On-the-Record Press Call by Office of Science and Technology Policy Director Dr. Eric Lander and NSC Director for Global Health Security and Biodefense Dr. Beth Cameron on American Pandemic Preparedness
11:31 A.M. EDT
MS. RAYMOND: Good morning, everyone. And thank you so much, Brad. To all our participants, thank you for joining us for this embargoed briefing today.
We will be providing an overview of the American Pandemic Preparedness Plan, also entitled "Transforming our Capabilities," which will advance the President's commitment to building back better for the next biological threat.
We'll start with some comments from our speakers. Today, we have the President's Science Advisor and Director of the White House Office of Science and Technology Policy, as well as a member of the President's Cabinet, Dr. Eric Lander; as well as the Special Assistant to the President and National Security Council Senior Director for Global Health Security and Biodefense, Dr. Beth Cameron.
After they both give initial remarks, we'll open it up for question-and-answer.
As a reminder, this briefing is on the record, but the call contents and the materials that we shared prior to the call are embargoed until 3:00 p.m. this afternoon.
And with that, I'll turn it over to our speakers, starting with Dr. Lander.
DR. LANDER: Well, thank you very much, and good morning to everybody and thank you for joining the call. So, my name is Eric Lander. I'm the President's Science Advisor and I'm the Director of the White House Office of Science and Technology Policy.
And today, we're releasing a plan for transforming U.S. capabilities to prepare for and respond rapidly and effectively to future pandemics and other high-consequence biological threats.
The COVID-19 pandemic arrived at a time when science and technology capabilities were changing very rapidly. Recent scientific advances made it possible to respond much more rapidly than ever before. Had COVID-19 emerged five years ago, we would have had far fewer tools to do this.
But, five years from now, we need to have much better capabilities. We need to have better capabilities because, well, even with the knowledge and the tools that dramatically improved our ability to respond, COVID-19 has still been devastating for the nation and the world.
As of today, COVID-19 has killed at least 642,000 Americans and many, many millions of people around the world, and many recovered patients are living with long-term effects of the disease.
It's also caused economic damage to the United States that's been estimated in the range of $16 trillion in lost economic output, direct spending, mortality, and morbidity. And the societal impact has been borne disproportionately by frontline and vulnerable populations, especially people of color.
We need better capabilities also because there is a reasonable likelihood that another serious pandemic that could be worse than COVID-19 will occur soon, possibly even within the next decade. And the next pandemic will very likely be substantially different than COVID-19. So, we must be prepared to deal with any type of viral threat.
Now, because of ongoing progress in science and technology and innovation, we can have better capabilities for medicine, for situational awareness, for public health, and for lots more. For the first time in the nation's history, we have the opportunity, due to these kinds of advances in science and technology, not just to refill stockpiles, but transform our capabilities. But we really need to start preparing now.
We've got to seize the unique opportunity to transform our scientific capabilities so we're prepared for the increasing frequency of biological threats on the horizon. Investing to avert or mitigate the huge toll of future pandemics or other biological threats is both an economic and moral imperative.
So, five years from now, we need to be in a far stronger position to stop infectious diseases before they become global pandemics like COVID-19.
Now, there's a lot we can do to transform our scientific capabilities for vaccine, therapeutic, diagnostic development; for early warning; for public health systems.
Importantly, these kinds of advances will not only strengthen our systems for dealing with future biological threats, they will be valuable for everyday public health and medical care for all Americans and for the world. This will help everyday public health for everyone.
Now, all these efforts, I've got to say, must, from the very outset, include a strong emphasis on reducing inequities and increasing access for all Americans to the resulting advances, because as we've seen from this pandemic, having the burden largely borne by vulnerable populations is unacceptable.
The COVID-19 pandemic has exposed fundamental issues with America's public heath that go far beyond pandemic preparedness.
The issues include the need to increase overall public health funding, strengthen the public health workforce, eliminate barriers to access, improve data systems, address disparities, improve communications, and improve coordination across federal, state, local, and Tribal authorities.
The plan that's being released today addresses needs directly related to pandemic preparedness, but I just want to emphasize there are broader public health issues that'll need to be addressed separately and in a coordinated fashion.
So, today, the White House is releasing a document entitled "American Pandemic Preparedness: Transforming our Capabilities," and the document describes goals under five pillars to protect the U.S. against biological threats.
Pillar number one is: transforming our medical defenses, including improving vaccine, therapeutics, and diagnostics.
Pillar number two: ensuring situational awareness about infectious disease threats, for both early warning and real-time monitoring.
Pillar three: strengthening public health systems, both in the U.S. and internationally, to be able to respond to emergencies, with a particular focus on protecting the most vulnerable communities.
