Congress and the American Public Must Not Turn a Blind Eye to Legislation Promoting Pandemic Surveillance

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
June 22, 2023

As the COVID-19 public health emergency in the United States has officially come to a close along with the World Health Organization’s declaration of a Public Health Emergency of International Concern, many are now turning to the question of how to prepare for the next pandemic threat. Numerous reports have recently been issued with recommendations as to what national governments and the international community should do to prevent future diseases from having the disruptive impact of COVID-19.

The U.S. Congress is in the midst of exploring these issues as its members prepare to consider the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA). Originally enacted in 2006, this legislation established many U.S. government pandemic preparedness programs, such as the Biomedical Advanced Research and Development Authority (BARDA). The House Energy and Commerce Committee and Senate Health, Education, Labor, and Pensions Committee issued calls for recommendations regarding PAHPA 2023, with one focus being public health surveillance.

A variety of organizations have weighed in on how the United States should improve upon its public health surveillance capabilities. The American Society for Microbiology and the Johns Hopkins Center for Health Security advised that the Centers for Disease Control and Prevention should invest more in cutting-edge genomic technology to facilitate early disease detection. The American Society for Microbiology also recommends that the U.S. government be more proactive in terms of bolstering and protecting the supply chain for diagnostic supplies. Along with shoring up the supply line for material resources, the Infectious Disease Society of America recommends using student loan repayment as an incentive to attract more students to pursue careers in the field of epidemic intelligence. 

The American Society for Microbiology recommends that academic, hospital-based and independent labs be placed on equal footing to develop laboratory-developed tests without pre-market approval in the midst of an on-going pandemic. The Johns Hopkins Center for Health Security, on a related note, called for improved data sharing between public health, clinical care and clinical laboratories, as well as across governmental jurisdictions. America’s Blood Centers emphasized the important role of blood collection facilities in detecting emerging pathogens, as was evident during the COVID-19 pandemic.

The National Association of County and City Health Officials (NACCHO) specified a needed investment of $7.84 billion over the next five years and sustained annual increases over the next 10 years in order to support federal, state and local data modernization. Recommendations by the organization OCHIN focused on state and local health departments as well, particularly the outdated nature of their information technology systems which hinders surveillance and early identification of emerging threats. Meanwhile, AIHA called for greater collaboration between civilian federal agencies engaged in public health surveillance and military organizations that participate in such efforts.  

Along with the improved integration of different types of labs into the pandemic detection system, it has also been recommended that the United States makes better use of varied types of surveillance as well. These include wastewater surveillance, in addition to pharmacy surveillance, school absenteeism, internet searches and animal surveillance. Additionally, the Infectious Disease Society of America calls for more attention to be paid to monitoring zoonotic diseases that could one day spill over into humans, thus strengthening a One Health approach already codified previously.

The Infectious Disease Society of America also made a controversial recommendation pertaining to surveillance with their support of enhanced potential pandemic pathogens programs (ePPP). Such programs are described in the document as a form of gain-of-function research that make pandemic threats easier to detect more rapidly. Recognizing the danger and controversy inherent in such research, the society points to recent recommendations issued by the National Science Advisory Board for Biosecurity (NSABB) to make ePPP and dual-use research of concern safer while at the same time allowing necessary research to move forward.

It remains unclear how much authoritative legislative action on future pandemic preparedness will be taken in the United States. This uncertainty makes the authorization of the long-standing, bipartisan PAHPA all the more essential. While attitudes regarding public health measures became increasingly partisan as the pandemic went on, it is important to remember that there was a time in the wake of the 9/11 terrorist attacks that pandemic preparedness was a bipartisan priority. Promptly reauthorizing PAHPA with support from Republicans and Democrats is not only necessary to ensure American security, but to send the message to American citizens that public health preparedness will not remain a wedge issue. One thing all parties should be able to agree upon is the need to monitor for emerging infectious disease threats, thus allowing for the most deliberate and coordinated response. All political constituencies should favor a public health early warning system and oppose turning a blind eye to a future threat.  

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Author: Nathan Myers, Ph.D. is a Professor in the Department of Political Science and Director of the Master of Public Administration at Indiana State University. His areas of research include public policy, public health emergency preparedness, and the governance of biotechnology. He is the author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies. Myers serves as an academic advisor to the Continuity of Supply Initiative. Email: [email protected]; Twitter: nagremye1980

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