Pandemic and All Hazards Preparedness Act of 2006

Pandemic and Preparedness Act of 2006

The Pandemic and All Hazards Preparedness Act was signed into law by President George W. Bush in 2006. It gives authority to the Department of Health and Human Services (HHS) for handling the medical countermeasures in the event of a biological attack, and created a position inside the HHS -- an Assistant Secretary for Preparedness and Response (ASPR). According to the Congressional Budget Office Cost Estimate, the total amount of grants available to "…support the readiness of the public health system" for potential public health and medical emergencies -- and the overall cost of the legislation -- between the years 2007-2011 was projected to be $6 billion (Congressional Budget Office).

Issues Surrounding the Pandemic and Preparedness Act

An article in the Journal of the American Medical Association (JAMA) points out that the public "…is skeptical about the government's capabilities" subsequent to the "lack of leadership and accountability following Hurricane Katrina" (Hodge, et al., 2007, p. 1). Hodge, with the Center for Law & the Public's Health at Johns Hopkins Bloomberg School of Public Health, and colleagues point out several troubling issues about the Pandemic and all-Hazards Preparedness Act (PAHPA).

The PAHPA puts forward the notion that interjurisdictional coordination "is pivotal during emergencies," Hodge explains, but the PAHPA does not "specify how federal entities should align with Tribal, state, and local governments… specification is lacking" (p. 1). The way the law is written, it may give federal authorities the legal right "…to usurp traditional subnational public health activities" (Hodge, p. 2). And if states are not compliant with PAHPA, will they be denied federal funds "on an escalating scale" -- and will those funds then be "redistributed to other jurisdictions," in effect denying funds to deserving states? (Hodge, p. 2).

The JAMA article points out that while the federal government certainly needs "meaningful health data" to be able to respond to public health emergencies, by collecting "identifiable, often sensitive health information" the government may be invading "personal privacy" in the process (Hodge, p. 2). In fact, Hodge continues, the PAHPA allows federal officials "…too much discretion to accumulate and share personal health information without adequate safeguards" (p. 2). Another problem the JAMA piece mentions is that the PAHPA does not reduce the potential "liability exposure" for medical volunteers that arrive at emergency events. In other words, the PAHPA should protect volunteers (that rush to the scene of a disaster like Hurricane Katrina) from lawsuits for their "non-criminal actions" in humanitarian efforts (Hodge, p. 3).

Also, Hodge writes that PAHPA does not "…ensure adequate economic incentives to stimulate maximum private sector participation"; in other words, pharmaceutical companies asked to produce vaccines for potential bio-terror attacks, are not guaranteed a return on their investment to produce the vaccines (Hodge, p. 4).

When the U.S. House of Representatives reauthorized PAHPA in 2011, the Trust for America's Health (TFAH) -- a nonprofit advocacy group -- praised the legislation but cautioned that "…the bill freezes public health preparedness funding at the fiscal-year 2011 levels" which, the TFAH asserts, "will not provide sufficient resources to…ensure we are prepared in the event of an emergency" (Roos, 2011). In fact, Jeffrey Levi, the executive director of TFAH, mentioned that cuts in local, state and federal funding in recent years "…have contributed to the loss of an estimated 43,000 state and local public health jobs" (Roos, p. 1).