The AAMC sent letters on June 30 to Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-Wash.) and Ranking Member Richard Burr (R-N.C.) and House Energy and Commerce Committee Chair Frank Pallone (D-N.J.) and Ranking Member Cathy McMorris Rodgers (R-Wash.) detailing recommendations for Congress to prepare for the next pandemic. The letter follows an April 29 Dear Colleague Letter from Murray and Burr, which announced their intent to engage in “bipartisan discussions to consider how to better prepare the nation for future public health emergencies in light of the COVID-19 pandemic.”
The AAMC letter highlighted the AAMC and academic medical centers’ contributions to combatting the pandemic as they have “been engaged in nearly every dimension of the nation’s response to COVID-19” as well as the “unique perspective on the early lessons we can apply to prevent and respond to future threats.” The letter outlined eight recommendations that Congress can take to enhance the nation’s preparedness infrastructure, as well as specific steps to advance the recommendations.
The recommendations are:
- Reinvest in public health infrastructure and strengthen opportunities for coordination between academic medicine and public health by providing support for foundational public health activities, strengthening existing public health and health care preparedness programs, strengthening the relationship between health departments and academic medical centers, bolstering the nation’s genomic sequencing infrastructure for surveillance, and recognizing the critical role of federal coordination in pandemics, with academic medicine input.
- Support Clinical Preparedness by equipping academic medical centers to build flexible surge infrastructure, expanding existing networks to address special pathogens and disaster response, establishing a network of pandemic preparedness centers, preserving regulatory flexibility for the Acute Hospital Care at Home program, expanding broadband access and taking other steps to increase access to care via telehealth, prioritizing mental health parity and promoting access to mental/behavioral health care, and supporting infrastructure to build physical hospital resilience against pandemics, climate events, and other disasters.
- Ensure Access to Key Supplies and Medical Countermeasures by strengthening the Strategic National Stockpile and establishing complementary mechanisms, strengthening testing infrastructure, and ensuring geographic diversity of vendors and domestic manufacturing capacity.
- Invest in Data Modernization by providing reliable funding to modernize and maintain data systems at public health departments and the digital architecture of health care facilities nationwide, identifying essential data elements in advance, promoting a commitment to transparency and trustworthiness, and collecting sociodemographic, social needs, and social determinants data to promote equity.
- Prioritize Equity by applying a health equity framework to all elements of pandemic planning, including support for planning grants to address social determinants of health; promoting meaningful community engagement and considering unique needs of certain populations; and making it easier to reach communities where they are through support for mobile units and other community-based solutions.
- Advance and Facilitate Medical Research and Innovation by maintaining a robust commitment to medical research supported by the NIH, establishing clear rules and procedures for engagement of labs in testing for pathogens during a public health emergency, supporting multisector public-private/academic research partnerships, making telehealth flexibilities permanent to support clinical trials, and creating the structure to rapidly address complex bioethical issues
- Ensure Ample Workforce to Mount A Nimble and Effective Response to Public Health Crises by increasing federal support for physician training, considering challenges related to workforce staffing in emergencies, investing in health professions students and education infrastructure, and promoting health professionals’ health and well-being.
- Other Key Structural and Programmatic Priorities such as ensuring sustained funding for core needs and emergency investments as needed, exempting key Department of Health and Human Services agencies from discretionary spending limits, and streamlining processes for administrative flexibilities in a public health emergency.
The letter emphasized that the recommendations attempt “to integrate equity throughout all of our recommendations” and urged the Committees “to do the same given the clear disparities that the pandemic illuminated.” It concluded by recognizing the broad scope of the recommendations and the need to work across multiple Congressional committees to draft “potential legislation to enhance and rebuild our public health, health care, and scientific infrastructure to strengthen the nation’s resilience against future emerging hazards.”