."
However, when asked why the United States did not order Tamiflu earlier, Leavitt said, "I can't answer that. I don't know the answer."
The concerns about avian flu come as U.N. Secretary-General Kofi Annan today appointed one of the World Health Organization's most senior experts to lead a coordinated global response to a possible pandemic. Dr. David Nabarro -- WHO's top health crisis official -- has led the response within the agency to several potential crisis situations, including malaria, environmental health and food safety.
"The appointment is critical as the world is fast recognizing the risk of an imminent human influenza pandemic and is taking steps to reduce the risk and to get prepared," WHO said in a statement.
WHO said several countries have already joined forces to coordinate preparation. Agriculture ministers from the Association of Southeast Asian Nations began meeting in the Philippines today to discuss measures to curb the avian flu virus in birds. One such measure is the creation of a regional animal health trust fund.
In addition, the United States announced a new International Partnership on Avian and Pandemic Influenza at last month's World Summit in New York. Several countries are joining the effort, with a planning meeting slated Oct. 7-8 in Washington. WHO is also hosting a meeting of all partners on Nov. 7-8 to coordinate the funding needed.