Monday, October 18, 2004
international papersOutsourcing the VoteWho the world wants to elect president on Nov. 2.By Carl SchragPosted Monday, Oct. 18, 2004, at 9:37 AM PT
Newspapers around the world paid particular attention to the results of a coordinated poll that measured how people who can't vote on Nov. 2 hope to see the U.S. presidential race end. One paper went a few steps further by providing step-by-step instructions in how to influence the American election's results.
A consortium of 10 newspapers conducted parallel polls of the people in their countries, asking who they would like to see win in the race between President George Bush and Sen. John Kerry. In eight out of the 10 countries, Kerry won. (For tables of the questions asked and each country's responses, click here.)
The Age of Australia reported that "voters" Down Under mirrored the average of respondents in the nine other countries (Canada, Britain, France, Spain, South Korea, Japan, Israel, Russia, and Mexico):
Fifty-four per cent of Australian voters would prefer to see John Kerry in the White House—a figure that exactly matches the average of the 10 surveys.
Sixty-five per cent of Australians have an unfavorable view of Mr. Bush. Just 28 per cent would prefer him to win on November 2. The averages across the 10 nations were 63 per cent and 27 per cent respectively.
Millions of undecided American make this race a cliffhanger, but the world does not seem to suffer from any such indecision. Only in Russia were the results of the poll within the margin of error; 52 percent of Russians polled said they want Bush to win, while 48 percent preferred Kerry. Kerry has the solid support of respondents in eight of the nine other countries that participated in the project. The lone state to rally for Bush was Israel, where 50 percent said they prefer the president and 24 percent supported Kerry.
Ha'aretz of Israel assessed why Israel is so far out of synch with the rest of the world. While others may resent Bush's domineering role on the international scene, Israelis appreciate the support he has offered. Bush "supports Israel's struggle against Palestinian terror and holds Yasser Arafat responsible, whether passively or actively; at the same time, he presents a vision of an agreement with a moderate and democratic Palestinian state," the paper said. "To other countries, Iraq may look like an unnecessary entanglement. To Israel, it means the removal of a serious threat."
As part of the package of stories circulated by the 10 polling papers, the Age ran a roundup of interpretations of the results in each country. Some highlights:
Britain: "[O]nly one in four British voters says they have a favorable opinion of the American President."
South Korea: "93 per cent of Koreans surveyed said they believed in the importance of good Korea-US relations, but 67 per cent said the current relationship was worrying."
France: "It could not be more clear: 72 per cent of the French population wishes for John Kerry's victory at the US presidential election, while the incumbent is backed by only 16 per cent. France rejects President George Bush more than any other country."
Israel: "Israel loves America and loves the American President. It loves George Bush, but it also loved Bill Clinton very much. … It loves the American president because he holds the umbrella that protects Israel from its enemies."
The Guardian of Britain wasn't satisfied with merely polling British sentiments about the upcoming U.S. election. It launched an ambitious project aimed at showing Brits how they can play a pivotal role in determining the outcome. Dubbed the Clark County Project, the paper has targeted one of the most hotly contested counties in the key battleground state of Ohio and is offering readers the names and addresses of registered voters. "Writing to a Clark County voter is a chance to explain how US policies effect you personally, and the rest of the world more generally, and who you hope they will send to the White House," the paper told its readers.
Anticipating the cries of meddling, a Guardian columnist argued that the Declaration of Independence foreshadows the right of the world to have a say in this election. It "excoriate[s] the distant emperor George for his recklessness, insisting that authority is only legitimate when it enjoys 'the consent of the governed.' As the world's sole superpower, the US now has global authority. But where is the consent?"
Thousands of Britons have joined the effort, but if the sampling of replies published in the pages of the Guardian is representative of how the good citizens of Clark County are taking the British attention, the effort may backfire. One American Democrat summed it up, writing, "Nothing will do more to undermine the Democratic cause in Ohio than having patronizing Brits wander around Clark County telling people how to vote."Carl Schrag, formerly the editor of the Jerusalem Post, is a writer and lecturer.Article URL: http://slate.msn.com/id/2108332/
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Newspapers around the world paid particular attention to the results of a coordinated poll that measured how people who can't vote on Nov. 2 hope to see the U.S. presidential race end. One paper went a few steps further by providing step-by-step instructions in how to influence the American election's results.
A consortium of 10 newspapers conducted parallel polls of the people in their countries, asking who they would like to see win in the race between President George Bush and Sen. John Kerry. In eight out of the 10 countries, Kerry won. (For tables of the questions asked and each country's responses, click here.)
The Age of Australia reported that "voters" Down Under mirrored the average of respondents in the nine other countries (Canada, Britain, France, Spain, South Korea, Japan, Israel, Russia, and Mexico):
Fifty-four per cent of Australian voters would prefer to see John Kerry in the White House—a figure that exactly matches the average of the 10 surveys.
Sixty-five per cent of Australians have an unfavorable view of Mr. Bush. Just 28 per cent would prefer him to win on November 2. The averages across the 10 nations were 63 per cent and 27 per cent respectively.
Millions of undecided American make this race a cliffhanger, but the world does not seem to suffer from any such indecision. Only in Russia were the results of the poll within the margin of error; 52 percent of Russians polled said they want Bush to win, while 48 percent preferred Kerry. Kerry has the solid support of respondents in eight of the nine other countries that participated in the project. The lone state to rally for Bush was Israel, where 50 percent said they prefer the president and 24 percent supported Kerry.
Ha'aretz of Israel assessed why Israel is so far out of synch with the rest of the world. While others may resent Bush's domineering role on the international scene, Israelis appreciate the support he has offered. Bush "supports Israel's struggle against Palestinian terror and holds Yasser Arafat responsible, whether passively or actively; at the same time, he presents a vision of an agreement with a moderate and democratic Palestinian state," the paper said. "To other countries, Iraq may look like an unnecessary entanglement. To Israel, it means the removal of a serious threat."
As part of the package of stories circulated by the 10 polling papers, the Age ran a roundup of interpretations of the results in each country. Some highlights:
Britain: "[O]nly one in four British voters says they have a favorable opinion of the American President."
South Korea: "93 per cent of Koreans surveyed said they believed in the importance of good Korea-US relations, but 67 per cent said the current relationship was worrying."
France: "It could not be more clear: 72 per cent of the French population wishes for John Kerry's victory at the US presidential election, while the incumbent is backed by only 16 per cent. France rejects President George Bush more than any other country."
Israel: "Israel loves America and loves the American President. It loves George Bush, but it also loved Bill Clinton very much. … It loves the American president because he holds the umbrella that protects Israel from its enemies."
