How can the United States prevent another COVID-19 stockpile disaster?

WASHINGTON – What can be done to prevent poor federal responses to disasters, such as the National Strategic Reserve (SNS) which was woefully under-stocked when COVID-19 hit? This is the question addressed in a new report of the National Academies of Science, Engineering and Medicine (NASEM).

Responding to public health emergencies falls largely under the purview of the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE, pronounced FEM-see), a multi-agency coordinating body within the federal government. Its mission is to ensure that the government has the tools it needs to save lives, including antibiotics, antivirals and personal protective equipment, said Alan Leshner, PhD, co-chair of the committee that wrote the report, on Wednesday. an online briefing.

However, he added, “it is an organization that has had a troubled history and mixed record,” with limited adoption of its ideas.

The report contains a list of 11 recommendations for improving PHEMCE, starting with making sure that group members actually have the power to act, or are close to someone who does.

“The people who represent the different partners must have a sufficient reputation in their respective agencies to be able to act with agility and relatively quickly, so that, as recommendations have to be made to go to their bosses, they do not have to go. . through five or six layers for something to happen, ”said Leshner, former CEO of the American Association for the Advancement of Science.

PHEMCE must better reflect the perspectives of stakeholders and give them guidance on which they can act, he continued.

“One of the problems we heard over and over was that historically this organization tends to work …” He had a bit of a release, but he didn’t get enough or didn’t take seriously enough “the input he received.

Other recommendations for PHEMCE included:

  • Use measurable outcome indicators. “They need to be measurement-driven and have a process to assess what they’re doing at all stages,” said Gigi Gronvall, PhD, NASEM committee co-chair. “There has to be an objective third party to look at what they’re doing and assess how progress is being made.”
  • Establish an advisory committee of non-federal and private partners and stakeholders. Regarding the above recommendation, Gronvall noted that all members of PHEMCE are federal agencies, “But in order to be able to fulfill the mission of PHEMCE, it must have private sector involvement,” said Gronvall. “He has to be able to coordinate beyond the federal government. One of the ways we suggest doing this is to establish an advisory committee that includes this expertise from both non-federal and private sector partners. This advisory committee should be a strong advisory committee, listened to and consulted in important decisions. This would give an opportunity for communication between the non-federal partners and the federal partners … And it would also give more visibility to the PHEMCE ”, which is important because its mission deserves greater visibility within and within the outside the federal government, she said.
  • Establish an integrated and accessible medical countermeasures data system. “There are many things to follow with the PHEMCE [mission], and being able to have all of that so that gaps can be identified and vulnerabilities can be addressed – that would be a big step forward, ”said Gronvall, who is also a senior researcher at the Johns Hopkins Center for Health Security.

The report also recommended a root cause assessment of the COVID-19 experience with the SNS and determining “lessons learned.” Gronvall noted that PHEMCE orders an inventory report every year.

“We all know that during COVID-19, the national strategic stockpile did not have what we wanted it to have,” she said. “We think it’s important not only to have an assessment of what happened during the COVID experience, but also to go a little beyond and ensure that the SNS assessments that the PHEMCE conducts annually – or should be conducted annually – produces a good result and leads to a better prepared or better stocked stock. “

Committee member Craig Vanderwagen, MD, a retired family physician, pointed out that many of PHEMCE’s efforts are focused on developing new products – such as vaccines and diagnostics – that can be useful in emergencies. public health, “but the end of the game is, How do we distribute this? What’s the ‘last mile’ feature set?”

The committee was not asked about the role of the SNS as a ‘last mile’ distributor, “but it is a problem that the [Assistant Secretary for Preparedness and Response] and others will need to respond very succinctly to ensure that we are effective in this last mile distribution process, ”said Vanderwagen.

In addition, the CARES law passed by Congress to help fight the pandemic asked NASEM to “review and offer recommendations on how to improve supply chain security,” he said. -he adds.

Another NASEM committee that Vanderwagen is a part of has been working on this and is close to finalizing its recommendations, and although they are not finalized, “we are dealing very actively and extensively with these last mile and SNS issues, and its role in delivering those products. ”That report will likely come out in January, Vanderwagen said.

  • Joyce Frieden oversees Washington’s coverage of MedPage Today, including articles about Congress, the White House, the Supreme Court, health professional associations and federal agencies. She has 35 years of experience in health policy. To follow

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