After 2020, pandemic preparedness budget cuts should be unthinkable

We’re still in the midst of the worst public health crisis in more than a century. We should be doing all we can to prevent anything like COVID-19 from ever happening again. Yet, despite the unspeakable toll COVID-19 has taken on our families and communities, sources are telling us that Congress may slash President Biden’s proposal in the American Jobs Plan for pandemic preparedness funding — from a $30 billion investment to just $5 billion, barely one-tenth of 1 percent of the $3.5 trillion infrastructure initiative Senate Democrats proposed. 

When the White House released its proposal in the American Jobs plan, they argued: “Outbreaks of SARS, Ebola, influenza, Zika and others have cost billions in lost productivity. The risk of catastrophic biological threats is increasing due to our interconnected world, heightened risk of spillover from animals to humans, ease of making and modifying pandemic agents, and an eroding norm against the development and use of biological weapons.” 

We couldn’t agree more: $30 billion to protect Americans from future pandemics pales in comparison to the cost of responding to another pandemic. The cost of COVID-19 in the United States alone may top an unthinkable $16 trillion before we’re finally able to get it under control; we can’t afford to shortchange the critical public health infrastructure our nation needs to be prepared for the next pandemic or other public health crisis.

The United States experienced one of the highest per-capita mortality rates in the world during the pandemic, nearly double that of Germany, nearly triple that of Canada, and more than ten times that of Norway and Finland. A lack of federal leadership in the previous administration and our chronically underfunded public health infrastructure can be credited for what can only be regarded as a catastrophic failure at nearly every level. 

We can’t bring back the lives lost. What we can do is begin to make the investments today to ensure that a preventable catastrophe on this scale does not happen again. 

Now is the time to build the sustainable public health infrastructure we need to prevent, detect and respond to the next pandemic — a pandemic that could happen ten years from now, or ten days from now.

How do we do this?  We must make significant multi-year investments in pandemic preparedness and response — and we must start today. For instance, when the pandemic struck in early 2020, it was evident early on that our public health data infrastructure was hopelessly stuck in the last century. The U.S. public health informatics infrastructure must be dramatically strengthened to make real-time, accurate, consistently presented information available from national, state and local public health departments, with inputs from laboratories and health care providers. Lack of accurate, real-time information was one of the greatest failures of the U.S. response to the COVID-19 pandemic. 

We also must strengthen the ability of state and local health agencies to quickly detect and respond to infectious disease outbreaks. This will require having a strong infrastructure in place before the outbreak happens. Local health departments were decimated by budget cuts prior to the pandemic, and an uneven response from state to state was the result. These professionals, many of whom faced a barrage of criticism and even some death threats, continue to fight this pandemic in their communities. Our public health departments are the front lines of our health defense, and must be able to respond quickly to outbreaks and the many other public health threats that face our communities, including opioid abuse, influenza, antibiotic-resistant bacteria, and more. 

Additionally, as a matter of national and global health security, the United States must make investments to increase its “warm” or “always on” manufacturing surge capacity that can be activated in the event of an outbreak to expand fill-finish capacity and produce products such as vaccines, tests, personal protective equipment, syringes and needles. These investments should expand vaccine production capacity; rapidly develop partnerships for vaccines, therapeutics and diagnostics; improve supply chain resilience for vaccine raw materials; expand active pharmaceutical ingredient (API) manufacturing for small molecule drugs and provide training programs to build biomedical engineering expertise. Importantly, building these facilities, and running and maintaining them, will create a significant number of well-paid, high-skill jobs based in this country. 

Furthermore, advances in biological science have made it increasingly easy to create dangerous pathogens. The intentional or unintentional release of a biological agent could be as deadly as a nuclear war, and we need a similarly vigorous system of standards and inspections to reduce that horrifying risk. While it remains unclear (and may never be known for certain) whether the SARS-CoV-2 virus emerged naturally or from a laboratory, it is clear that biosafety and biosecurity — domestically and abroad — poses a significant national security threat to every American. We must improve our preparedness infrastructure to meet this reality.

Finally, we must strengthen global health security, because it is essential to protecting the United States from health threats. The plain truth is that in our increasingly interconnected world, disease spread anywhere is a risk everywhere. If the world is safer, we will be safer here at home. Throughout this pandemic and other infectious disease events, we have seen unfortunate examples of failures of global cooperation which hasten the spread of infectious diseases. By working together — sharing data, knowledge and resources, and holding countries accountable for progress on reducing threats — we can increase our safety and security. 

This is our now-or-never moment to make the investments we need to strengthen our nation’s public health infrastructure. We must prevent the next pandemic and ensure that we and the rest of the world never again are as underprepared as we were for COVID-19. The costs are high, but nowhere near as high as the cost of failing to invest in our health security.  

For all these reasons, we urge the Senate to ensure the $3.5 trillion infrastructure package currently under discussion includes the full $30 billion funding proposal to prevent the next pandemic, and that these funds go toward practical, gap-filling programs to strengthen the ability to find, stop and prevent health threats.

No matter how divided we may be politically, we share a common enemy — dangerous microbes. We lost more lives in this pandemic than in the biggest wars of the 20th century combined. We must make these critical investments to ensure that our nation can depend on our public health infrastructure to defend us from health threats, just as we depend on our military to defend us from threats foreign and domestic. 

This is the moment. Don’t let it pass us by. 

Dr. Tom Frieden director of the Centers for Disease Control and Prevention during the Obama administration, when he oversaw responses to the H1N1 influenza, Ebola and Zika epidemics, is president and CEO of Resolve to Save Lives, an initiative of Vital Strategies and senior fellow for Global Health at the Council on Foreign Relations. Twitter: @DrTomFrieden. Sen. Tom Daschle is a Democrat who represented South Dakota in Congress from 1979 to 2005 and served as Senate majority leader from 2001 to 2003. He is the founder and CEO of The Daschle Group, a Public Policy Advisory of Baker Donelson.