A strain of avian flu known as H5N1 has killed at least 50 people in several Asian nations, including Vietnam and Thailand, and experts fear the virus could become adapted to humans and spread across the globe, similar to the 1918 flu pandemic that killed as many as 50 million people.

The Department of Health and Human Services previously announced plans to stockpile enough vaccine and anti-viral medications for 20 million people, and today's announcement is part of that effort.

HHS said it awarded a $100 million contract to Sanofi Pasteur for a supply of vaccine still being developed that is designed to protect against infection with the H5N1 strain. In addition, GlaxoSmithKline was awarded a $2.8 million contract for 84,300 treatment courses of Relenza, an anti-viral medication that has been shown to be effective against the bird-flu strain.

"These new contracts are part of our aggressive, multi-pronged approach to planning for pandemic influenza," HHS Secretary Mike Leavitt said in a statement. "These countermeasures provide us with tools that we have never had prior to previous influenza pandemics."

Officials do not yet know how many people the vaccine supply would protect. Initial studies indicated it would require at least two 90-microgram doses of the vaccine to induce full protection against the bird flu, but researchers are evaluating whether less vaccine could be just as effective.

Despite the HHS' efforts, the Infectious Diseases Society of America has criticized the government's plan for not being adequate to stop a widespread outbreak of the disease.

Dr. Andrew Pavia, chair of the IDSA's pandemic influenza task force, praised the agency's decision to purchase Relenza, but said "the overall effort is still not adequate." A lot more needs to be done in terms of preparedness, Pavia told United Press International.

Comparing it to the aftermath of Hurricane Katrina, he said it's similar to installing an effective levee system before a storm hits.

"You see the price tags up front and the politicians find reasons to spend the money elsewhere," Pavia said, "but it has to be spent up front or the consequences of a pandemic will be much higher, and it's not a matter of if, but when, a flu pandemic occurs."

Pavia said the HHS' goal of 20 million doses of anti-viral medications "is really not enough to make a significant difference." A minimum effective supply would be enough for treating 40 million people, he said, and ideally more than 100 million treatment courses should be stockpiled.

He said the move to award the vaccine contract will help speed up the development of the inoculation, but there again the target goal of 20 million will be insufficient.

"Ultimately you would want to be able to vaccinate the whole population because historically pandemics come in waves and continue to come in waves," Pavia said. "So you're shooting for 280 or 300 million doses. Twenty million doses would just give you a head start" for vaccinating emergency responders and critical personnel, he said. In the meantime, vaccine product will have to be ramped up, and it can take six months or longer to make flu vaccines.

Dr. Walter Tsou, president of the American Public Health Association, said the HHS announcement was "a step in the right direction" but agreed with Pavia that the government should stockpile more anti-viral medications.

"The ideal level is probably 50 million doses," or 30 million more than the HHS goal, he said.

Tsou added that more emphasis should be placed on having a fast surveillance system to monitor for the first cases of human bird flu in the United States. Efficient use of the vaccine will depend on a rapid response, he said.

"We need to be putting more money in a disease surveillance system so when the first case comes here we're ready to use the vaccine," he said.

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