The Guardian of Britain wasn't satisfied with merely polling British sentiments about the upcoming U.S. election. It launched an ambitious project aimed at showing Brits how they can play a pivotal role in determining the outcome. Dubbed the Clark County Project, the paper has targeted one of the most hotly contested counties in the key battleground state of Ohio and is offering readers the names and addresses of registered voters. "Writing to a Clark County voter is a chance to explain how US policies effect you personally, and the rest of the world more generally, and who you hope they will send to the White House," the paper told its readers.
Anticipating the cries of meddling, a Guardian columnist argued that the Declaration of Independence foreshadows the right of the world to have a say in this election. It "excoriate[s] the distant emperor George for his recklessness, insisting that authority is only legitimate when it enjoys 'the consent of the governed.' As the world's sole superpower, the US now has global authority. But where is the consent?"
Thousands of Britons have joined the effort, but if the sampling of replies published in the pages of the Guardian is representative of how the good citizens of Clark County are taking the British attention, the effort may backfire. One American Democrat summed it up, writing, "Nothing will do more to undermine the Democratic cause in Ohio than having patronizing Brits wander around Clark County telling people how to vote."Carl Schrag, formerly the editor of the Jerusalem Post, is a writer and lecturer.Article URL: http://slate.msn.com/id/2108332/
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October 17, 2004
Lower Your Window Shades. Today's Film Is 'The Rookie.'By MICHELINE MAYNARD
S the Civil War burst into full flame, Abraham Lincoln went through one commander after another, searching for a leader to resolve the desperate situation, all while losses were mounting.
Surely, board members at the nation's airlines would sympathize. At a time when the airlines are facing their most difficult challenges in recent history, they are running through one chief executive after another. And as they fire or otherwise lose the old and hire the new, they are left with chief executives who are the least-seasoned industry leaders in decades.
All seven of the major airlines have changed C.E.O.'s since the Sept. 11, 2001, terrorist attacks. The full rotation was completed this month, when Richard H. Anderson left Northwest Airlines for a health care company. What's more, four airlines got new leaders just this year; a fifth, Continental, will do so in January, when Larry D. Kellner is scheduled to succeed Gordon M. Bethune, now the dean of industry chief executives.
The turnover has coincided with bankruptcy filings at US Airways and United Airlines, a unit of the UAL Corporation; the threat of a filing at Delta Air Lines; and a close call at American Airlines, a unit of the AMR Corporation, which avoided having to seek bankruptcy-court protection only by receiving last-minute employee concessions. Over all, the major carriers have shed 100,000 jobs and reported losses of $30 billion in the last four years, with billions more in losses expected this year and next.
The C.E.O. churn shows the depth of the industry's problems - and suggests a paucity of solutions. "This is a picture of an industry in crisis," said John A. Challenger, president of Challenger, Gray & Christmas, the outplacement firm based in Chicago.
Certainly, airlines have not been alone in shuffling top management. So far this year, 516 major companies have changed C.E.O.'s, a Challenger, Gray survey showed.
But few other industries face the kinds of problems found at the major airlines. Their two biggest operating costs - labor and fuel - have been difficult to rein in. They have no power to raise fares because of competition from lower-cost rivals, whose discounted prices are all the more visible as consumers compare fares online. Their debts and pension obligations are crushing. Their very business models are under attack.
Herbert D. Kelleher, who stepped down as chief executive of Southwest Airlines in June 2001 but remains chairman, calls the situation "the denouement of deregulation."
Once Mr. Bethune departs Continental, the longest-serving airline chief executive will be Glenn F. Tilton of United, a former oilman who took charge there in September 2002. Ranking behind him in C.E.O. seniority in the industry is Gerard J. Arpey at American, who has spent 18 months in that job.
The relative lack of experience is a recent phenomenon. Chief executives in the airline business were once like those of many other industries, spending many years rising through the ranks of their companies, then many more years at the top. Mr. Bethune, who came from Boeing, is leaving Continental after 10 years in his job. Robert L. Crandall spent 13 years as chief executive at American before retiring in 1998 after a 25-year career in the industry. And Mr. Kelleher ran his airline for two decades.
"You ask yourself: Why are there so many rookies?" said Michael Useem, a professor at the Wharton School at the University of Pennsylvania. "I guess the impish answer is: You might as well give it a try."
Whether the corner-office quadrille is good or bad is a matter of debate. "On the good side, you'll get some fresh looks" at airlines' problems, said Noel M. Tichy, a University of Michigan professor and the author of "The Cycle of Leadership" and other management books. "On the bad side, mixed in there are probably some rank amateurs who are not going to make it."
The new chief executives acknowledge that they are guiding the industry through uncharted territory. "We're now in a deregulated, e-commerce world," said Douglas M. Steenland, who was named chief executive at Northwest on Oct. 1.
Although he is the rookie among the rookies, Mr. Steenland said he believes he came to the job well prepared, having served as Northwest's president for more than three years before his promotion. Indeed, three of the five newest C.E.O.'s were promoted from within. Mr. Steenland and Mr. Kellner were both presidents, and Gary C. Kelly of Southwest was chief financial officer before he was promoted in July, replacing James F. Parker, who had succeeded Mr. Kelleher.
Mr. Kelleher said he helped to groom Mr. Kelly over the years by making sure that he took on extra duties. But Mr. Kelleher said such training was still no substitute for time spent at the top. "There's always some new little surprise" that a new C.E.O. encounters, he said.
This year's other newcomers - Gerald A. Grinstein at Delta and Bruce R. Lakefield of US Airways - were board members before taking over. Mr. Grinstein ran Western Airlines before it was acquired by Delta in 1986; Mr. Lakefield was a Lehman Brothers executive with no previous airline experience.
Appointing board members rather than promoting executives reflects those airlines' inability to recruit and groom their own successors, Professor Tichy said. "It's not an industry that's attracted the best leadership talent," he said. "Nobody is dying to go work for an airline. You won't get rich on stock options in the airline industry."
In the latest crop of C.E.O.'s, only Mr. Kellner had any chance to anticipate his promotion. It came after a lengthy battle of wills between Mr. Bethune and David M. Bonderman, the chief executive of the Texas Pacific Corporation, the investment firm that was once a major shareholder of Continental. Each agreed to leave the airline's board; Mr. Bethune also agreed to retire.
The other four found out with as little as a few hours' notice that they would be assuming the top positions at their companies. Mr. Steenland said the lack of advance word did not throw him, because he had been working closely with his predecessor. On Thursday, Northwest reached a tentative deal with its pilots' union on $265 million in cuts.
It helps to be picked to run the right airline, of course, one with a clearly defined strategy like that at Southwest when Mr. Kelly took over. Southwest has not deviated from its lean approach or its perky culture since it was founded in the 1970's. For now, that approach has paid off. On Thursday, Southwest beat estimates with a modest third-quarter profit, despite higher fuel costs; that profit will probably be the only one at a major airline this fall.
