“The United States and the world were caught unprepared by the COVID-19 pandemic despite decades of warnings of the threat of global pandemics and years of international planning,” asserts a new bipartisan Council on Foreign Relations (CFR)-sponsored Independent Task Force report on pandemic preparedness. “The failure to adequately fund and execute these plans has exacted a heavy human and economic price.”
“As harmful as COVID-19 has been, a future pandemic of novel influenza could be even more catastrophic, killing millions more people and destabilizing governments and economies alike,” the Task Force warns. “To prevent that possibility, the United States and other nations need to learn from their recent, costly mistakes.”
Co-chaired by Sylvia Mathews Burwell, former secretary of health and human services under President Barack Obama, and Frances Fragos Townsend, former chair of the White House Homeland Security Council under President George W. Bush, the Task Force is composed of twenty-two public health and international policy experts. They conclude that “one of the most important lessons of this pandemic is that preparation and early execution are essential for detecting, containing, and rapidly responding to and mitigating the spread of potentially dangerous emerging infectious diseases.”
A Lack of Global Preparedness
The Task Force finds that “despite a succession of previous global public health emergencies, the United States and other governments failed to invest adequately in prevention, detection, and response capabilities to protect the populations most vulnerable to infectious disease outbreaks, or to fulfill their multilateral obligations to international organizations and to one another.”
- “Early action and investment in preparedness have mattered in this pandemic. In the early stages, a diverse group of nations was prepared to respond rapidly and aggressively to COVID-19 with public health fundamentals, including contact tracing, isolating, testing, and clear, science-based risk communication to the public. Others, including the United States, were not.”
- “China’s compliance with its reporting and information-sharing obligations under [the International Health Regulations] was at best flawed, particularly in the early days of the outbreak, when transparency was most important.”
- “As in other recent outbreaks, [the World Health Organization (WHO)] prioritized solidarity in its international crisis response, proving hesitant to criticize China publicly over these flaws and to declare a public health emergency of international concern over China’s objections.”
- “The U.S. decision to pull out of WHO . . . threatens to make the agency’s leadership role even more precarious and the United States even more vulnerable to future pandemics.”
A Lack of Domestic Preparedness and Execution
The Task Force assesses the U.S. performance during the COVID-19 pandemic as “deeply flawed.”
- “The United States has declared pandemics to be a national security threat but has not acted or organized itself accordingly. The federal government lacks a strong focal point and expertise at the White House for ensuring pandemic readiness and coordinating an effective response.”
- “Despite intelligence and public health warnings of an imminent pandemic, the United States did not act quickly enough in mobilizing a coherent nationwide response, wasting precious weeks that could otherwise have been used to implement a nationwide strategy and capacity for testing and contact tracing to identify new infections and reduce their spread.”
- “Elected U.S. officials, including President Donald J. Trump himself, often fell short as communicators, failing to offer the American people clear, reliable, and science-based information about the risk of infection; to adequately defend public health officials against harassment and personal attacks; and to release timely guidance on the utility of the public health measures implemented to combat the spread of the disease.”
- “COVID-19 revealed tremendous confusion over the respective responsibilities of federal, state, local, and tribal governments, resulting in blame-shifting and an incoherent U.S. approach to this public health emergency.”
The Task Force makes a number of recommendations to manage the current pandemic and to prevent or mitigate the next one.
- “The United States should remain a member of WHO, working with other nations to strengthen it from within. The UN agency is not a perfect institution, but no multilateral substitute exists to advance U.S. interests in the current pandemic or the next one. The United States should collaborate with other member states to ensure adequate, dedicated funding for WHO’s Health Emergencies Program.”
- “Congress [should] appoint an independent commission to review the Centers for Disease Control and Prevention’s (CDC) record during the initial months of the pandemic, identify obstacles to the CDC’s effectiveness, and consider how it could do better in the future, including on surveillance, data transparency, and capacity to scale up nationwide testing and tracing.”
- “The United States [should] immediately develop and adequately fund a coherent national strategy and capability to support testing and contact tracing by states and localities, following CDC guidance, that can be rapidly scaled up in any public health emergency, including by leveraging the latest digital technologies, incentivizing research and development of diagnostics such as low-cost rapid tests, and training tens of thousands of contact tracers.”
- “The executive branch and Congress should work together to ensure that the Strategic National Stockpile (SNS) is appropriately resourced and stocked for future pandemics, and that there is no confusion between federal and state governments as to its purpose. In an extended pandemic crisis, the SNS system should be prepared to act as a central purchasing agent on behalf of state governments.”
- “The United States should use incentives to diversify its global supply chains of critical medical supplies and protective equipment for resilience and reliability, without unduly distorting international trade and running afoul of WTO commitments. . . . The [U.S. Food and Drug Administration] should produce regular updates on supply chain vulnerabilities.”
- “The United States [should] support multilateral mechanisms to develop, manufacture, allocate, and deliver COVID-19 vaccines, therapeutics, and diagnostics in a globally fair manner consistent with public health needs.”
“Pandemic threats are inevitable, but the systemic U.S. and global policy failures that have accompanied the spread of this coronavirus were not,” concludes the Task Force. “This report is intended to ensure that in future waves of the current pandemic and when the next pandemic threat occurs, the United States and the world are better prepared to avoid at least some of the missteps that have cost humanity so dearly.
The Task Force stresses that “the national and international dimensions of the pandemic challenges are mutually reinforcing, above all when it comes to the role of the United States. If the COVID-19 pandemic has revealed anything, it is that strong and sustained U.S. global leadership remains essential.”
The Task Force is directed by Thomas J. Bollyky, CFR senior fellow for global health, director of the Global Health program, and editor of Think Global Health, and Stewart M. Patrick, James H. Binger senior fellow in global governance and director of the International Institutions and Global Governance program at CFR. Burwell is president of American University and Townsend is vice chairman, general counsel, and chief administrative officer of MacAndrews & Forbes, Inc.
To read the full report, visit www.cfr.org/PandemicPreparedness
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