Pillar four: building core capabilities, including personal protective equipment, stockpiles and supply chains, biosafety and biosecurity, and regulatory improvement.
And pillar five: managing the mission, with the seriousness of purpose, commitment, and accountability of an Apollo Program.
So, while the government -- the U.S. government has made and must continue to make investments in basic science research, this plan includes the full set of capabilities needed to transform our ability to be prepared for any family of virus. The cost is $65.3 billion over 7 to 10 years.
And it's vital that we start with an initial outlay of $15- to $20 billion to jumpstart these efforts. And, accordingly, we're proposing that the current budget reconciliation provides at least $15 billion towards this goal.
The administration will work through other appropriations to support the remainder of that $65.3 billion budget, above baseline, needed to execute the plan in full.
And over the coming months, the White House will be developing the President's budget, which will provide resources to ensure that the United States is prepared for the next pandemic.
So, let me just say, these critical investments will build on and complement the broader U.S. government biomedical and health research portfolio.
We strongly believe that this mission is so important that it needs to be managed with the seriousness of purpose, commitment, and accountability of, well, President Kennedy's Apollo Program, overseen by a dedicated program office.
So we're proposing there be a centralized "Mission Control" acting as a single, unified program management unit that draws on expertise from multiple agencies at HHS, including NIH, CDC, BARDA, FDA, and CMS, as well as other agencies and departments such as DOD, DOE, VA. You know, for example, the Countermeasures Acceleration Group -- formerly "Operation Warp Speed" -- is led by a single joint program management unit.
And Mission Control should have the responsibility and the authority to develop and update plans with objective and transparent milestones; regularly assess and publicly report on mission progress; shift funding to ensure that goals are achieved; coordinate linkages across performers in government -- academia, philanthropy, and industry; and conduct periodic exercises to evaluate our actual national pandemic preparedness by deploying these capabilities, including through testing rapid product development. And it should seek input of outside experts and have working groups that allow it to get the best possible advice.
So, like any ambitious endeavor -- whether it's going to the Moon with the Apollo mission or cracking the human DNA with the Human Genome Project -- an effort like this will take serious, sustained commitment and accountability.
And like those kinds of efforts, it is likely to yield benefits far beyond the initial mission -- in this case, advances in human health and providing tools that can help overcome health inequities and ensure equitable access to innovative products for all Americans.
So, we at the Office of Science and Technology have been working hard on the plan in very close partnership with the National Security Council, and particularly the National Security Advisor, Jake Sullivan.
And so I'm now pleased to pass this over to my colleague from the NSC, Dr. Beth Cameron. And thanks for all you have been doing on this, Beth. Over to you.
DR. CAMERON: Thanks, Eric. And thanks so much for the great humongous work on this plan, and also just the huge partnership between the National Security Council staff and your staff at the Office of Science and Technology Policy.
I'm Beth Cameron, the Special Assistant to the President and Senior Director for Global Health Security and Biodefense on the NSC staff. And just quickly, I wanted to situate this plan within a number of the other activities that we're working on together in close concert with the Office of Science and Technology Policy and, really, across the U.S. government and the White House.
As you all know, the President has been committed from day one to pandemic readiness, including ending this pandemic which threatens the world and continues to create dangerous variants.
In parallel, he and the administration remain committed to advancing, repairing, and strengthening health security and pandemic preparedness for the future, including obviously here in the United States but also around the world.
And that's why the President took swift action early to lay out a vision and plans for this work, including signing his first National Security Memorandum, which focused on the COVID-19 health and humanitarian response; advancing health security; and building better biological preparedness. And this plan is really one central piece of that effort.
We're also actively implementing many of the actions called for in NSM-1, including, obviously, releasing a COVID-19 response strategy, both domestically and globally. We've established a new domestic Center for Epidemic Forecasting and Outbreak Analytics. We've reengaged with the WHO on day one. We're working across the government to raise the global and domestic research and development ambition to decrease the timing between detection of the new biological threat and safe delivery of targeted countermeasures and therapeutics. And you obviously heard a lot more about that from Dr. Lander.
We're reviewing the existing state of our biodefense enterprise -- and I'll come back to that in a second -- and we continue to prioritize helping other countries in need to build their capacities to prevent, detect, and respond, and to advance our programs that support the global health security agenda and establish catalytic health security financing for the future.
The President signed, on his first day in office, Executive Order 13987, and that focused on the organization here in the United States for COVID-19, but also on emerging biological threats. And it included reestablishing my office -- the Directorate for Global Health Security and Biodefense on the NSC staff.
And we're really here to provide a high-level "belly button," if you will, to elevate these important issues to the President and the NSC.
Our team has a "no-fail" mission to rapidly mobilize the policy machinery to elevate high-consequence infectious disease outbreaks quickly across the White House and to the National Security Advisor, and really to empower agencies to adopt a no-regrets response.