Mr. Kelly's rivals can only wish for such a debut. At US Airways, Mr. Lakefield is consumed by its second trip through bankruptcy court in two years, and Mr. Grinstein is trying to keep Delta from making its first visit there. While facing challenges like these, C.E.O.'s will also have to decide how to approach employees and the public.
THE macho styles of Mr. Bethune, Mr. Crandall and Mr. Kelleher, which made them business celebrities during the 1990's, could seem jarring at a time when David G. Neeleman, the chief executive of JetBlue, the upstart low-fare airline, is regularly found in an apron serving snacks to passengers and hauling trash. Moreover, experience in bankruptcy court is now as valuable in the industry as time spent running an airline.
"You do need different leadership styles, according to the era, the challenge, the contingency," Professor Useem said.
For, as President Lincoln discovered, it sometimes takes the challenge of being in charge to reveal hidden abilities. Once Ulysses S. Grant finally was put in overall command of the Union Army, he brought the Civil War to a close, albeit a bloody one. Whether the new airline generals will prove as successful remains to be seen.
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October 17, 2004
Pierre Salinger, Kennedy Aide, Dies at 79By THOMAS J. LUECK
ierre Salinger, the spokesman for the Kennedy White House who later became a European correspondent for ABC News, died yesterday at a hospital near his home in Le Thor, France. He was 79.
Mr. Salinger had been in declining health for four years and died of heart failure, said a longtime associate, Elizabeth Bagley, an ambassador to Portugal under President Bill Clinton. Ms. Bagley said she learned of Mr. Salinger's death from his wife, Nicole, the operator of a bed-and-breakfast in Le Thor, in Provence.
Mr. Salinger, a native of San Francisco who was regarded as a child prodigy on the piano, spent the early years of his career as a print journalist, working for The San Francisco Chronicle and as a contributing editor for Collier's magazine. His research in 1956 for articles on James Hoffa led him to a close association with Robert F. Kennedy, who hired Mr. Salinger as a legal counsel for the Senate Select Committee investigating organized crime.
At Mr. Kennedy's urging, Mr. Salinger became press secretary to John F. Kennedy, who was then a member of the Senate. Mr. Salinger worked on Kennedy's presidential campaign in 1960, and was appointed White House press secretary after the election.
Mr. Salinger's appointment came as the pervasive influence of television was becoming clear in politics and world affairs, and he assumed an unusually powerful role for a press secretary. He accompanied Kennedy to conferences with other world leaders, including the 1961 meeting with Khrushchev in Vienna, and was dispatched by the president to Moscow the following year to confer directly with Soviet leaders.
An affable cigar smoker, Mr. Salinger demonstrated an ability throughout his career to engage a broad spectrum of personalities on the world stage. It was an ability that served him well when he returned to journalism as a television correspondent.
"He had the biggest network of people I have ever seen," said Ms. Bagley, who worked under Mr. Salinger as an ABC News producer in 1980. "It was simply amazing what he could find out because he knew so many people."
After Kennedy was assassinated in 1963, Mr. Salinger continued as White House press secretary for several months under President Lyndon B. Johnson.
He resigned in 1964 to run for the Senate from California. After winning the Democratic primary, he was appointed to fill the Senate seat when Senator Claire Engle died. But Mr. Salinger was defeated in the 1964 general election by George Murphy, a Republican.
Mr. Salinger, whose mother was a native of France, and who had been fluent in French since childhood, spent much of the next 30 years as a journalist in France and England. His first post in France was as a correspondent for L'Express, the French magazine. He then became a French correspondent and later Paris bureau chief for ABC News.
As a television newsman, Mr. Salinger delivered months of detailed reporting on the Iranian hostage crisis of 1979 and 1980, and on the release of the American hostages.
The latter days of his career took a strange turn, however, when Mr. Salinger claimed to have a secret document showing that "friendly fire" from a United States Navy ship was responsible for the downing of Trans World Airlines Flight 800 off Long Island in 1996. The claims were widely publicized and immediately disputed by federal authorities. The document turned out to be an Internet posting that had been long discredited by the Federal Bureau of Investigation.
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October 17, 2004
With Few Suppliers of Flu Shots, Shortage Was Long in MakingBy DENISE GRADY
his article was reported by Denise Grady, Lizette Alvarez, Gardiner Harris and Andrew Pollack and was written by Ms. Grady.
Scene by disheartening scene, the spectacle of a severe shortage of flu vaccine is unfolding around the country.
Last week, elderly and chronically ill people waited in line for hours to get flu shots; some were turned away. One died, after hitting her head when she passed out or fell while waiting. Price gougers demanded $800 for $60 vials of vaccine. States threatened to fine or jail doctors and nurses who gave shots to anyone not in the high-risk groups. Congress, the Justice Department and the Securities and Exchange Commission began investigations into how the nation has been left, on the brink of flu season, with half the flu vaccine it needs.
The shortage caught many Americans by surprise, but it followed decades of warnings from health experts who said the nation's system for vaccine supply and distribution was growing increasingly fragile.
"We're in the middle of a crisis that could have been averted,'' said Dr. Irwin Redlener, associate dean of the Mailman School of Public Health at Columbia University and director of its national center for disaster preparedness.
In particular, public health experts have long cautioned against the country's dependence on a few vaccine makers, and yet this has become standard practice. There are now only two major manufacturers for the nation's supply of flu vaccine, and at least a half-dozen other vaccines are made by single suppliers. Britain, by contrast, has spread its order for flu vaccines among five suppliers, precisely to avoid the kind of predicament America now faces.
In recent years there have been many significant disruptions of vaccine supplies. Between November 2000 and May 2003, there were shortages of 8 of the 11 vaccines for childhood diseases in the United States, including those for tetanus, diphtheria, whooping cough, measles, mumps and chicken pox. There have been flu vaccine shortages or miscues for four consecutive years.
In recent decades, many drug companies in the United States abandoned the manufacture of vaccines, saying that they were expensive to make, underpriced and not profitable enough. Flu vaccine can be a particular gamble, because the demand for it varies from year to year and companies throw away what they do not sell because a new vaccine must be made each year to deal with changing strains of the virus. Some companies dropped out because of lawsuits, and others because they determined that it would not pay to retool aging vaccine plants to meet regulatory standards.
The government did little to stop companies from quitting the business, and in some cases may have created policies that made matters worse. A report last year by the Institute of Medicine, a unit of the National Academy of Sciences, noted that 30 years ago, 25 companies made vaccines for the United States, whereas today there are 5.
Dr. Jesse Goodman, director of the branch of the Food and Drug Administration that oversees vaccines, acknowledged that it was risky to have only one or two suppliers for products so essential for public health. "The more quality, licensed manufacturers we have, the more protected the system is if a problem occurs with one of them," he said.
The heart of the problem, experts say, may be that no one person or agency is in charge of making sure the United States has an adequate vaccine supply. The production, sale and distribution of vaccines, particularly those for flu, are handled almost entirely by pharmaceutical companies.
