One of the ironies that has resulted from more efficient management of manufacturing and supply chains in modern enterprise is that the very efficiency becomes a double-edged sword. The advent of information systems technology, and the use of that technology to manage manufacturing, transportation, delivery and inventory control is resulted in a Just In Time (JIT) management system. The effect of that system wrings out any ability to surge needed materials on an emergency basis. Hurricane Katrina demonstrated the vulnerability of the modern JIT system.
How does JIT affect our potential response to a pandemic flu situation? The New England Journal of Medicine identifies our current model of manufacture and supply as a major issue in our ability to respond to a pandemic flu situation. In the case of pandemic flu, the JIT system is even more disadvantaged because of a cumbersome and outdated system of pharmaceutical manufacture.
Bottom line: There are extraordinarily difficult systemic issues to be addressed if we are to mount a societal response to major disasters, including pandemic flu, unless we take a much more active role in involving private industry in the process of planning. This partnership is very much in its infancy and should be made a much higher priority in government planning--and given the nature of emergency response planning, this has to be accomplished at the federal level.