The United States is struggling to implement a National Biodefense Strategy, according to a Government Accountability Office (GAO) review, but there are additional efforts that could make the strategy more effective.
GAO first recommended that the Health and Human Services (HHS) Secretary should direct the existing Biodefense Coordination Team to create a plan with new management practices, reinforce collaboration and prevent the many early challenges noted in its report from becoming institutionalized. Second, the HHS Secretary should direct this team to document guidance and methods for analyzing any data collected from various agencies, including nonfederal resources. Third, they should establish a resource plan for staffing, supporting and sustaining biodefense efforts and, lastly, they should also document agreed-upon processes, roles, and responsibilities for establishing and enforcing enterprise-wide decisions.
The National Biodefense Strategy, established in 2018, laid out the nation’s plan to address diseases and biological weapons alike, particularly through joint agency and private sector efforts. In actuality, GAO noted, the strategy offers no clear processes, roles, or responsibilities for joint decision making. Nothing guides data analysis or resource use, and nonfederal capabilities are not even properly accounted for, despite them being a sizable chunk of the nation’s capabilities.
Making up the Biodefense Steering Committee at the helm of the strategy — as established by National Security Presidential Memorandum-14 (NSPM-14) — are seven federal agencies, with the Secretary of Health and Human Services chairing. Other federal agencies with biodefense responsibilities were ostensibly required to collect and assess data on their activities to identify gaps and other concerns. All biological threats were meant to be on the table, addressed by a series of overarching visions, goals, and objectives.
Agency officials were unsure how decisions would be made, especially in the case of gaps, GAO said. There was no clear path for them to redirect resources across agency boundaries. Though HHS officials have pointed to existing processes and directives for what to do, GAO repeatedly noted the amount of uncertainty involved in who might make or enforce those decisions, among others concerns.
“As a result, questions remain about how this first-year effort to catalogue all existing activities will result in a decision-making approach that involves jointly defining and managing risk at the enterprise level,” GAO said. “Without clearly documented methods, guidance, processes, and roles and responsibilities for enterprise-wide decision-making, the effort runs the risk of failing to move away from traditional mission stovepipes toward a strategic enterprise-wide approach that meaningfully enhances national capabilities.”
GAO was required to review these efforts by the National Defense Authorization Act of 2017, and as a result, built its assessment and recommendations on the Strategy itself, plans and NSPM-14, interviewed officials from all agencies involved, and compared efforts to select characteristics of GAO’s other work on national strategies, risk management, organizational alterations, and interagency coordination.