U.S. Sen. Richard Burr (R-NC), who crafted and sponsored the nation’s original law protecting public health during man-made and natural disasters, and then took the lead on the law’s subsequent restructuring, again has commanded the next phase of reauthorizing the Pandemic and All-Hazards Preparedness Act (PAHPA).
Sen. Burr on May 15 introduced the bipartisan Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, S. 2852, with U.S. Sens. Bob Casey (D-PA), Lamar Alexander (R-TN), and Patty Murray (D-WA) signing on as original cosponsors.
“This legislation holds true to the spirit of our initial law, supporting a nimble, flexible and fast approach to the threats we are facing, whether they are naturally occurring or the result of a deliberate attack on our country,” said Sen. Burr on May 17 after unveiling S. 2852, which he added “underscores the daily urgency needed to prepare for and respond to these threats.”
PAHPA, enacted in 2006 and reauthorized in 2013, authorizes funding for public health and medical preparedness programs, medical countermeasures (MCMs) under the Project BioShield Act, and development of potential MCMs, according to the U.S. Department of Health and Human Services (HHS). The law also supports the U.S. Food and Drug Administration’s (FDA) public health emergency rapid-response measures, among other purposes.
According to a joint statement released May 17 by the senators, as well as information from a six-page summary of the measure released by Sen. Burr’s office, S. 2852 includes numerous provisions that would build on the existing PAHPA framework to update those programs, including by:
- Expanding the National Health Security Strategy to ensure planning for public health emergencies addresses the full range of threats facing the United States. Zoonotic disease outbreaks and food and agriculture-related disease outbreaks would be incorporated into the strategy, as would domestic preparedness responses related to global health security and environmental hazards and information on the nation’s current public health workforce and its capabilities for improving medical surge capacity.
- Improving preparedness and response by requiring the evaluation of existing performance measures, benchmarks and standards for the Hospital Preparedness Program (HPP) and Public Health Emergency Preparedness Program (PHEP).
- Requiring the Assistant Secretary for Preparedness and Response (ASPR) to develop guidelines within two years of the law’s enactment for a regionalized approach to healthcare response that would guide communities across the country in utilizing their local resources in an organized way in the event of an outbreak or attack. The guidelines would inform regional systems of hospitals and health care facilities to treat patients affected by chemical, biological, radiological, or nuclear (CBRN) threats, including emerging infectious diseases, and improve medical surge capabilities and capacity.
- Modernizing the Centers for Disease Control and Prevention’s (CDC) situational awareness and biosurveillance capabilities to better monitor potential threats that could result in a public health emergency, for instance by improving coordination within HHS and across federal agencies through the exchange of data in the biosurveillance network to better inform the situational awareness necessary to monitor, identify and respond to CBRN threats, and by convening a public meeting for public and private stakeholders to improve the development and function of the biosurveillance network.
- Improving the existing Public Health Emergency Fund (PHEF) by identifying key activities for which PHEF dollars may be used in the context of immediate support for the response activities for a public health emergency or prior to such an emergency.
- Updating and aligning the term “at-risk individual” across the PAHPA framework to ensure consistency and provide clarity throughout the framework.
- Strengthening the PAHPA framework to encourage the consideration of children prior to, during and after a public health emergency.
- Ensuring a threat-based focus for MCMs purchased under the Strategic National Stockpile (SNS) and providing additional direction and a threat-based focus for the existing annual review of the SNS.
- Codifying the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE), an entity comprised of heads of relevant federal agencies, to inform the direction of research, development and procurement of MCMs for the SNS, including considerations for deployment and distribution of MCMs.
- Providing authorities to the director of the Biomedical Advanced Research and Development Authority (BARDA) to develop strategic initiatives for threats that pose a significant level of risk to national security. These strategic initiatives will accelerate and support advanced research, development and procurement of countermeasures to address threats that include those having no current existing countermeasure, those resistant to current countermeasures, or those that may be rendered ineffective; threats that consistently exist or are continually circulating in a human or animal population and have significant potential to become a pandemic; threats resulting from exposure to a CBRN agent and which may present increased complications in treating a countermeasure-resistant disease or condition during a public health emergency.
- Reauthorizing BARDA, the BioShield Special Reserve Fund, the HPP, and the PHEP cooperative agreement — clarifying that it be administered via the CDC — through 2023, as well as reauthorizing funding for VA medical facilities and influenza vaccine tracking and distribution during an influenza pandemic, among other items.
“I look forward to working with my colleagues to move this critical piece of legislation through the Senate,” said Sen. Burr, a leading member on the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee, which has received S. 2852 for consideration.
Senate HELP Committee Chairman Alexander has put the bill on a fast track.
“The Senate health committee will consider and seek to approve this bill next Wednesday, [May 23] so the full Senate can consider it before many programs expire at the end of September,” Sen. Alexander said in a joint statement he made with the other cosponsors of S. 2852 that was released on Thursday.
“After a deadly hurricane season, Americans want to know we are better prepared to face public health threats — whether that’s natural disasters, flu outbreaks, or bioterror attacks,” said Alexander. “This bipartisan proposal, led by Senators Burr and Casey, takes the next step toward ensuring we are able to better protect Americans from 21st century threats by strengthening our preparedness and response capabilities to ensure we are ready for the full range of public health threats we may face.”
Senate HELP Committee Ranking Member Murray, another champion of S. 2852, said that the proposal “includes additional steps to help us prepare against emerging threats by bolstering critical work to combat antimicrobial resistance and ensuring that we are doing as much as we can to keep all families safe.”
“In order to respond effectively to keep families safe from pandemics and other public health threats when they strike, we need to have a strong national framework prepared and ready well before they strike,” Sen. Murray said.
She added that S. 2852 is “an important bill to protect our communities against serious health threats, and I’m going to keep working with my colleagues across the aisle to make sure we get this done.”
Sen. Casey, who also serves on the Senate HELP Committee, noted he was equally pleased “to work in a bipartisan manner again on this legislation to support our nation’s preparedness and response capabilities, and I look forward to swift action in the Senate on this vital bill.”
All four senators on April 26 released draft legislation to reauthorize PAHPA, which is set to expire Sept. 30. Comments were due May 4 and the lawmakers took them into consideration in drafting text for S. 2852.