Biden Is Looking to Improve Pandemic Preparedness With His Budget Proposal  

As the country is still reeling from the COVID-19 pandemic, the $5.8 trillion fiscal 2023 budget proposal President Biden sent to Congress on Monday looks to better prepare the federal government for future pandemics or health emergencies.

“The Biden-Harris administration has made great progress in combating COVID-19 and building better health security to protect against future pandemics and other health emergencies,” said a fact sheet from the White House. “However, much more is needed to prevent future biological catastrophes…We must increase and sustain our investments across the U.S. government to better prevent, detect and respond to pandemics, and to build a world safe and secure from biological threats.” 

In total, the president proposed $88.2 billion in mandatory funding for the Health and Human Services Department, Office of the Assistant Secretary for Preparedness and Response, Centers for Disease Control and Prevention, National Institutes of Health, Food and Drug Administration, State Department, and U.S. Agency for International Development to prepare for biological threats in the future. Some of the specific provisions are as follows: 

• Support the development of vaccine production technologies, therapeutics, personal protective equipment, diagnostics and other countermeasures, with the goal of being able to develop effective vaccines and therapeutics within 100 days of a biological threat being identified and producing enough to vaccinate the general U.S. population within 130 days; 
• Enhance the CDC’s domestic and global threat surveillance, workforce development, laboratory capacity, global health security and other public health infrastructure; 
• Modernize the FDA’s regulatory capacity; 
• Expand the CDC and National Institute of Health’s biosecurity and biosafety efforts domestically and globally; and, 
• Transform how the State Department and U.S. Agency for International Development prepare for pandemics and biological threats globally. 

“It is not surprising that the president’s [fiscal] 2023 budget makes a significant investment in pandemic preparedness,” Dr. Anand Parekh, chief medical advisor at the Bipartisan Policy Center, told Government Executive. “The biomedical focus on pandemic preparedness related to development of future vaccines, therapeutics, testing and surveillance is critical; however, without complementary and proportionate investments in the public health system the implementation and promise of these tools will not be fully realized.”

He also said increased funds for the CDC—“especially for data modernization and the public health infrastructure”—are essential, but the “challenge for Congress is ensuring long-term sustained funding in these areas to shore up our nation’s public health system.” 

Finally, the “vaccines for adult” program the administration is proposing that would be modeled after the current “vaccines for children” program, to give uninsured adults access to vaccines that the CDC’s advisory committee on immunization practices recommended, “could help uninsured Americans access vaccines such as COVID-19, flu, pneumococcal and others, thus saving lives and reducing disparities,” Parekh said. 

Dr. Jeremy Faust, emergency physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School who is also the editor-in-chief of MedPage Today, was very enthusiastic about crisis readiness among other public health provisions in the budget, tweeting “do it!” 

As anticipated, there was much opposition from Republican lawmakers generally on the budget proposal, which will likely undergo significant changes before it’s enacted. 

The budget release comes just after the two-year anniversary of the CARES Act’s enactment and the start of lockdowns in the United States. It also comes after a COVID-19 supplemental for current vaccine, treatment and other needs was stripped from the fiscal 2022 appropriations package due to disagreements in Congress, to the dismay of the administration officials who have been warning of the dire consequences of not having such funds.