When companies began to leave the market, Dr. Redlener said, government health officials should have tried to find ways to keep them in it, in order to avoid shortages and dependence on too few suppliers.
Bill Pierce, a spokesman for Health and Human Services Secretary Tommy G. Thompson, acknowledged that vaccine supplies in the United States were vulnerable to disruptions. But he blamed years of neglect by previous administrations.
Mr. Thompson has made fixing the system a priority, Mr. Pierce said. The administration has increased financing for handling the flu, including considerably more money for research into more reliable manufacturing techniques for vaccines, and has also explored measures to lure more manufacturers into making flu vaccine, he said.
The government cannot force companies to make vaccines, however. Legally, of course, manufacturers are free to quit the business. But, Dr. Redlener said, "When there is a vital public health issue at stake here like protection against the flu, that's not good enough." The government, he added, "had an ethical obligation to work with manufacturers."
A Shortage and an Apology
Influenza can be dangerous. It kills 36,000 people a year in the United States and puts about 200,000 in the hospital. The very old, the very young and people with chronic illnesses are particularly likely to become severely ill from the flu, and in recent years health officials have recommended wider use of the vaccine. The message seems to be reaching the public: demand for the vaccine has grown greatly in the past decade, to more than 85 million doses a year in 2003 from around 20 million in the early 90's.Just as people had begun to appreciate the value of flu shots, the worst vaccine shortage yet struck. It was announced on Oct. 5, when bacterial contamination led British regulators to suspend the license of a vaccine plant in Liverpool on which the United States was depending for 46 million to 48 million doses, nearly half of America's supply. The plant is owned by Chiron, an American company.
A second supplier, Aventis Pasteur, with a plant in Pennsylvania, is providing about 55 million doses, and a third, Medimmune, 2 million doses of vaccine in the form of a nasal spray - but that still leaves the nation with only about half the vaccine it needs.
At a news conference on Tuesday, the director of the Centers for Disease Control and Prevention, Dr. Julie L. Gerberding, apologized for the vaccine shortage, but had little to offer the public beyond a plea to people who get sick to stay home and cover their mouths when they cough.
"We're sorry for the people who need flu vaccine and may not be able to get it this year," Dr. Gerberding said. "That's disappointing for all of us."
Regulatory Obstacles
The problems this year are not a surprise. Indeed, on Sept. 28, exactly one week before Chiron's license was suspended, the Government Accountability Office offered a prescient warning of potential disruptions in the flu vaccine supply.
With few suppliers, the report said, if one's production was cut off there would be great imbalances, with some providers unable to vaccinate even those at highest risk and others able to hold mass immunization clinics even for people at low risk.
The report said that even though the disease control centers had begun monitoring the projected supply of flu vaccine more aggressively since the shortages of 2000, "there is no system in place to ensure that seniors and others at high risk for complications receive flu vaccinations first when vaccine is in short supply."
One reason companies have given up making vaccine, industry officials and other experts say. is the difficulty in meeting regulations for quality control and safety. A change in the approach to regulating vaccine production might also have contributed to problems in meeting the standards.
In the 1990's, contamination of blood products by the AIDS virus and other incidents led to criticism of the agency's inspections of so-called biologic products, which are made from living cells. In the late 90's the agency tightened its inspections of factories making biologics.
The new system, which took effect for vaccines in 1999, led to more compliance violations and contributed to the spate of shortages in pediatric vaccines that began in 2000, according to a 2002 report by the General Accounting Office, now known as the Government Accountability Office.
Older factories have had particular trouble meeting standards, experts say.
"Over time the barriers to make vaccines and stay in this business have gone up, but the prices for old vaccines haven't gone up that much," said J. Leighton Read, the founder of Aviron, the company that developed the nasal spray flu vaccine.
The Warner Lambert factory in Rochester, Mich., had made Fluogen flu vaccine for at least 20 years, but had increasing problems complying with government rules in the 90's. In 1998, the company decided to quit the business and sold the factory to King Pharmaceuticals in Bristol, Tenn. But the F.D.A. continued to find violations, including some it considered so serious that it shut down the plant twice in 2000. After the second time, King said it would stop making Fluogen rather than commit more money to trying to bring the plant into compliance.
King did not return calls seeking comment.
Dr. Peter Paradiso, vice president for medical affairs at Wyeth, said his company ended production of its FluShield vaccine in 2002 because the company sold only half the 20 million doses that it manufactured every year. It was forced to throw out the remaining 10 million doses, he said.
Worse, he said, the new federal regulations would have required the company to spend huge sums upgrading its facilities. With little or no profit projected, the company quit making flu vaccine.
But Dr. Goodman of the F.D.A. defended its policies, saying that they were the "gold standard" for safety worldwide and that if companies could not measure up or chose not to, it might be better for them to pull out.
What Happened at Chiron
Chiron acquired the Liverpool factory in 2003 through its purchase of PowderJect Pharmaceuticals, a British company, for $878 million. Chiron, which sold vaccines mainly overseas, saw the acquisition as a chance to vastly expand its vaccine business, particularly in the American market.
Howard Pien, the chief executive of Chiron, said that with two manufacturers having dropped out of the American flu vaccine business, the company saw a need for more vaccines in the United States and a good business opportunity.
But the factory was aging and had been through a series of owners, and it had also had some quality control problems. Still, Chiron rapidly expanded production there. It was planning to ship more than 50 million doses of flu vaccine to the United States this year, compared with 26 million in 2002, the year before it bought the factory.
But Chiron said it would invest $100 million to upgrade the factory.
In June 2003, just as Chiron was buying the factory, an F.D.A. inspection found quality control problems similar to what the British government found this year: bacterial contamination in vaccine in the early production stages but not in the final product after sterilization.
F.D.A. officials have said the problems were corrected to their satisfaction, and they let the plant continue to operate. But one question likely to be raised by Congressional investigators is why the British found problems so soon after the agency had deemed them resolved.
Chiron announced on Aug. 26 that during routine testing it had found bacterial contamination in a small number of lots of flu vaccine that should have been sterile, a more serious contamination than what the agency had found a year earlier. It said it would delay shipping vaccine until early October and cut its supply forecast from about 50 million doses to between 46 and 48 million. Both the F.D.A. and its British counterpart, the Medicines and Healthcare Products Regulatory Agency, were informed.
Chiron began its own investigation and also began holding weekly conference calls with officials at the F.D.A. and the disease control centers to report on its progress.
In written testimony to the House Committee on Government Reform on Oct. 8, Mr. Pien said Chiron had completed its internal investigation on Sept. 27. The results, he said, confirmed that the contamination was limited to the initial lots identified. Indeed, on Sept. 28, a confident Mr. Pien told a Senate committee that Chiron expected to start shipping the vaccine in early October.
