Two panels of witnesses, including the leaders of three agencies under the Department of Health and Human Services (HHS), provided testimony on various aspects of the Pandemic and All-Hazards Preparedness Act (PAHPA) during a hearing before the Senate Health, Education, Labor, and Pensions (HELP) Committee on May 4.
The hearing offered the committee input as they develop legislation to reauthorize the law, which is set to expire by Sept. 30. Senate (HELP) Committee Chair Bernie Sanders (I-Vt.), Ranking Member Bill Cassidy, MD, (R-La.), Sen. Bob Casey (D-Pa.), and Sen. Mitt Romney (R-Utah) had previously issued a March 15 request for information about PAHPA reauthorization [refer to Washington Highlights, March 31].
In her testimony, Assistant Secretary for Preparedness and Response Dawn O’Connell urged the Committee to provide the Administration for Strategic Preparedness and Response (ASPR) with additional authorities around procurement, domestic manufacturing, pay flexibilities, and a Working Capital Fund to strengthen the agency’s preparedness and response capabilities. Centers for Disease Control and Prevention Director Rochelle Walensky MD, MPH, voiced support for the president’s FY 2024 budget proposal to support the CDC’s work and the public health workforce, and highlighted the CDC’s ongoing modernizations efforts in her testimony. Food and Drug Administration Commissioner Robert Califf, MD also proposed “modernized” authorities, as well as greater supply chain transparency, operational readiness in surge capacity, and improving laboratory testing regulations in his testimony.
The second panel of witnesses included Yale School of Medicine Assistant Professor Reshma Ramachandran, MD, MPP, MHS; Public Citizen President Robert Weissman; and Johns Hopkins University Professor Martin Makary, MD, MPH. In her testimony, Ramachandran called for additional studies of medical countermeasures that demonstrate safety and efficacy, affordable access to medical countermeasures, and greater evaluation of publicly awarded incentives to generate safe medical countermeasures. Weissman recommended requiring greater transparency, affordability, production, licensing terms in research and development (R&D) and acquisition contracts through the Biomedical Advanced Research and Development Authority (BARDA) and other agencies and the adoption of prize funds or other creative measures to fund biomedical R&D and other public health objectives. In his testimony, Makary stated that “the U.S. failed to fund basic clinical research on the big COVID questions,” and proposed a rapid response team that would conduct or fund clinical research to better inform pandemic responses.
Sanders and Cassidy emphasized the importance of bolstering a response to future threats and improving communication with the public. Sen. Murray (D-Wash.) and Romney called for improved data collection. Other members of the subcommittee discussed the impact of lockdowns on mental health and the disproportionate impact of the COVID-19 pandemic on vulnerable populations.