And we're working very closely with OSTP and across the White House with all relevant departments and agencies as well to do a whole-of-government review and update of national bio-preparedness policies, which is directed by that executive order and by National Security Memorandum-1.
And so the document that we're releasing today that Eric outlined in detail lays out a set of urgent needs and opportunities that are necessary to protect the United States against biological and pandemic threats.
We believe that transforming our capabilities will require a systematic effort and a shared vision for biological preparedness that, as you heard from Eric, is really akin to an Apollo mission.
And that's why we envision that this will be a core element of our strategy going forward on biodefense and pandemic readiness, informed by lessons from the COVID-19 pandemic.
Importantly, though, we continue to take stock of our full range of biodefense, pandemic readiness, and global health security needs, including capabilities, policies, and practices that we need to update and refresh, building on our lessons from COVID-19 and other outbreaks.
While this plan does lay out a clear vision for bio-preparedness, it doesn't cover everything. As Dr. Lander said, it's really focused on our capabilities at home to prepare for pandemic.
COVID-19 has enumerated a number of challenges in our preparedness for a moderate pandemic, but we do need additional capabilities to be fully prepared for any biological event that comes our way, and that includes countering bioterrorism; countering the development and use of biological weapons; strengthening the Biological Weapons Convention; improving food security and food defense, zoonotic spillover events, and others.
And we really focused this document on specific capabilities to stop a pandemic sooner, including a strong emphasis on science and technology, and early countermeasure development. And we felt it was urgent to get started on this issue immediately.
Simultaneously, we remain focused on reviewing and updating our other policies and practices, including across the broader healthcare system, workforce, and other areas. And of course, we remain laser focused on the domestic and global COVID-19 response and our full programs of -- a full suite of programs in support of those efforts. These are vital, and the President has also placed a major priority on them, including in his FY22 Budget Request.
So, just in closing, as we finalize our broader whole-of-government bio-preparedness effort, as directed by the President, this an important and crucial element, and we have to start now.
Thanks so much. And back over to the moderator.
Q: Hi, thanks for taking the question. I wanted to ask about the funding component. So, it lays out $65.3 billion over 7 to 10 years (inaudible). Could you talk about where this funding would come from, what action Congress would need to take, and if the previous relief bills would be able to be re-appropriated for this purpose?
DR. LANDER: I'm sorry. I lost the last part of your question.
Q: And if previous relief bills could be used to help pay for this type of plan.
DR. LANDER: Well, the plan is to seek at least $15 billion in reconciliation and then to seek additional appropriations to support the rest of the plan. And I think that's the description right now where we're seeking to fund this from.
Q: And just for clarity, (inaudible). It outlines $5 billion. Obviously, the American relief fund and other bills have poured in much more than that into diagnostic preparedness. How -- how is this adequate to achieve the goals that are laid out here (inaudible)?
DR. LANDER: Well, I think it's a very important thing to think about fighting this current pandemic, which is incredibly important, and then transforming our capabilities for future pandemics.
So, as laid out in the report, we would like to get to the place where, in a future pandemic some years from now, you don't have to drive to CVS to get a test, but we have incredibly inexpensive tests that, if needed, people could apply daily at home to know if they were infected, if they needed medical care. And so, we would like to -- you know, we would like to be able to -- or drive to their doctor, or to wherever.
We would like to be able to have this be capabilities that could be done extremely frequently and conveniently and inexpensively, and so -- and, of course, I have to add, accurately -- so that we can get this information because it would be so much more effective if everyone can know every day if they should stay home, if they need medical care to come to them.
So, that kind of transformation is very different than expanding the capacity in the current pandemic. So, I think it's important to be able to focus on both. We have tremendous amounts to do for this pandemic, and we really have to think about creating capabilities that may take several years to develop but that can be truly transformative for the next events that we will see, surely, in the coming decades.
Q: Thanks for the briefing, and thanks (inaudible).
DR. LANDER: Hello? Hello?
DR. LANDER: We lost you a second -- or I lost you at least. I got "Thanks for the briefing…"
Q: (Laughs.) I -- if that's my legacy on this call, that's unfortunate; I'm not doing my job. So, let me try my question again.
This is for Dr. Cameron, who worked on the Obama-era pandemic preparedness initiatives, including the so-called "pandemic playbook." I'm curious how much of this effort draws on the Obama-era work?
DR. LANDER: Let me turn over to my colleague, Dr. Cameron.
DR. CAMERON: Thanks, Dan. This work very much draws on lessons from those efforts. And importantly, I think, in addition to that, draws on lessons from this pandemic, which really showed us that we had to be able to act much more -- much more quickly to provide -- to be able to provide medical countermeasures quickly, which, as Dr. Lander said, we were able to do more quickly in this pandemic. But we want to bring that timeline as far to the left as we possibly can.