But British regulators visited the factory again and on Oct. 5 suspended its license, saying it was not being operated in accordance with regulations on good manufacturing practice. Only after the suspension was the nature of the contamination revealed: it was a type of bacteria called serratia, which, though found in the environment and usually not harmful there, can cause illness if injected into the body, especially in a frail elderly person or someone chronically ill.
The bombshell reached Chiron's California headquarters at 3 a.m. Company executives than called and awoke officials in Washington, who have said they were also shocked.
Chiron has said it is now under investigation by federal prosecutors in New York and by the Securities and Exchange Commission. The investigations are apparently concerned with whether the company misled investors and federal health authorities about the conditions at its factory. The company, while saying it would cooperate with the investigations, has denied any deception.
"Chiron did not at any time mislead public health stakeholders or the public," Mr. Pien said in written testimony to the House. He added, "The results of Chiron's internal investigations confirmed our belief that our product was safe."
But inspectors from both Britain and the F.D.A. disagreed, saying they could not be confident that Chiron had identified all the sources of contamination. On Friday, health officials in the United States said that none of the vaccine in the plant could be salvaged.
The remaining question is whether Chiron can repair its problems in time to prepare sterile vaccine for next year's flu season. The company has said it expects to do so.
Dr. Goodman said "a lot of hard work on their part" would be needed. But, he added, "I think they are serious about this business, and from everything I've heard I expect they will be eager and effective about addressing these things."
But he and other government officials said they were also looking for other sources of flu vaccine for next year.
Solutions
Many experts say one way to avert vaccine shortages is to charge more for vaccines, so that more companies will want to produce them. To some extent, that was already starting to happen. Aventis Pasteur, now the major source of flu vaccine in the United States this year, noted that prices for flu vaccines have been rising steadily in recent years and are likely to be higher next year. In 1996, they sold for $1.80 a dose. The list price this year is $8.50.
Several companies, including GlaxoSmithKline and ID Biomedical, a Canadian company, have said they hope to begin selling flu vaccines in the United States soon. Dr. Goodman said the F.D.A. was encouraging some foreign manufacturers to apply for licensing here.
Dr. Robert B. Belshe, director of the center for vaccine development at Saint Louis University, said many experts in infectious diseases and vaccination believe that ultimately, the only way to control influenza will be to vaccinate nearly all school-age children every year.
If the medical profession does make that recommendation, and the public follows it, there will be a greater need than ever for vaccines - and possibly a more stable market to tempt manufacturers.
Government health officials said in interviews that they would propose other ways to avert vaccine shortages to Congress within weeks. Among the possible initiatives, said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, are measures to guarantee that the government will buy a certain amount of vaccine each year, buy larger vaccine stockpiles and increase research into different ways to make the vaccines.
The disease control centers this year for the first time bought 4.5 million doses of flu vaccine for $40 million as an emergency reserve. It was not nearly enough, acknowledged Dr. Bruce Gellin, director of the National Vaccine Program Office. The government may buy a bigger reserve next year, he said.
But flu reserves can be expensive. Unlike reserves for other vaccines, which can be held for years and refreshed with new product, a flu vaccine reserve must be used or thrown away and replaced every year.
Dr. Fauci said the Bush administration had increased financing for research and other efforts to fight flu to $283 million this year, from $47 million in fiscal year 2002. Among the initiatives is a $60 million effort to develop new ways to manufacture flu vaccines, which are currently made in a laborious process that requires the use of hundreds of thousands of eggs.
But those sums are small compared with what the nation plans to spend on vaccines against diseases that the government fears terrorists might use. William Schaffner, chairman of the department of preventive medicine at Vanderbilt Medical School in Nashville, noted that the Bush administration last year promised to spend $5.6 billion to help develop vaccines for anthrax and other biological agents.
"They're creating a very expensive program against diseases that don't exist anywhere in the world," Dr. Schaffner said. "What we need is an adult immunization program for diseases that kill tens of thousands every year."
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With Few Suppliers of Flu Shots, Shortage Was Long in MakingBy DENISE GRADY
his article was reported by Denise Grady, Lizette Alvarez, Gardiner Harris and Andrew Pollack and was written by Ms. Grady.
Scene by disheartening scene, the spectacle of a severe shortage of flu vaccine is unfolding around the country.
Last week, elderly and chronically ill people waited in line for hours to get flu shots; some were turned away. One died, after hitting her head when she passed out or fell while waiting. Price gougers demanded $800 for $60 vials of vaccine. States threatened to fine or jail doctors and nurses who gave shots to anyone not in the high-risk groups. Congress, the Justice Department and the Securities and Exchange Commission began investigations into how the nation has been left, on the brink of flu season, with half the flu vaccine it needs.
The shortage caught many Americans by surprise, but it followed decades of warnings from health experts who said the nation's system for vaccine supply and distribution was growing increasingly fragile.
"We're in the middle of a crisis that could have been averted,'' said Dr. Irwin Redlener, associate dean of the Mailman School of Public Health at Columbia University and director of its national center for disaster preparedness.
In particular, public health experts have long cautioned against the country's dependence on a few vaccine makers, and yet this has become standard practice. There are now only two major manufacturers for the nation's supply of flu vaccine, and at least a half-dozen other vaccines are made by single suppliers. Britain, by contrast, has spread its order for flu vaccines among five suppliers, precisely to avoid the kind of predicament America now faces.
In recent years there have been many significant disruptions of vaccine supplies. Between November 2000 and May 2003, there were shortages of 8 of the 11 vaccines for childhood diseases in the United States, including those for tetanus, diphtheria, whooping cough, measles, mumps and chicken pox. There have been flu vaccine shortages or miscues for four consecutive years.
In recent decades, many drug companies in the United States abandoned the manufacture of vaccines, saying that they were expensive to make, underpriced and not profitable enough. Flu vaccine can be a particular gamble, because the demand for it varies from year to year and companies throw away what they do not sell because a new vaccine must be made each year to deal with changing strains of the virus. Some companies dropped out because of lawsuits, and others because they determined that it would not pay to retool aging vaccine plants to meet regulatory standards.
The government did little to stop companies from quitting the business, and in some cases may have created policies that made matters worse. A report last year by the Institute of Medicine, a unit of the National Academy of Sciences, noted that 30 years ago, 25 companies made vaccines for the United States, whereas today there are 5.
Dr. Jesse Goodman, director of the branch of the Food and Drug Administration that oversees vaccines, acknowledged that it was risky to have only one or two suppliers for products so essential for public health. "The more quality, licensed manufacturers we have, the more protected the system is if a problem occurs with one of them," he said.
The heart of the problem, experts say, may be that no one person or agency is in charge of making sure the United States has an adequate vaccine supply. The production, sale and distribution of vaccines, particularly those for flu, are handled almost entirely by pharmaceutical companies.
When companies began to leave the market, Dr. Redlener said, government health officials should have tried to find ways to keep them in it, in order to avoid shortages and dependence on too few suppliers.
