3/13/20
When President Trump took office in 2017, the White House’s National Security Council Directorate for Global Health Security and Biodefense survived the transition intact. Its mission was the same as when I was asked to lead the office, established after the Ebola epidemic of 2014: to do everything possible within the vast powers and resources of the U.S. government to prepare for the next disease outbreak and prevent it from becoming an epidemic or pandemic. One year later, I was mystified when the White House dissolved the office, leaving the country less prepared for pandemics like covid-19. The U.S. government’s slow and inadequate response to the new coronavirus underscores the need for organized, accountable leadership to prepare for and respond to pandemic threats. In a health security crisis, speed is essential. When this new coronavirus emerged, there was no clear White House-led structure to oversee our response, and we lost valuable time. The job of a White House pandemics office would have been to get ahead: to accelerate the response, empower experts, anticipate failures, and act quickly and transparently to solve problems. It’s impossible to assess the full impact of the 2018 decision to disband the White House office responsible for this work. What’s especially concerning about the absence of this office today is that it was originally set up because a previous epidemic made the need for it quite clear.
The U.S. government worked hard to fight the 2014 Ebola epidemic. in 2016, after the formidable U.S.-led Ebola response, the Obama White House established the global health security office at the National Security Council and asked me to lead the team. We were to prepare for and, if possible, prevent the next outbreak from becoming an epidemic or pandemic. We partnered with federal departments and agencies as they monitored evolving outbreaks, triggering alarms for decision-makers when those outbreaks began to take on unusual or worrisome characteristics. My office was also tasked with preparing — at home and around the world — for the next health emergency, no matter its origin. A directorate within the White House would have been responsible for coordinating the efforts of multiple federal agencies to make sure the government was backstopping testing capacity, devising approaches to manufacture and avoid shortages of personal protective equipment, strengthening U.S. lab capacity to process covid-19 tests, and expanding the health-care workforce. Pandemics, like weapons of mass destruction and climate change, are transnational threats with potentially existential consequences. No single department or agency can be responsible for handling them. Pandemic threats may not arise every year, but the White House should constantly prepare for them. We can’t afford for federal decision-makers to waste time relearning old lessons when they should be innovating and acting. Covid-19 wasn’t preventable, but it was predictable. Hopefully, its impact can still be limited. But it is well past time for the U.S. government to show the leadership required for an effective domestic and global response. We need to start sprinting. Come April and May, no one will wish the United States had done less.
