Trump’s biodefense plan aims to improve coordination across agencies

In an attempt to bolster the U.S. government’s defenses against biological threats, President Donald Trump’s administration yesterday announced a strategy to better coordinate the often overlapping efforts of 15 departments and agencies and 16 branches of the intelligence community. “Our National Biodefense Strategy will address the full range of biological threats, including those that are naturally occurring, deliberate, and accidental—a first for the United States Government,” Trump said in a statement. He pledged the change would “promote a more efficient, coordinated, and accountable biodefense enterprise.”

A senior administration official, who would only speak on background without being named, explained in a press briefing that “There wasn’t a clear accountability of who’s in charge.” In the new scheme, spelled out in a presidential memorandum and a 30-page report, the National Security Council in Washington, D.C., will oversee biodefense policy and the Department of Health and Human Services (HHS), also in Washington, D.C., will take the lead on carrying it out. The HHS secretary will oversee a related Cabinet-level steering committee. There also will be an annual review of the strategy “to move away from the concept we see in too many strategy documents, that they’re written and then that’s the end of the process,” National Security Advisor John Bolton said at a separate press briefing with HHS Secretary Alex Azar.

The steering committee plans to survey all government departments and agencies involved with biodefense, which will lead to requests for new funding—possibly as early as fiscal year 2020, Azar said. “It is really the first-ever holistic look across the government to see where we are acting, and where might there be any gaps in light of our awareness of threats, our preparedness needs, and our ability to respond,” Azar said.

Nicole Lurie, who worked at HHS in former President Barack Obama’s administration as the assistant secretary for preparedness and response, says it’s always a good idea to try and “connect the dots” in the sprawling, complex U.S. government. But, she notes, her former HHS division already has the Public Health Emergency Medical Countermeasures Enterprise, which specifically coordinates federal preparedness for biological threats, including emerging infectious diseases. “This largely looks to me like a repackaging of what’s been going on,” says Lurie, who now is a strategic adviser to the Coalition for Epidemic Preparedness Innovations, a nonprofit based in Oslo.

Lurie says she was surprised the new strategy leaves many important questions up in the air. “What puzzled me is usually if you have a strategic plan there’s an implementation plan that spells out who’s doing what when and who has the lead and who is helping,” Lurie says. “I didn’t see any of that, and I didn’t see intended outcomes.”

Attempts to better coordinate the U.S. government’s response to biothreats date back to former President Bill Clinton. The Trump plan grew out of a report issued in 2015 by the Blue Ribbon Study Panel on Biodefense, a bipartisan nonprofit based in Washington, D.C. That report called for making the U.S. vice president the point person for biodefense, and it led to a congressional law, passed in December 2016, which mandated that four agencies involved with biodefense issue a new plan within 275 days. “I don’t think it’s great that it’s an entire year late,” says microbiologist Asha George, executive director of the group. “But at the same time, Congress wasn’t really willing to push for it, and I’m just glad that this did come out. I wouldn’t say it’s perfect and has every little thing we could possibly imagine put into such a strategy, but it’s still pretty comprehensive and a good start.”

George says the hard work lies ahead. “It’s an easy thing to say, ‘Hey we’re going to do this holistic thing, here’s a strategy, everyone tell us what you’re doing and here’s the cost,’” George says. “But it’s going to be quite a lift.”