Bill Pierce, a spokesman for Health and Human Services Secretary Tommy G. Thompson, acknowledged that vaccine supplies in the United States were vulnerable to disruptions. But he blamed years of neglect by previous administrations.
Mr. Thompson has made fixing the system a priority, Mr. Pierce said. The administration has increased financing for handling the flu, including considerably more money for research into more reliable manufacturing techniques for vaccines, and has also explored measures to lure more manufacturers into making flu vaccine, he said.
The government cannot force companies to make vaccines, however. Legally, of course, manufacturers are free to quit the business. But, Dr. Redlener said, "When there is a vital public health issue at stake here like protection against the flu, that's not good enough." The government, he added, "had an ethical obligation to work with manufacturers."
A Shortage and an Apology
Influenza can be dangerous. It kills 36,000 people a year in the United States and puts about 200,000 in the hospital. The very old, the very young and people with chronic illnesses are particularly likely to become severely ill from the flu, and in recent years health officials have recommended wider use of the vaccine. The message seems to be reaching the public: demand for the vaccine has grown greatly in the past decade, to more than 85 million doses a year in 2003 from around 20 million in the early 90's.Just as people had begun to appreciate the value of flu shots, the worst vaccine shortage yet struck. It was announced on Oct. 5, when bacterial contamination led British regulators to suspend the license of a vaccine plant in Liverpool on which the United States was depending for 46 million to 48 million doses, nearly half of America's supply. The plant is owned by Chiron, an American company.
A second supplier, Aventis Pasteur, with a plant in Pennsylvania, is providing about 55 million doses, and a third, Medimmune, 2 million doses of vaccine in the form of a nasal spray - but that still leaves the nation with only about half the vaccine it needs.
At a news conference on Tuesday, the director of the Centers for Disease Control and Prevention, Dr. Julie L. Gerberding, apologized for the vaccine shortage, but had little to offer the public beyond a plea to people who get sick to stay home and cover their mouths when they cough.
"We're sorry for the people who need flu vaccine and may not be able to get it this year," Dr. Gerberding said. "That's disappointing for all of us."
Regulatory Obstacles
The problems this year are not a surprise. Indeed, on Sept. 28, exactly one week before Chiron's license was suspended, the Government Accountability Office offered a prescient warning of potential disruptions in the flu vaccine supply.
With few suppliers, the report said, if one's production was cut off there would be great imbalances, with some providers unable to vaccinate even those at highest risk and others able to hold mass immunization clinics even for people at low risk.
The report said that even though the disease control centers had begun monitoring the projected supply of flu vaccine more aggressively since the shortages of 2000, "there is no system in place to ensure that seniors and others at high risk for complications receive flu vaccinations first when vaccine is in short supply."
One reason companies have given up making vaccine, industry officials and other experts say. is the difficulty in meeting regulations for quality control and safety. A change in the approach to regulating vaccine production might also have contributed to problems in meeting the standards.
In the 1990's, contamination of blood products by the AIDS virus and other incidents led to criticism of the agency's inspections of so-called biologic products, which are made from living cells. In the late 90's the agency tightened its inspections of factories making biologics.
The new system, which took effect for vaccines in 1999, led to more compliance violations and contributed to the spate of shortages in pediatric vaccines that began in 2000, according to a 2002 report by the General Accounting Office, now known as the Government Accountability Office.
Older factories have had particular trouble meeting standards, experts say.
"Over time the barriers to make vaccines and stay in this business have gone up, but the prices for old vaccines haven't gone up that much," said J. Leighton Read, the founder of Aviron, the company that developed the nasal spray flu vaccine.
The Warner Lambert factory in Rochester, Mich., had made Fluogen flu vaccine for at least 20 years, but had increasing problems complying with government rules in the 90's. In 1998, the company decided to quit the business and sold the factory to King Pharmaceuticals in Bristol, Tenn. But the F.D.A. continued to find violations, including some it considered so serious that it shut down the plant twice in 2000. After the second time, King said it would stop making Fluogen rather than commit more money to trying to bring the plant into compliance.
King did not return calls seeking comment.
Dr. Peter Paradiso, vice president for medical affairs at Wyeth, said his company ended production of its FluShield vaccine in 2002 because the company sold only half the 20 million doses that it manufactured every year. It was forced to throw out the remaining 10 million doses, he said.
Worse, he said, the new federal regulations would have required the company to spend huge sums upgrading its facilities. With little or no profit projected, the company quit making flu vaccine.
But Dr. Goodman of the F.D.A. defended its policies, saying that they were the "gold standard" for safety worldwide and that if companies could not measure up or chose not to, it might be better for them to pull out.
What Happened at Chiron
Chiron acquired the Liverpool factory in 2003 through its purchase of PowderJect Pharmaceuticals, a British company, for $878 million. Chiron, which sold vaccines mainly overseas, saw the acquisition as a chance to vastly expand its vaccine business, particularly in the American market.
Howard Pien, the chief executive of Chiron, said that with two manufacturers having dropped out of the American flu vaccine business, the company saw a need for more vaccines in the United States and a good business opportunity.
But the factory was aging and had been through a series of owners, and it had also had some quality control problems. Still, Chiron rapidly expanded production there. It was planning to ship more than 50 million doses of flu vaccine to the United States this year, compared with 26 million in 2002, the year before it bought the factory.
But Chiron said it would invest $100 million to upgrade the factory.
In June 2003, just as Chiron was buying the factory, an F.D.A. inspection found quality control problems similar to what the British government found this year: bacterial contamination in vaccine in the early production stages but not in the final product after sterilization.
F.D.A. officials have said the problems were corrected to their satisfaction, and they let the plant continue to operate. But one question likely to be raised by Congressional investigators is why the British found problems so soon after the agency had deemed them resolved.
Chiron announced on Aug. 26 that during routine testing it had found bacterial contamination in a small number of lots of flu vaccine that should have been sterile, a more serious contamination than what the agency had found a year earlier. It said it would delay shipping vaccine until early October and cut its supply forecast from about 50 million doses to between 46 and 48 million. Both the F.D.A. and its British counterpart, the Medicines and Healthcare Products Regulatory Agency, were informed.
Chiron began its own investigation and also began holding weekly conference calls with officials at the F.D.A. and the disease control centers to report on its progress.
In written testimony to the House Committee on Government Reform on Oct. 8, Mr. Pien said Chiron had completed its internal investigation on Sept. 27. The results, he said, confirmed that the contamination was limited to the initial lots identified. Indeed, on Sept. 28, a confident Mr. Pien told a Senate committee that Chiron expected to start shipping the vaccine in early October.
But British regulators visited the factory again and on Oct. 5 suspended its license, saying it was not being operated in accordance with regulations on good manufacturing practice. Only after the suspension was the nature of the contamination revealed: it was a type of bacteria called serratia, which, though found in the environment and usually not harmful there, can cause illness if injected into the body, especially in a frail elderly person or someone chronically ill.
