Getting Ready for Future Pandemics an ‘Economic and Moral Imperative’

WASHINGTON — The U.S. must invest time and money now to prepare for the next pandemic, Biden administration officials said Friday.

“We really need to start preparing now,” said Eric Lander, PhD, director of the Office of Science and Technology Policy at the White House, on a phone call with reporters. “We’ve got to seize the unique opportunity to transform our scientific capabilities so we’re prepared for the increasing frequency of biological threats on the horizon. Investing to avert or mitigate the huge toll of future pandemics or other biological threats is both an economic and a moral imperative.”

“Five years from now, we need to be in a far stronger position to stop infectious diseases before they become open pandemics, like COVID-19,” he continued. “There’s a lot that we can do to transform our scientific capabilities for vaccines, therapeutics, diagnostic development, for early warning for public health systems. Importantly, these kinds of advances will not only strengthen our systems for dealing with future biological threats, they will be valuable for everyday public health and medical care for all Americans, and for the world.”

Beth Cameron, PhD, Special Assistant to the President and senior director for Global Health Security & Biodefense on the National Security Council (NSC), said that the COVID-19 pandemic “enumerated a number of challenges in our preparedness for a moderate pandemic, but we do need additional capabilities to be fully prepared for any biological event that comes our way. And that includes countering bioterrorism, countering the development and use of biological weapons, strengthening the Biological Weapons Convention — including food security, food defense, zoonotic spillover events and others.”

Cameron and Lander introduced the administration’s new 27-page pandemic preparedness plan. Lander explained that the plan rests on five pillars:

• Transforming our medical defenses, including dramatically improving vaccines, therapeutics, and diagnostics
• Ensuring situational awareness about infectious disease threats, for both early warning and real-time monitoring
• Strengthening public health systems, both in the U.S. and internationally, to be able to respond to emergencies, with a particular focus on protecting the most vulnerable communities
• Building core capabilities, including personal protective equipment, stockpiles and supply chains, biosafety and biosecurity, and regulatory improvement
• Managing the mission, with the seriousness of purpose, commitment, and accountability of the Apollo Program

The estimated cost of the plan is $65.3 billion over 10 years, Lander said. “It’s vital that we start with an initial outlay of $15-to-$20 billion to jump-start these efforts. Accordingly, we’re proposing that the current budget reconciliation provides at least $15 billion for this goal,” he noted, referring to a “soft” infrastructure bill currently being considered by Congress. “The administration will work toward other appropriations to support the remainder of that $65.3 billion budget above baseline needed to execute the plan in full.” Asked during a question-and-answer session about the likelihood of getting that first $15-to-$20 billion in funding into the bill, Lander said, “We are in discussions with [Capitol] Hill, and are very optimistic.”

Lander likened the seriousness and importance of the pandemic program’s mission to the Apollo space program. “We’re proposing there be a centralized Mission Control, acting as a single, unified program management unit that draws on expertise from multiple agencies at HHS — including NIH, CDC, BARDA [the Biomedical Advanced Research and Development Authority], FDA, and CMS — as well as other agencies and departments, such as the DOD [Department of Defense], DOE [Department of Energy], and the VA [Department of Veterans Affairs],” he said.

In addition to reporting on the mission’s progress, Mission Control should “conduct periodic exercises to evaluate our actual national pandemic preparedness by deploying these capabilities, including through testing rapid product development, and it should seek input of outside experts and working groups that allows us to get the best possible advice.”

Cameron pointed out that on his first day in office, President Biden signed an executive order that re-established the Office of the Directorate for Global Health Security and Biodefense, an office that is part of the NSC and for which Cameron worked during the Obama administration; that office was folded into another part of the NSC by President Trump in 2018. “We’re really there to provide that high-level ‘belly button,’ if you will, to elevate these important issues to the president and the NSC. Our team has a ‘no fail’ mission to rapidly mobilize the policy machinery to elevate high-consequence infectious disease outbreaks quickly across the White House and to the national security adviser and really to empower agencies to adopt a ‘no regrets’ response.”

Cameron was asked how much the current plan was built on the one developed during the Obama administration. “This work very much draws on lessons from those efforts, and … in addition to that, draws on lessons from this pandemic, which really showed us that we had to be able to act much more quickly to provide medical countermeasures,” Cameron said. “We were able to do more quickly in this pandemic, but we want to bring that timeline as far to the left as we possibly can.”

One such lesson relates to home testing, Lander said. “We would like to get to the place where, in a future pandemic some years from now, you don’t have to drive to CVS to get a test, but we have incredibly inexpensive tests that, if needed, people could apply daily at home to know if they were infected, if they needed medical care … We would like to be able to have this capability that can be done extremely frequently, conveniently, inexpensively, and accurately so we can get this information. That would be so much more effective, for everyone to know every day if they should stay home or if they need medical care to come to them.”