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Management and Budgeting for Biodefense Threats: A Call to Action for the OMB

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

By Nathan Myers
May 18, 2018

Addressing a major biodefense event in the U.S may require coordination among up to two dozen federal agencies. In order to facilitate this work in advance, a more cohesive budgeting process is needed. The Blue Ribbon Study Panel on Biodefense  has put forth recommendations to create such a process.

“Budgeting isn’t just about the money, it’s prioritizing what the money will be used for,” said Dr. Ellen Carlin, senior advisor to the Study Panel. A recent report from the Panel calls not only on the Office of Management and Budget (OMB) to annually provide an integrated budget to Congress, but also for lawmakers from budget, appropriations, and authorizing committees to reform their separate processes into a more strategic oversight and legislative system.

The Panel also recommends that an OMB Program Associate Director (PAD) be designated to manage biodefense issues in the federal budgeting process. This PAD would work with a special assistant to the president and a Biodefense Coordination Council to make budget recommendations to the Vice President.

The Study Panel further recommends that biodefense be designated as a Cross-Agency Priority (CAP) Goal, which would facilitate the development and implementation of specific performance targets for biodefense. Agencies involved in biodefense would create performance and outcome measures exceeding the requirements of the Government Performance and Results Modernization Act of 2010 and would be required to develop business plans involving collaboration with other departments as well as with the private sector.

The report’s central recommendation calls for OMB to send an integrated biodefense budget request to Congress, one which would account for the needs of all departments and agencies involved in biodefense. In doing this, the Panel advocates for protecting core programs by budgeting for sustained or increased funding for them.

“We spent a lot of time thinking about why biodefense is a special case and deserves extra time and attention allocated to it,” said Carlin. “From an OMB perspective, if I was in charge of a critical national security mission area, across two dozen departments and agencies, I would want to know what they were working on, how they are related to the national strategy, and how much it is costing the American taxpayer. I’ve been very impressed with the staff at OMB and the National Security Council who work on national security and biodefense and public health security. None have needed convincing that this is a critical national security issue.” It should be noted that a National Biodefense Strategy is set to be issued soon by the executive branch to provide guidance for streamlining budgeting and programming.

An integrated budget should also help to incentivize private sector participation and planning, as well as overall advanced and strategic planning at the federal level.

“I think public-private partnerships are going to be the answer to challenges,” Carlin said, “not only when it comes to medical countermeasures, but all along the spectrum, awareness of the threat through recovery. There is a lot more to do than just medical countermeasures. There are plenty of other technologies that need to be developed that we need to think of ways to better engage the private sector in. I think globally the U.S. could be a leader in pursuing a public-private system for response to outbreaks, epidemics, and pandemics.”

According to the Panel, willingness to make commitments to long-term funding will be critical to this effort. They point to the ten-year funding commitment for Project BioShield as an example of the benefits that can come from providing strong incentives to engage in sustained research and development. The Panel points to a loss of momentum in the overall enterprise to develop medical countermeasures in the private sector due to an inadequate level of investment.

“Annual funding is just so disruptive to the way the rest of the world operates, particularly the way the private sector operates,” said Carlin. “The private sector companies do not operate on a single year basis. They are often looking at multiple years, five or even 10 years, especially when you are looking at drug development programs. That’s why multi-year funding for medical countermeasures is so relevant. I think there is starting to be an acknowledgement that the annual appropriations process is failing the medical countermeasures community. Companies do not want to invest for many reasons, not the least of which is it is hard to see the government as a serious partner when you are only looking at one year at a time of funding.”

Panel members recommend restoring the long-term funding commitment for Project BioShield as well as committing funding to the development of countermeasures not covered under that program. This effort may include a combination of more traditional grant funding and contracting, as well as more creative approaches such as allowing increased use of other transactional authority for countermeasure development.

The economic impact of infectious disease outbreaks is becoming entirely unsustainable,” said Carlin. “We’re not asking the administration and Congress just as an exercise or because it is a messy system that needs cleaning. We believe it’s really mission critical.”

“I think we’ll save money and save lives,” Carlin emphasized.

Author: Nathan Myers is an associate professor of Political Science at Indiana State University. He primarily teaches courses in the Master of Public Administration program. Myers is also a member of the Indiana State University Center for Genomic Advocacy. His teaching and research interests include organizational behavior, public health policy, and biotechnology policy associated with genomic research. He can be reached at [email protected] 

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