The bombshell reached Chiron's California headquarters at 3 a.m. Company executives than called and awoke officials in Washington, who have said they were also shocked.
Chiron has said it is now under investigation by federal prosecutors in New York and by the Securities and Exchange Commission. The investigations are apparently concerned with whether the company misled investors and federal health authorities about the conditions at its factory. The company, while saying it would cooperate with the investigations, has denied any deception.
"Chiron did not at any time mislead public health stakeholders or the public," Mr. Pien said in written testimony to the House. He added, "The results of Chiron's internal investigations confirmed our belief that our product was safe."
But inspectors from both Britain and the F.D.A. disagreed, saying they could not be confident that Chiron had identified all the sources of contamination. On Friday, health officials in the United States said that none of the vaccine in the plant could be salvaged.
The remaining question is whether Chiron can repair its problems in time to prepare sterile vaccine for next year's flu season. The company has said it expects to do so.
Dr. Goodman said "a lot of hard work on their part" would be needed. But, he added, "I think they are serious about this business, and from everything I've heard I expect they will be eager and effective about addressing these things."
But he and other government officials said they were also looking for other sources of flu vaccine for next year.
Solutions
Many experts say one way to avert vaccine shortages is to charge more for vaccines, so that more companies will want to produce them. To some extent, that was already starting to happen. Aventis Pasteur, now the major source of flu vaccine in the United States this year, noted that prices for flu vaccines have been rising steadily in recent years and are likely to be higher next year. In 1996, they sold for $1.80 a dose. The list price this year is $8.50.
Several companies, including GlaxoSmithKline and ID Biomedical, a Canadian company, have said they hope to begin selling flu vaccines in the United States soon. Dr. Goodman said the F.D.A. was encouraging some foreign manufacturers to apply for licensing here.
Dr. Robert B. Belshe, director of the center for vaccine development at Saint Louis University, said many experts in infectious diseases and vaccination believe that ultimately, the only way to control influenza will be to vaccinate nearly all school-age children every year.
If the medical profession does make that recommendation, and the public follows it, there will be a greater need than ever for vaccines - and possibly a more stable market to tempt manufacturers.
Government health officials said in interviews that they would propose other ways to avert vaccine shortages to Congress within weeks. Among the possible initiatives, said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, are measures to guarantee that the government will buy a certain amount of vaccine each year, buy larger vaccine stockpiles and increase research into different ways to make the vaccines.
The disease control centers this year for the first time bought 4.5 million doses of flu vaccine for $40 million as an emergency reserve. It was not nearly enough, acknowledged Dr. Bruce Gellin, director of the National Vaccine Program Office. The government may buy a bigger reserve next year, he said.
But flu reserves can be expensive. Unlike reserves for other vaccines, which can be held for years and refreshed with new product, a flu vaccine reserve must be used or thrown away and replaced every year.
Dr. Fauci said the Bush administration had increased financing for research and other efforts to fight flu to $283 million this year, from $47 million in fiscal year 2002. Among the initiatives is a $60 million effort to develop new ways to manufacture flu vaccines, which are currently made in a laborious process that requires the use of hundreds of thousands of eggs.
But those sums are small compared with what the nation plans to spend on vaccines against diseases that the government fears terrorists might use. William Schaffner, chairman of the department of preventive medicine at Vanderbilt Medical School in Nashville, noted that the Bush administration last year promised to spend $5.6 billion to help develop vaccines for anthrax and other biological agents.
"They're creating a very expensive program against diseases that don't exist anywhere in the world," Dr. Schaffner said. "What we need is an adult immunization program for diseases that kill tens of thousands every year."
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October 17, 2004OP-ED COLUMNIST
'Oops. I Told the Truth.'By THOMAS L. FRIEDMAN
ometimes it's useful to stand back and ask yourself: If I could vote for anyone for president other than George W. Bush or John Kerry, whom would I choose? I'd choose Bill Cosby - on the condition that he would talk as bluntly to white parents and kids about what they need to do if they want to succeed as he did to black kids and parents a few months ago.
The one thing that has gone totally missing, not only from this election, but from American politics, is national leaders who are actually ready to level with the public and even criticize their own constituencies. The columnist Michael Kinsley once observed that in American politics "a gaffe is when a politician tells the truth." We could use a few really big gaffes right now. Because we have not one, but three baby booms bearing down at us, and without a massive injection of truth-telling they could all explode on the next president's watch.
The leading edge of the American baby boom generation is now just two presidential terms away from claiming its Social Security and Medicare benefits. "With unfunded entitlement liabilities at $74 trillion in today's dollars - an amount far exceeding the net worth of our entire national economy - and with payroll taxes needing to double to cover the projected costs of Social Security and Medicare, how can any serious person not call entitlement reform the transcendent domestic policy issue of our era?" asks former Commerce Secretary Peter G. Peterson, whose book on this subject, "Running on Empty," provides a blueprint for a bipartisan solution to this problem for any president daring to lead.
The second group of boomers barreling down the highway are the young people in India, China and Eastern Europe, who in this increasingly flat world will be able to compete with your kids and mine more directly than ever for high-value-added jobs. Attention Wal-Mart shoppers: The Chinese and the Indians are not racing us to the bottom. They are racing us to the top. Young Indian and Chinese entrepreneurs are not content just to build our designs. They aspire to design the next wave of innovations and dominate those markets. Good jobs are being outsourced to them not simply because they'll work for less, but because they are better educated in the math and science skills required for 21st-century work.
When was the last time you met a 12-year-old who told you he or she wanted to grow up to be an engineer? When Bill Gates goes to China, students hang from the rafters and scalp tickets to hear him speak. In China, Bill Gates is Britney Spears. In America, Britney Spears is Britney Spears. We need a Bill Cosby-like president to tell all parents the truth: throw out your kid's idiotic video game, shut off the TV and get Johnny and Suzy to work, because there is a storm coming their way.
The third group of boomers our next president will have to deal with is from the Arab world. The Arab region has had the highest rate of population growth in the world in the last half century. It has among the highest unemployment rates in the world today. And one-third of the Arab population is under the age of 15 and will soon be entering both a barren job market and its child-bearing years. There are eight Saudis under age 15 for every one between ages 45 and 60.
This is why I believed so strongly in trying to partner with the people of Iraq to establish some sort of decent government there that might serve as a beachhead for more progressive governance in the Arab world. I have not given up hope for this, but it may turn out that we made too many mistakes and that Iraqis are too divided for such a project to succeed. If so, the next president is going to need plan B - some combination of oil conservation that reduces our exposure to this region, a new military strategy and a renewed focus on promoting better government there through diplomatic and economic means. The Arab world is not even close to educating its baby boomers with the skills needed to succeed in the 21st century. Left untended, this trend is a prescription for humiliation and suicide terrorism.
