Biden, Congress Transition to New Era of Pandemic Prevention

By Jonathan Springston, Editor, Relias Media

The Biden administration and congressional leaders are taking steps to better prepare the United States for future public health threats.

On Aug. 7, the current COVID-19 and Mpox response teams will give way to a new permanent task force in the executive office of the president — the White House Office of Pandemic Preparedness and Response Policy (OPPR). Led by Major Gen. (ret) Paul Friedrichs, MD, OPPR will be “charged with leading, coordinating, and implementing actions related to preparedness for, and response to, known and unknown biological threats or pathogens that could lead to a pandemic or to significant public health-related disruptions in the United States,” according to language in a fact sheet issued by the White House.

Meanwhile, Congress is working on reauthorizing the Pandemic and All Hazards Preparedness Act (PAHPA), a critical funding mechanism for biosecurity that expires at the end of September. Enacted in 2006, PAHPA provides the money to help stockpile medical supplies, accelerate vaccine development, ensure ongoing infectious disease surveillance, and more.

The House Energy and Commerce Health Subcommittee recently advanced PAHPA reauthorization. One week later, the Senate Health, Education, Labor, and Pensions (HELP) Committee reported favorably on reauthorization.

“This legislation will help us make sure that we have a capable workforce in place — not just nurses and doctors, but also public health workers, our ‘disease detectives’ — who can figure out where an outbreak is happening and set up vaccination clinics, among many other things,” said U.S. Sen. Bernie Sanders, I-VT, chairman of the HELP Committee. “This legislation will help make sure that we have accurate public health data to know who is getting sick. This legislation will help make sure that we have enough medical supplies for our healthcare workers.”

There seems to be broad support for PAHPA reauthorization, although those endorsements are accompanied by plenty of suggestions. For example, the National Governors Association requested more resources for states to better manage their own strategic stockpiles of critical medical supplies. The American Society for Microbiology believes the reauthorization package should include more attention on antimicrobial resistance.

The American Hospital Association (AHA) sent a letter to the HELP Committee on July 10 in which the group reiterated its recommendations it made in March regarding PAHPA reauthorization and to offer some other ideas. Specifically, AHA underlined its desire for lawmakers to boost funding for the hospital preparedness program (HPP), from a proposed $385 million to double that amount for fiscal years 2024 through 2029.

“This investment would help prepare and equip our nationwide healthcare system in advance of the growing number and scope of future disasters and public health emergencies,” the AHA wrote. “The HPP has provided critical funding and other resources to aid the healthcare system response to a wide range of emergencies via cooperative agreements with 62 health departments in all states, U.S. territories, and in four cities. These investments contributed to saving lives and reducing the impact of emergencies and disasters, particularly for localized events.”

In the two years leading up to the start of the COVID-19 pandemic, budget cuts and shifting priorities left the United States vulnerable to public health emergencies. In 2018, the National Security Council directorate for global health and security and biodefense was eliminated. That unit was critical for surveilling infectious disease threats globally.

The CDC cut back on staff at its China office in Beijing. Overall, by the time COVID-19 became a public health emergency in the United States, the agency had trimmed or eliminated epidemic prevention programs in 39 of 49 countries.

In 2019, the United States Agency for International Development shuttered its “Predict” program. Over a decade, Predict staff had collected 140,000 biological samples, identified thousands of new viruses, trained 5,000 people in 30 African and Asian countries, and built or strengthened 60 medical research laboratories around the world.

“Virtually every public health official in America tried their best, but it would be an understatement to say that we were tragically unprepared to respond to this [COVID] crisis,” said Sen. Sanders of the importance of PAHPA reauthorization. “Common sense dictates that we have got to do a much better job to either prevent or be much better prepared for the next pandemic.”

For more on this and related subjects, be sure to read the latest issues Hospital Infection Control & Prevention and Infectious Disease Alert.