WHILE THE US GOVERNMENT may stockpile vaccine and antiviral medication, Uncle Sam also wants you to fight any outbreak of pandemic influenza. The “National Strategy for Pandemic Influenza—Implementation Plan,” released in early May by the US Homeland Security Council, sets out the federal government’s actions in the event of a potential pandemic, along with the roles of state and local governments, public health agencies, physicians, hospitals, businesses, and citizens. While those who will fight a pandemic from the trenches think the government’s plan is sensible, they are concerned that federal funding is too low to provide for the local response. “There is recognition in the plan that communities and states, in many ways, are going to be on their own,” said Patrick Libbey, executive director of the National Association of County & City Health Officials. “We don’t find that discouraging, but the plan does not go far enough financially.” According to the implementation plan (http://www.whitehouse.gov /homeland/nspi_implementation .pdf), the federal government hopes to establish and maintain a stockpile of 20 million doses of vaccine against prepandemic influenza strains that present a pandemic threat (currently the H5N1 variant of avian influenza) and to expand routine domestic influenza vaccine manufacturing to be able to produce vaccines for the entire US population within 6 months of a pandemic declaration. The government would also expand stockpiles of antiviral medication to treat 75 million people, or 25% of the US population, plus 6 million courses of antiviral therapy to be used for containment of initial outbreaks. The plan lays out federal government preparation and response; international efforts; transportation and border control issues; protection of human and animal health; law enforcement, including public safety and security; and institutional considerations to ensure continuity of government and business operations and maintenance of critical infrastructure. It also presupposes that up to 40% of employees will miss work for up to 2 weeks at the height of an outbreak and that between 200 000 and 2 million people will die due to influenza-related causes. In January, to jump-start national readiness, Congress appropriated $3.8 billion in pandemic funds. Of this, about $3.4 billion is earmarked for vaccine and antiviral drug activities, leaving only about $350 million for readiness programs at the local level. “When you start with a plan, you start with resource commitment,” Libbey said. “It is extremely important that we improve our vaccine production, but what good is it if you don’t have the resources at the local level to quickly inoculate the public?” Georges C. Benjamin, MD, executive director of the American Public Health Association, also wants additional funding at the local level: “I’d like to see more investment in the communities—more dollars forplanning, for thinking through the material the government has put out.” But Benjamin thinks the federal plan is the “next logical step” following President Bush’s call in November for a national strategy addressing pandemic influenza. “This plan integrates all the federal agencies and allows one to see what they will do in case of the pandemic,” Benjamin said. “Of course the devil is very much in the details as to how this plan will be implemented.” James Bentley, PhD, senior vice president with the American Hospital Association, agrees the plan’s delineation of the responsibilities of the individual agencies is helpful. “It allows all of us to know . . . which agency will answer which questions and lays out a time frame for getting things done,” he said. So how will the various constituencies at the local level coordinate their plans for pandemic influenza? Libbey said it is appropriate that local public health officers get the ball rolling to