I realize that elections are no time to expect honesty from politicians. But we're in this hole because the political season used to stop on Election Day. Now it's a permanent campaign. That is simply not a luxury our next president will have. The boomers are coming - from three directions - and we will not be able to deal with them without a president with a real penchant for gaffes of honesty.
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October 17, 2004OP-ED CONTRIBUTOR
Debating Your Way to DefeatBy MICHAEL BESCHLOSS
ashington — Smoking a pipe in his Kansas City hotel room just before the 1976 Republican convention, behind by 30 points in some polls, President Gerald Ford told advisers that he had to "do something dramatically different" to win re-election. What he did enhanced American democracy, but it has been a specter for incumbent presidents ever since - and it may yet come to haunt President Bush.
Accepting his party's nomination in the Kemper Arena on Aug. 19, Mr. Ford declared, "I am eager to go before the American people and debate the real issues face to face with Jimmy Carter." Mr. Ford's gamble began a modern tradition of televised presidential debates. This tradition has had one important and, for Mr. Ford at least, unintended effect: presidents don't win re-election as often as they used to.
During the 80 years before Mr. Ford's challenge to Jimmy Carter, only two presidents lost: William Howard Taft, who suffered from a once-in-a-lifetime party split, and Herbert Hoover, who presided over the worst economic depression in American history. In contrast, during the 28 years since Mr. Ford threw down the gauntlet, three incumbent presidents - Mr. Ford himself, Mr. Carter and George H. W. Bush - have lost re-election. And if the latest polls on the current race have any meaning, a fourth defeated president is a distinct possibility.
No sane person would argue that a challenger can beat a sitting president simply by going on television with him as an apparent equal and criticizing him to his face. But, as John Kerry - who used his three debates to close the gap with President Bush in most major polls - would surely attest, it can provide a glittering opportunity.
The power of televised debates as an anti-incumbent weapon revealed itself as early as 1960, with the encounters between John F. Kennedy and Richard M. Nixon, which occurred in one of the meanest years of the cold war. Before those debates, many Americans considered the seemingly callow, absentee junior senator from Massachusetts no match for the worldly vice president, who had acted in Eisenhower's stead during the president's three major illnesses and who had stood up to the Soviet leader, Nikita Khrushchev, in their much-ballyhooed Moscow "kitchen debate."
But Kennedy's televised performance against Nixon gave him presidential stature. As Nixon later said, "The incumbent or whoever represents an incumbent administration will generally be at a disadvantage in debate because his opponent can attack while he must defend." After Kennedy won the election, he said, motioning toward a TV set, "We wouldn't have had a prayer without that gadget."
After 1960 and until Mr. Ford's fateful decision in 1976, incumbent presidents used any excuse - even ridiculous ones - to avoid such unpredictable events. Lyndon Johnson, for example, insisted that appearing with his Republican rival, Barry Goldwater, would be unfair to third-party candidates like Earle Harold Munn of the Prohibition Party. They were abiding by the logic of Dwight Eisenhower's press secretary, Jim Hagerty, who said after the 1960 debates, "You can bet your bottom dollar that no incumbent president will ever engage in any such debate or joint appearance in the future."
After 1976, however, it was harder for an incumbent to deny his challenger a forum. And President Jimmy Carter, who had benefited from the new tradition that year, was its second casualty.
Ronald Reagan's lone television debate against Mr. Carter, a week before the 1980 election, helped him vault from a statistical dead heat to an electoral landslide. Mr. Carter's handlers had hoped to fan suspicions that Mr. Reagan was an empty suit - a former actor who could not possibly cope with grave menaces like 21 percent interest rates and Soviet armies marching through Afghanistan. Like George W. Bush's team a generation later, Mr. Carter's strategists tried to keep the opponent "from reaching the 'plausibility threshold.' " Mr. Carter was advised to make frequent references to his office in the debate, and he complied - literally, with no less than 10 mentions of the decisions he made and pressure he faced "in the Oval Office."
Mr. Carter let Mr. Reagan speak first, as his aide Hamilton Jordan recalled, hoping that Mr. Reagan wouldn't feel "psychologically prepared to find himself standing toe-to-toe with the president of the United States." But Mr. Reagan was not intimidated. He proceeded to give a performance that remains the template for how to debate a sitting president without quite crossing the line into insolence. When Mr. Carter told Mr. Reagan that his attitude toward the Soviet Union was "dangerous and belligerent," Mr. Reagan scored by replying that he was "like the witch doctor that gets mad when the doctor comes along with a cure that'll work."
Running for re-election in 1984, Mr. Reagan was never at serious risk of losing his job, but his first debate allowed his challenger, former Vice President Walter Mondale, to pull almost even in the polls - albeit briefly - thanks to Mr. Reagan's halting performance, which aroused public anxiety about his age and health. But this time a president was protected by his incumbency. Asked in 1990 why he did not in their second encounter "go after" Mr. Reagan on "whether he had the mental capacity to function," Mr. Mondale said such a strategy would have backfired. "I would have been spanked," he said, for failing to respect the presidency.
When President George H. W. Bush debated Bill Clinton and Ross Perot in 1992, Mr. Clinton established his credentials against the charge that he was merely the "failed governor of a small state." Voters were able to compare Mr. Clinton with the president who had presided over the end of the cold war. As Mr. Clinton recalled in 2000, they wanted reassurance about his foreign policy expertise and knowledge of national issues. "I just wanted to try to make sure that people had no questions about my competence when the debate was over," he said.
Like George H. W. Bush in 1992, Gerald Ford in 1976 presumed that his debates against Jimmy Carter would demonstrate his stature and foreign policy experience in contrast to that of a little-known Southern governor. But when Mr. Ford insisted that there was "no Soviet domination of Eastern Europe and there never will be under a Ford administration," many voters thought the emperor had shown that he had no clothes.
In retrospect, we know that Mr. Ford meant that he would never accept the Soviet control of Eastern Europe. But at the time it wasn't clear, and Mr. Carter exploited the opening: "I would like to see Mr. Ford convince the Polish-Americans and the Czech-Americans and the Hungarian-Americans in this country that those countries don't live under the domination and supervision of the Soviet Union behind the Iron Curtain." Despite damage control efforts by Mr. Ford's chief of staff, Dick Cheney, some voters suspected that the president might not be everything he was cracked up to be.
Mr. Ford went on to lose in 1976, of course; the first incumbent president to open himself to debate may have been the first victim of the tradition he started. Mr. Carter later said that if it weren't for televised debates, he could never have defeated an incumbent president. If John Kerry should defeat George W. Bush this year, he may well say the same thing.
Michael Beschloss is the author, most recently, of "The Conquerors: Roosevelt, Truman and the Destruction of Hitler's Germany."
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