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A Letter to President-Elect Biden on Pandemic Preparedness

December 2, 2020

Dear President-elect Biden:

The Partnership to Fight Infectious Disease congratulates you on your election as the 46th

President of the United States. We wish you and Vice President-elect Harris well as you begin

your new administration. You will, no doubt, face significant challenges -- including the relentless COVID-19 pandemic -- during your tenure as our nation's chief executive.

Amid this pandemic, which has already claimed more than 270,000 American lives, our country

has witnessed firsthand the health, economic and societal impacts of national health

emergencies. The need to improve pandemic preparedness now, in order to prevent or otherwise lessen the impact of current and future national health emergencies, has never been more apparent.

To that end, the Partnership to Fight Infectious Disease urges you and your administration to

prioritize the buildout of a National Pandemic Preparedness Strategy (NPPS) in the months to

come. The NPPS must:

  • Address the needs of front-line workers;

  • Address existing and growing public health threats associated with pandemics;

  • Address the current and growing crisis of antimicrobial resistance (AMR);

  • Support a health care infrastructure that ensures access for all and addresses challenges to achieving health equity; and

  • Encourage the public and private sectors to work collaboratively.

We believe that an effective NPPS must deal not only with the direct response to a novel

pathogen, but also with collateral health care issues a pandemic can produce. It should support investment in the array of medical products that will prove critical to preventing future pandemics when an infectious disease threat arises.

While the current COVID-19 threat is viral, our experience with pandemics illustrates that

secondary bacterial and fungal infections can also pose a massive health risk, particularly as

hospitalization levels rise as noted in a recent CDC report. Unfortunately, new antibiotic and

antifungal drug development is declining at a time when we need it most. Already, drug-resistant bacteria and fungi infect 2.8 million Americans each year, claiming as many as 35,000 lives. The absence of new drugs to fight these types of infections may prove far more detrimental to human health under a future pandemic than even COVID-19.

Clearly, a renewed federal effort is needed to ensure that front line medical staff have all the

resources they need to save lives, including life-saving antibiotics. Two bills currently under

consideration in Congress -- the DISARM and PASTEUR Acts -- would incentivize innovation and encourage scientists and drug developers to redouble antibiotic research and development efforts. This element of the NPPS must also include programs that promote smarter use of antibiotics -- and help guard against overuse. It must also educate patients about the importance of taking antibiotics as prescribed.

Further, it will be essential to provide continued support for public-private partnerships that

advance and underpin progress in these areas. For example, the Biomedical Advanced Research and Development Authority (BARDA) work in AMR, through both their clinical programs and their support of funding alliances, has in four short years built the world’s most innovative preclinical pipeline. Such efforts must be fortified to reap the full benefits and be sustainable.

The new NPPS must also facilitate safe, ongoing and uninterrupted access to health care for

America's most vulnerable. National health emergencies threaten everyone, but pose a

particularly acute danger to those with chronic and underlying conditions and those facing access to care problems or other health disparities. The COVID-19 pandemic exposed how woefully unprepared we have been in this regard.

Consider that as of June, 41 percent of adults had avoided medical care due to COVID-19. For

Black and Hispanic Americans, as well as those with underlying conditions, the prevalence of

health care avoidance during the pandemic has been even greater. A successful national strategy should therefore include provisions for ensuring vulnerable populations are successfully supported in the event of a pandemic.

One way to achieve this goal is through investment in telehealth systems, which enable patients to access medical care remotely. The CDC contends that telehealth offers many benefits during widespread disease outbreak, as it reduces exposure to disease, helps preserve personal protective equipment, and limits demand on health care facilities. However, fewer than 40 percent of Americans are currently able to access telemedicine through their care provider. Bolstering the accessibility of remote medical care would go far to ensure Americans can safely manage their health during future crises.

The NPPS should also strengthen our public health infrastructure by reinforcing the medical

workforce and investing in innovative data collection, monitoring, and tracking technology -- like the CDC's National Healthcare Safety Network. Doing so will help prevent the spread of future outbreaks and facilitate the equitable distribution of scarce resources to the hardest-hit


A strong public health infrastructure accelerates a community's ability to respond and minimizes the economic consequences of restrictions on in-person activities. Importantly, though, tracking systems must avoid placing an additional administrative burden on hospitals and health care facilities. Such systems should work in tandem -- not in competition -- with one another.

As of mid-July, more than half of U.S. adults polled by the Kaiser Family Foundation said that

coronavirus-induced stress had an adverse impact on their mental health. An effective NPPS

should also address the behavioral health impacts associated with infectious disease outbreaks, and it should facilitate coordination between federal and state authorities, the private sector and others to ensure that supply reserves are adequate and reliably sourced, can be surged regionally as needed, and will be replenished in a timely fashion.

The strategy should also be supported with a national communications plan to disseminate

credible information about ongoing and emerging public health threats. According to a study

published in the journal Progress in Disaster Science, COVID-19 misinformation on social media had a deleterious impact on how individuals personally responded to pandemic conditions.

The Partnership to Fight Infectious Disease implores you to devote ample resources to a new

National Pandemic Preparedness Strategy. We stand ready to support and encourage the above policies -- pairing the expertise and experience of the private sector with the knowledge and regulatory capabilities of the public sector -- to help better prepare our nation for the next pandemic. Without effective planning, we may one day face an infectious disease crisis even more deadly and disruptive than COVID-19.


Kenneth Thorpe, PhD

Robert W. Woodruff Professor and Chair, Department of Health Policy and Management, Rollins School of Public Health, Emory University

Cc: The Honorable Mitch McConnell, Senate Majority Leader

The Honorable Nancy Pelosi, Speaker of the House


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