In November 2022 the White House issued a statement indicating the intention of the Biden-Harris Administration to continue to “prioritise global health security” as part of wider efforts in “national biodefence”. Highlighting ongoing outbreaks alongside the continued threat of COVID-19, the statement emphasised the importance of preparedness for infectious diseases and how “global health systems remain ill-equipped to identify and contain these threats”. With “new actions” the Administration hopes to accelerate the “National Biodefence Strategy and Implementation Plan for Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security (Strategy)”.  

Constant and consistent threats 

The statement began with the acknowledgement that the world is continuing to fight COVID-19. This comes just weeks after Biden’s statement that the pandemic was “over”, perhaps inadvertent, which caused ripples in the pharmaceutical industry. It continued by referring to the suffering caused by Mpox, recently renamed, and the Ebola outbreak in Uganda. These are “two of the most recent examples of how the risks and impact of emerging infectious diseases are increasing daily”.  

A roadmap  

The Administration describes a “bold and ambitious roadmap” that will “protect American lives and livelihoods” and offer protection against infectious disease threats, “whether naturally occurring, accidental, or deliberate”. This qualification is perhaps a recognition of the heated debate over the origins of COVID-19.  

Capacity-building partnerships 

Through secure partnerships, the statement highlights the importance of stopping disease threats “at their source”. As we saw recently in the mpox outbreak, this is something we continue to fail to do, prioritising apparent national interests over obvious international health.  

“The United States is committed to directly supporting at least 50 countries, by 2050, to strengthen and achieve regional, national, and local capacity in five critical areas to prevent, detect, and respond to infectious disease threats.” 

How will this happen? The White House sets out several specific goals as follows: 

  • Expand and strengthen bilateral partnerships with at least 25 countries to develop measurable capacity to prevent, detect, and rapidly respond to epidemic and pandemic threats. 
  • Build and expand regional partnerships in Africa, Asia, and Latin America on infectious disease surveillance and early warning systems, biosafety and biosecurity, strengthening emergency operations centres, training and supporting health workers, investing in community and national leadership for global health security, and legal preparedness. These partnerships also include the multisectoral African Partner Outbreak Response Alliance (APORA) and joint efforts between the US Indo-Pacific Command and Australian Defence Force.  
  • Leverage bilateral US global health security programmes alongside investments from the newly established Pandemic Fund at the World Bank to achieve additional measurable results at the national, regional, and global level, and spur new resource mobilisation for pandemic preparedness and response. 
  • Support implementation of the third edition of the WHO’s Joint External Evaluation (JEE). The CDC will provide technical experts to support 10 countries’ JEEs, assisting in gap assessments and developing recommendations to address them.
Global example and encouragement 

The statement suggests that global health security “cannot be achieved alone”. Thus, in addition to “expanding bilateral partnerships”, the US will “utilise its unparalleled catalytic leadership to unlock more commitments” to “bolster support”. The following actions are set out in the statement: 

  • Strengthen and support the extension of the multilateral GHSA beyond 2023, as a forum for working across countries, regions, sectors (including non-governmental) to provide technical assistance and share best practices and measure and hold global partners accountable for progress.  This week, the United States joined other multi-sectoral delegations in committing to and calling for new actions during the 7th GHSA Ministerial in Seoul, Republic of Korea. 
  • Strengthen the new Pandemic Fund at the World Bank as a founding Board Member to deliver early impact for those countries and regions most in need, including supporting them to strengthen and achieve measurable capacity in critical areas. 
  • Accelerate G7 commitments made by the United States and its close allies in 2021 and 2022, including meeting milestones of the G7 Pact for Pandemic Readiness towards assisting at least 100 countries, and collaborating with Japan’s G7 Presidency to expand health security investments, bolster medical countermeasure development and delivery, and grow pandemic preparedness and response financing.  This G7 commitment matches the United States’ own 50 country target commitment and aligns with the target of the GHSA 2024 initiative. 
  • Support the planned Global Health Security Coordinating Office being established by Republic of Korea and expected to launch in 2023, including strengthening coordination and collaboration with the U.S. Centers for Disease Control & Prevention’s new East Asia regional office. 
Regional safety 

As well as global concerns, the White House will continue to promote national pandemic preparedness within the country and its region, working with “partners in the Western Hemisphere”. Working regionally, in North and South America, the Administration will: 

  • Commit, working with the WHO and the Pan American Health Organisation (PAHO), to initiate and conduct a renewed external evaluation of U.S. health security and pandemic preparedness capacity by the end of 2024, in line with strong U.S. commitment to the International Health Regulations and using the new Joint External Evaluation (JEE) 3.0 Tool. 
  • As tasked in NSM-15, revise the U.S. Global Health Security Strategy to incorporate lessons from the COVID-19 pandemic and further outline the Administration’s international strategy and support for achieving a stronger, more secure global health security architecture with equity at the centre. 
  • Work collaboratively with Canada and Mexico under the North American Leaders’ Summit (NALS) to revise the North American Plan for Animal and Pandemic Influenza (NAPAPI) based on lesson learned from COVID-19. The three countries plan on developing and launching a new NAPAPI at the 11th NALS as a key cross-sectoral, flexible, and scalable trilateral framework for strengthening regional preparedness and response to a broader range of health security threats that includes influenza and beyond. 
  • Strengthen regional engagement, including establishing a new U.S. Centers for Disease Control & Prevention regional office in Panama City, Panama, serving Central America and the Caribbean.  
  • Establish and support, in collaboration with PAHO and the InterAmerican Development Bank, the Economic and Health Dialogue of the Americas (EHA), which aims to convene Ministries of Health, Finance, Economy, and Foreign Affairs of countries in the Western Hemisphere to jointly address the economic repercussions of COVID-19 and strengthen regional pandemic preparedness. 
Results delivered 

“Investing billions of dollars today in global health security can save trillions of dollars and millions of lives.” 

The Biden-Harris Administration thus “urges” Congress to “fully meet this unique moment in history”. With the opportunity to provide the additional resources to “sustain and accelerate progress” for the partnerships, the Administration hopes that Congress will respond favourably. To demonstrate the effect of such investments, the Administration also released its annual report to detail “key outcomes”.

“In publishing these significant and measurable results, the United States continues to model transparency and accountability for its health security investments with global partners and calls on countries and non-governmental organisations to do the same.”

“The results are clear:  Investing in preparedness and prevention saves lives and yields tangible results, including helping to rapidly address outbreaks of Ebola, yellow fever, Lassa fever, polio, influenza, and many others.” 

To access the full report, click here.  

For more from the White House at the World Vaccine Congress in Washington 2023, click here to get your tickets.