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RENEE MONTAGNE, host:

It's MORNING EDITION from NPR News. I'm Renee Montagne. The outbreak of swine flu has spotlighted the fact that the Obama administration has yet to fill any of the top spots at the Department of Health and Human Services. The Senate today is set to take up the nomination of Kansas Governor Kathleen Sebelius to be HHS secretary. That vote has been held up by Republicans concerned primarily about her views on abortion. But as NPR's Julie Rovner reports, in the flu fight, the department seems to be doing OK without much political oversight so far.

JULIE ROVNER: More than 65,000 people work in the Department of Health and Human Services, not just in its main office in Washington, but at the Centers for Disease Control and Prevention in Atlanta, and the Food and Drug Administration in Maryland. But right now, the agency is lacking most of its highest-level political appointees.

Mr. JEFF LEVI (Trust for America's Health): We don't have a confirmed secretary. We don't have a confirmed deputy secretary. We don't have an appointed CDC director. We don't have a confirmed FDA commissioner.

ROVNER: Jeff Levi heads the Trust for America's Health, an advocacy group for disease prevention. He says the good news is that when it comes to dealing with the swine flu outbreak, the people who are staffing the department, the doctors and scientists at the CDC, for example, are doing just fine.

Mr. LEVI: I think this is an instance where the career people are really carrying out the policy and the planning that's been under way for many years, and they're executing it in a wonderful way.

ROVNER: Much of that policy and planning took place during the Bush administration, part of a multibillion-dollar effort to prepare for a possible bird flu pandemic. But the Obama administration gets some credit, too, says Levi, for choosing which career people to put in charge for now.

People like Richard Besser, the acting head of the CDC, who was already leading the agency's emergency preparedness program.

Mr. LEVI: I think the administration was very clear, when they came in, that one of the things they need to be most concerned about was if there was an emergency of this kind, would the right people be in charge? And I think that that's one of the reasons that Dr. Besser was chosen.

ROVNER: The lack of political leaders at HHS is also offset somewhat by the fact that responsibility for emergencies like these is shared with the Department of Homeland Security, which does have a confirmed secretary, former Arizona Governor Janet Napolitano.

Bioterrorism expert Eric Toner, of the University of Pittsburgh, said that Napolitano and acting CDC Director Besser made a formidable team at their premiere White House briefing on Sunday.

Dr. ERIC TONER (Center for Biosecurity, University of Pittsburgh): They explained very complicated issues in a very understandable way. They were calm, they were reassuring - but not overly so. They stressed the serious nature of the outbreak, but without scaring people. I think they were pitch perfect. They got it just right.

ROVNER: Moving forward from here, however, Jeff Levi says it will be important for HHS to get its political appointees settled in so they can go about things like asking Congress for more money.

Mr. LEVI: We're still $870 million short on the original estimate for what would be needed to build our research and development capacity for a pandemic. We have not given money to state and local health departments since fiscal year 2006 to support their pandemic preparedness.

ROVNER: In fact, that $870 million was included in the House version of the economic stimulus bill last winter, but it was dropped at the insistence of Senate Republicans like Maine's Susan Collins. Here's how she put it in February.

Senator SUSAN COLLINS (Republican, Maine): Everybody in the room is concerned about a pandemic flu, but does it belong in this bill? Should we have $870 million in this bill? No, we should not

ROVNER: A statement issued by Senator Collins' office on Monday pointed out that she's been a longtime backer of additional money for pandemic flu planning, but that she wanted the funding to go through the regular budget process. And bioterrorism expert Eric Toner says that if the additional money really does become necessary to deal with the current outbreakā€¦

Dr. TONER: I think they can find a way to do that.

ROVNER: Collins, meanwhile, chided the administration for not filling its HHS vacancies faster, and urged her Senate colleagues to confirm Kathleen Sebelius as HHS secretary. That's expected later today.

Julie Rovner, NPR News, Washington.

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