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Sunday, February 5th, 2023

National Health Security Strategy includes all-of-government approach to combat threats

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Extreme weather events, a CBRN incident, cyberthreats and infectious diseases having pandemic potential all put Americans on notice for 21st century health security hazards, the U.S. Department of Health and Human Services (HHS) says in its newly developed National Health Security Strategy 2019-2022.

“Threats are evolving every day, so we cannot wait to build a robust response,” according to the report from HHS and its Office of the Assistant Secretary for Preparedness and Response (ASPR). “To safeguard the health and well-being of our people, the strategies outlined in the NHSS must be brought to bear swiftly and effectively. This will require the involvement of the American people, their government, and the public health and health care systems that serve them.”

The NHSS is created every four years by HHS and ASPR to bolster the health of Americans during a crisis event via a strategic approach that this year includes three objectives: to prepare, mobilize and coordinate a whole-of-government approach; to protect the nation from emerging and pandemic infectious diseases and chemical, biological, radiological and nuclear (CBRN) threats; and to leverage the capabilities of the private sector.

“The National Health Security Strategy sets the right tone when it says that public health security is a collective responsibility among federal, state, local, tribal, and territorial governments, as well as industry, academia, and non-governmental organizations, former U.S. Sen. Joe Lieberman, who co-chairs the Blue Ribbon Study Panel on Biodefense, told Homeland Preparedness News this week.

The privately funded panel was established in 2014 to assess gaps and provide recommendations to improve the nation’s biodefense — which it did in its 2015 A National Blueprint for Biodefense: Leadership and Major Reform Needed to Optimize Efforts. The Blue Ribbon Study Panel on Biodefense includes ex officio members and staffers who have deep expertise in science, policy, intelligence and defense.

“We are glad to see that the National Health Security Strategy addresses many of the recommendations from the Panel’s National Blueprint for Biodefense to improve biosurveillance, hospital preparedness and response, management of the Strategic National Stockpile, and investments and innovation in medical countermeasures,” Lieberman said.

The top four health security threats, according to the National Health Security Strategy (NHSS), are extreme weather and natural disasters; infectious diseases and pandemics; technology and cyberthreats; and CBRN threats.

Threats from extreme weather and natural disasters, for instance, are becoming more frequent and severe, including wildfires in the West, intense precipitation in the Northeast, rising temperatures in the North and West, and droughts in the Southwest, among other examples listed in the NHSS report.

“These frequent, widespread national and regional climate trends lead to a surge in required services that can overwhelm public health and medical resources, can damage or destroy health infrastructure, can further limit access to life-saving products and/or services, and can damage communities’ public health and health care systems, resulting in loss of services and economic impact,” according to the NHSS.

At the same time, according to the report, increased threats from infectious diseases are largely due to the faster transmission of disease from a variety of hosts, including more unvaccinated people and a larger group of immunocompromised individuals.

Specifically, resistance to antibiotics, new virus strains and the reemergence of formerly extinct diseases create pandemic potentials and pose possible uses in bioterrorism or biological warfare, the NHSS says.

In fact, a report graph breaks down the infectious disease threats around the world into three categories: newly emerging diseases, such as E.coli, the Enterovirus D68 Heartland virus, the Bourbon virus, Zika, Ebola, human monkeypox, SARS, and various influenzas; re-emerging diseases, including measles, chikungunya, antimicrobial-resistant threats (i.e. MRSA), West Nile virus, drug-resistant malaria, plague, cholera, and yellow fever; and deliberately emerging diseases, like anthrax used for bioterrorism.

Meanwhile, the NHSS points to the pros and cons associated with cyberthreats and technology, which both has advanced how the nation saves more lives, but also creates consequences such as technology dependence that in turn requires huge investments in defense systems; the faster availability of myriad weapons that may get used for malicious purposes; and the increased chance that classified public health data or scientific research could be misused.

Healthcare’s increasing dependence on having an interconnected health IT infrastructure, for example, puts sensitive patient data at risk, HHS warned in the NHSS.

“As a result of these consequences, cyber attacks could damage critical infrastructure that impacts healthcare and public health such as power grids, or target medical infrastructure, significantly affecting patient treatment,” the NHSS says.

In addition to these details on health security threats facing the United States, the 24-page NHSS includes HHS protection objectives as part of the federal government’s planned strategy approach to counter these and other threats.

One objective — to leverage the capabilities of the private sector, for instance — will play a major role in responding to attacks against the healthcare infrastructure.

According to the NHSS, the federal government plans several initiatives with the private sector, such as developing partnerships to create medical countermeasures (MCMs), fostering a resilient medical product supply chain, incentivizing preparedness, and streamlining processes.

In terms of MCM partnerships, for example, the federal government “will implement partnership strategies to ensure MCMs can quickly traverse advanced R&D when no stable commercial market exists,” the NHSS says. “We will leverage innovative public-private partnership models for use for MCM development.”

Such an approach is consistent with the Blue Ribbon Study Panel on Biodefense recommendations, as well as U.S. President Donald Trump’s 2018 National Biodefense Strategy to combat biological threats. Trump’s strategy and related presidential memorandum created a new cabinet-level Biodefense Steering Committee tasked with defending the United States against biological threats by coordinating the efforts of 15 government agencies and the intelligence community, among other items.

“All levels of government and society have roles to play to improve the nation’s health security,” the NHSS concludes. “We must strategically strengthen our partnerships with the aim of improving operational effectiveness and building needed capabilities. We must marshal our best minds and best practices to spur innovation to counter emerging risks, some of which we have not faced in our lifetimes.”