But also, it does include some elements here for the global mission. This is not the sum total of what's needed for health security. Many of our baseline programs have been requested for increases for that effort. But it does include a piece so that we can act more quickly anywhere in the world, including by catalyzing financing for health security locally, which very much was a lesson from the Ebola epidemic that's been worked on throughout the federal government since that time, but which really hasn't had the level of ambition realized that was necessary.
So, the short answer to your question is: It very much builds on that work, but just keeping in mind that that effort was about operationalizing the work that we have. What this is about -- what this plan is about is ensuring that the United States has the capabilities it needs to operationalize them when we see the first signs of an emerging outbreak that could have epidemic or pandemic potential.
And so, we still have to be able to act quickly as a government to exercise these capabilities, but we have to have the capabilities to use. And that's really what this is about.
Q: Yeah, thank you for taking my call. I'm curious about the concept of the centralized Mission Control. It reminds me a little bit of the Office of Director of National Intelligence that was established about 9/11. And I'm wondering if that was part of your thinking. And, you know, who would run Mission Control? Where would it be centered? Would it be centered within HHS? Would it draw from DOD? Et cetera.
DR. LANDER: Well, it's a great question. And I would say I personally did not think of it in terms of the Director of National Intelligence, which is an incredibly important office that is integrating intelligence coming in on such a huge variety of topics from across the government.
In a way, it's: How do you manage a plan to create a set of needed capabilities? We need the whole set of capabilities -- if we were to make vaccines but not have diagnostics, diagnostics but not have therapeutics, if we couldn't actually track the evolution of the pandemic.
So, I think it's much more, I think, like an Apollo project. If you're getting to the Moon and you have a great booster rocket but you haven't got a capsule capable of landing or computers capable of directing, it's not going to work.
So, you actually need to have an office that is not merely, say, giving grants to researchers to explore things, or, you know, building individual components, but making sure that on a regular basis, looking at it every three months, that these pieces are adding up, and if there are roadblocks somewhere, to find paths around those roadblocks. So, I think of it more like that.
Where should it sit? Well, it's still a question being thought about. But I think we're in unanimous agreement that we need people who are focused full time -- 100 percent of their time -- on the mission. And we need to draw on the expertise of many different agencies.
So, there's still discussion about exactly, you know, who should house Mission Control, but I can say for sure that the idea is fully devoted to ensuring the accountability and responsibility for the mission and fully drawing on both expertise across the U.S. government and external expertise and advice to make sure that all of this is responsible and accountable.
This is a really major national responsibility, and we have to be sure we deliver on this mission.
MS. RAYMOND: Brad, let's do one last question, please. A quick one.
Q: Thanks. Can you hear me okay?
DR. LANDER: Yep.
Q: Great. Two quick questions. First, on the budget: You mentioned a couple of times the $15 billion that you want in the reconciliation. Can you let us know exactly where that stands? Do you think you're going to get it?
And secondly, on Mission Control: I'm wondering why you chose HHS. Obviously, it's a main agency for this topic, but there was a Blue Ribbon Commission a couple of -- maybe five, six years ago that recommended any effort of this type be centered at the White House. And I think, particularly, they specified in the Office of the Vice President. I wonder if that was considered.
DR. LANDER: With regard to your last question, there's no doubt that there would be White House oversight of this and deep White House involvement in this. So, even though it may not explicitly say that, let me explicitly say now: The expectation is that there will be very serious, engaged White House oversight and involvement.
But when you're talking about Mission Control going to the Moon, for example, that's a pretty complex project that will involve a significant number of staff devoted full time to this mission. And that just doesn't fit within running Mission Control out of the White House, whether you're going to the Moon, sequencing the human genome, or building all the capabilities.
But if it wasn't clear, let me be fully clear: This is something that is so important to the nation, the White House should and will be fully and appropriately involved.
Your first question was the $15 billion. And so, we are in discussions with the Hill and very optimistic.
Q: Thank you.
MS. RAYMOND: Thank you so much. And I'm going to now wrap today's call. As a reminder for those who may have joined after I started, this call was on the record, but the call contents and the materials that were shared are embargoed until 3:00 p.m. this afternoon.
Thank you so much to our participants and many thanks to our speakers -- Dr. Lander, Dr. Cameron. And that concludes today's call. Bye-bye.
11:58 A.M. EDT
Joseph R. Biden, On-the-Record Press Call by Office of Science and Technology Policy Director Dr. Eric Lander and NSC Director for Global Health Security and Biodefense Dr. Beth Cameron on American Pandemic Preparedness Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/352087