Associated Press Writer

By KEVIN FREKINBy KEVIN FREKING

WASHINGTON - Seven states have yet to participate in a federal program to buy antivirals for a potential influenza pandemic. Thirteen states do not have adequate plans to distribute vaccines and medical supplies from the Strategic National Stockpile.

Those findings and others are part of a new report on how well states have prepared for public health emergencies. The report concluded that states have made significant progress since the terrorist and anthrax attacks in 2001. However, critical gaps remain.

Seven states performed adequately in each of the 10 categories that were measured, which earned them a score of 10 from the Trust for America's Health, a research group. The top scores went to Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia.

The states that got the lowest score were Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming.

The report said North Dakota has met seven of 10 steps that indicate progress in preparing for public health emergencies, including emergency preparedness exercises and lab capability to test for biological threats. But North Dakota is among 21 states without enough legal protection from liability for health care volunteers, and one of seven states that have not purchased their share of antivirals, the report said.

Tim Wiedrich, chief of the North Dakota Health Department's emergency preparedness and response section, said state officials believe North Dakota's volunteers already are protected from liability. As for antivirals, he said the state has been waiting for children's doses to be available.

"The funds have been appropriated. We are in the process of making the purchase," Wiedrich said Tuesday. The state will spend about $2 million for the antivirals, he said.

Wiedrich also said the trust plans to upgrade North Dakota's score to eight instead of seven, because the state's plan for dispensing medical supplies has since been reviewed by the federal Centers for Disease Control and Prevention.

The criteria in the national assessment changes each year, he said.

"There really is controversy over whether these are or are not good indicators of preparedness," he said.

The federal government has had a difficult time measuring progress when it comes to the billions of dollars it has sent states over the past six years to improve preparedness. The money went to upgrade laboratories, buy medical supplies and conduct training exercises.

The Bush administration has encouraged states to stock up on antivirals in the event of an influenza pandemic. Under one program, the federal government will pay for a quarter of the cost of buying Tamiflu or Relenza, and states pay the remainder for a combined investment of about $680 million. Antivirals reduce the severity of influenza.

Seven states have so far declined to purchase any antivirals, according to the report: Colorado, Connecticut, Florida, Massachusetts, Mississippi, North Dakota and Rhode Island. Several more have bought only a fraction of what they're entitled to under the federal program.