Is the US prepared to deal with another pandemic or widespread health crisis?
No, the US is not fully prepared for another pandemic or widespread health crisis, though it has significant capabilities and has made improvements since COVID-19. Major gaps in coordination, funding, stockpiles sustainability, trust, equity, and sustained political commitment leave it vulnerable, and recent policy shifts have raised further concerns.[1]
The US ranks first globally in the Global Health Security (GHS) Index (score of ~83.5/100 out of 195 countries), reflecting strong lab systems, surveillance/reporting, biosafety/biosecurity, emergency planning frameworks, risk communication infrastructure, and medical countermeasure approval capacity. It outperforms averages substantially in prevention, detection, and international norms compliance.[1][2]
Post-COVID Improvements
The Biden administration (and prior efforts) rebuilt elements of readiness:
These built on decades of investments (e.g., PAHPA authorizations) and private-sector/academic strengths in R&D and manufacturing.
Persistent and Emerging Gaps
Independent assessments highlight unfinished business:
Recent Developments and Risks (as of 2025–2026 context)
Reports indicate the second Trump administration (with RFK Jr. at HHS) has scaled back or dismantled key elements: emptying or understaffing OPPR and related NSC roles; terminating or winding down substantial mRNA and other countermeasure R&D contracts (hundreds of millions to over $1B impacted); cuts to surveillance, NIH/NIAID pandemic portfolios, and global health security; staff reductions at HHS/CDC/ASPR; and skepticism toward certain vaccines/platforms. Experts describe this as damaging preparedness and creating gaps adversaries could exploit, while other countries partially fill voids. PAHPA modernization and hospital preparedness funding face uncertainty.[16][17][18]
Public health infrastructure was already strained; polarization, burnout, and eroded trust compound risks. No country is fully prepared (GHS Index average is low), and the next threat (e.g., novel virus, engineered pathogen, or severe flu) may differ from COVID.
Bottom Line
The US has world-leading scientific, industrial, and (on paper) planning strengths, plus rebuilt stockpiles and data tools that make it better positioned than in early 2020 for some scenarios. However, it is not adequately prepared overall due to incomplete implementation of lessons, chronic underfunding/coordination issues, variable state capacity, and recent erosions in R&D, coordination offices, and global engagement. Experts across bipartisan commissions, GAO, Stimson Center, and others urge sustained “always-on” investment, better leadership/integration, equity focus, and domestic + global efforts. Preparedness is a continuous process, not a finished state—political will and resources determine outcomes more than plans alone. Monitoring H5N1, AMR, and emerging pathogens remains critical.
Citations (18)
- https://ghsindex.org/country/united-states/
Backs: “Major gaps in coordination, funding, stockpiles sustainability, trust, equity, and sustained political commitment leave it vulnerable, and recent policy shifts have raised further concerns.”
- https://bit.ly/2UrPEMn
Backs: “It outperforms averages substantially in prevention, detection, and international norms compliance.”
- https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2025/01/14/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response/
Backs: “Dramatically increased PPE (e.g., 70x N95s, 34x gloves, 50x gowns) and ventilators compared to pre-COVID levels; supported responses to H5N1 and mpox.”
- https://www.cdc.gov/washington/testimony/2024/t20241114.htm
Backs: “Expanded electronic case reporting (from ~200 facilities pre-COVID to over 45,000–48,000), syndromic surveillance in most EDs, wastewater monitoring, and a “One CDC” data platform.”
- https://www.presidency.ucsb.edu/documents/fact-sheet-biden-harris-administration-releases-global-health-security-annual-report
Backs: “Created the White House Office of Pandemic Preparedness and Response Policy (OPPR) in 2023; released National Biodefense Strategy, Global Health Security Strategy (2024), and a detailed roadmap/playbook; invested billions in global health security, vaccine/therapeutic development (including mRNA platforms and 100-days…”
- https://bidenwhitehouse.archives.gov/wp-content/uploads/2024/04/Global-Health-Security-Strategy-2024-1.pdf
Backs: “Created the White House Office of Pandemic Preparedness and Response Policy (OPPR) in 2023; released National Biodefense Strategy, Global Health Security Strategy (2024), and a detailed roadmap/playbook; invested billions in global health security, vaccine/therapeutic development (including mRNA platforms and 100-days…”
- https://apnews.com/article/pandemic-preparedness-trump-biden-192518a8e1414cf40bafefdc2bf1f5ca
Backs: “Advances via BARDA/ASPR, warm-base lab contracts, and stockpiling (e.g., H5N1 vaccine doses). Responses to mpox and H5N1 showed some operational gains.”
- https://biodefensecommission.org/reports/the-national-blueprint-for-biodefense/
Backs: “It calls for immediate action on leadership, intelligence/attribution, S&T, preparedness, detection/surveillance, and response/recovery, with dozens of recommendations. Fragmentation persists across agencies.”
- https://biodefensecommission.org/wp-content/uploads/2024/05/National-Blueprint-for-Biodefense-2024_final_.pdf
Backs: “It calls for immediate action on leadership, intelligence/attribution, S&T, preparedness, detection/surveillance, and response/recovery, with dozens of recommendations. Fragmentation persists across agencies.”
- https://www.stimson.org/2024/prepare-for-the-next-biothreat-now/
Backs: “Coordination between PHEP (public health) and HPP (hospital) programs needs improvement.”
- https://www.gao.gov/products/gao-24-107175
Backs: “Coordination between PHEP (public health) and HPP (hospital) programs needs improvement.”
- https://center-forward.org/wp-content/uploads/2024/12/Final-Pandemic-Preparedness.docx.pdf
Backs: “PAHPA reauthorization has faced delays/lapses; state/local public health funding is uneven or declining post-COVID supplemental funds.”
- https://www.statnews.com/2024/09/16/h5n1-spread-cow-herds-us-response-who-pandemic-preparedness/
Backs: “H5N1 response drew criticism for incomplete animal testing, farmer cooperation, and One Health (human-animal) integration.”
- https://www.tfah.org/article/new-report-measures-states-preparedness-for-public-health-emergencies-including-infectious-disease-outbreaks-and-extreme-weather-events/
Backs: “H5N1 response drew criticism for incomplete animal testing, farmer cooperation, and One Health (human-animal) integration.”
- https://www.reuters.com/legal/litigation/us-rejects-who-pandemic-changes-global-health-rules-2025-07-18/
Backs: “US investments helped create tools like JYNNEOS (mpox) and supported the Pandemic Fund, but withdrawal from or rejection of WHO IHR amendments/pandemic-related efforts, plus cuts to global programs, weakens early warning and containment abroad.”
- https://www.science.org/content/article/trump-administration-dismantling-efforts-fight-next-pandemic
Backs: “PAHPA modernization and hospital preparedness funding face uncertainty.”
- https://www.thinkglobalhealth.org/article/white-house-empties-office-us-pandemic-policy-gaps-left-behind
Backs: “PAHPA modernization and hospital preparedness funding face uncertainty.”
- https://www.theguardian.com/us-news/2026/may/17/pandemic-preparedness-after-covid
Backs: “PAHPA modernization and hospital preparedness funding face uncertainty.”