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Of 21 national plans examined, seven don't mention the role of veterinary services, many don't include a strategy for containing an original outbreak and fewer than half address how to maintain essential services in the event of a pandemic, according to the study, by the London School of Hygiene and Tropical Medicine.

Titled "How Prepared Is Europe for Pandemic Influenza?" the study is due to be published in a coming issue of the Lancet. A draft dated February 2006 was reviewed by The Wall Street Journal. The study's methodology has already attracted criticism, and there may be changes in the published version. The report's authors declined to provide the most recent version before publication.

The authors, Sandra Mounier-Jack and Richard Coker, tested the national plans against 169 criteria laid out by the World Health Organization, including how antiviral drugs and vaccines would be distributed and to whom they would be given and whether restrictions would be placed on international travel.

The study scores countries according to how many of the WHO criteria their plans include. Overall country scores in the draft range from more than 80% to under 30%, with a European average of 54%. France, the Netherlands, the United Kingdom and Germany top the list, while Italy, Portugal and Lithuania bring up the rear.

The study, which was funded by Swiss drug maker Roche Holding AG, also addressed what percentage of certain countries' populations would be covered by their stockpiles of antiviral drugs, such as Roche's Tamiflu. The authors said there was a "strong correlation" between those countries that scored well and those that had large stocks of antiviral drugs.

The draft study singled out France and the Netherlands as having enough antivirals to cover 53% and 30% of their populations, respectively, while one unspecified country had coverage as low as 2%.
The study is likely to prove sensitive among European governments, which could encounter domestic political pressure for failing to prepare adequately for an epidemic. It already prompted debate at a recent meeting of Europe's top public-health officials in Vienna, where the study's findings were presented.
"It doesn't look too good for some of the countries," says Gudjon Magnusson, a director at the WHO's regional office in Copenhagen, who was in Vienna and reviewed the report. He said critics pointed out that the researchers reviewed only published bird-flu plans, potentially missing national legislation that deals with disasters without specifically referring to bird flu.

Concerns also were raised in Vienna that the authors had overlooked plans that had been updated or released more recently. The draft study only included plans published through November 2005, while bird flu arrived in Europe in force over the past few months. Previously it had spread from Asia as far west as the Balkans.

Roche's role as a source of funding for the research raised some eyebrows in Vienna. But Ms. Mounier-Jack said Roche's backing didn't represent a conflict of interest, and that the aim was for "countries to learn about each others' strengths." Dr. Coker added that funding from the private sector was important to this research because "individual countries aren't going to fund this," referring to the research as "very sensitive."

In a recent two-page opinion piece in the European Journal of Public Health, Ms. Mounier-Jack and Dr. Coker wrote that marked differences in the amount of antiviral drugs stockpiled in different countries raised questions about the role of the European Union in coordinating a response to the possible health threat.

Scientists and public-health officials have been warning for years that a particularly lethal strain of avian influenza, which has emerged in recent years, could quickly mutate into a form that spreads easily among humans and spark a global pandemic. Those worries have prompted governments around the world to prepare for a possible outbreak.

So far, the strain, H5N1, has killed at least 109 people in nine countries since late 2003. Most, if not all, of those people appear to have contracted the disease from birds. So far, H5N1 hasn't developed into a major health threat for humans.

Some health officials point out the difficulties of using written plans to generalize about a country's level of preparedness for a pandemic.

"It's like looking at the wiring diagrams of a Maserati and a Ferrari, and looking at which one handles better on the road without turning on the ignition," said Angus Nicoll, influenza coordinator for the European Centre for Disease Prevention and Control in Stockholm, who was sent an early draft of the study for review. However, he called the study "a useful piece of work."

Ben Duncan, a spokesman for the center, added that some new member states of the European Union "are, in fact, much better prepared than Coker's study suggests."