Is the US prepared to deal with another pandemic or widespread health crisis?

Based on current assessments, the picture is decidedly mixed — and many experts and official reports suggest the U.S. is less prepared now than it was even a few years ago, despite some pockets of scientific progress.

Signs of Weakening Preparedness

Federal funding and infrastructure cuts: Multiple 2025-2026 reports point to significant erosion of the federal public health system. The President's proposed FY 2026 budget for the Centers for Disease Control and Prevention (CDC) amounts to a 53 percent reduction in funding as compared to FY 2024. Over 100 public health programs and funding lines would be eliminated under this budget, including 61 programs at CDC and 40 programs at the Substance Abuse and Mental Health Services Administration. Within that, CDC's Public Health Emergency Preparedness program faces a 52 percent funding reduction.

Clawed-back COVID-era funds: The March 2025 termination of more than $12 billion in COVID-19-era grants had been broadened to support infectious disease monitoring, laboratory capacity, emergency preparedness, and mental health services. While court orders blocked terminations for plaintiff states and the District of Columbia, litigation remained unresolved through year's end, creating sustained uncertainty for preparedness planning at the health system level.

Leadership vacuum: The White House office specifically created to coordinate pandemic response has been gutted — in 2025, Gerald Parker resigned as head of the Office of Pandemic Preparedness and Response Policy, leaving the office with no employees.

Global health retrenchment: The second Trump administration dismantled USAID, the federal humanitarian agency that played a role in global outbreak prevention and response, after stating that large portions of USAID funding did not align with "core national interests." Analysts note this broader review of foreign assistance and biomedical research has created real uncertainty for the parts of the R&D ecosystem that underpin global health and pandemic preparedness.

Looking ahead to FY2027: Concern is compounding — the proposed FY 2027 budget would eliminate the Hospital Preparedness Program entirely and cut the Public Health Emergency Preparedness program further.

State-Level Variation

Trust for America's Health's Ready or Not 2026 report gives a more granular, mixed picture. It found that in 2025, the country faced the most severe flu season in nearly a decade, rising measles outbreaks, continued H5N1 avian influenza activity, and a growing number of extreme weather events—all while the federal systems built over decades to help states prepare for and respond to emergencies came under significant strain.

States were sorted into three performance tiers for emergency preparedness: 20 states in the high-performance tier, 17 states and the District of Columbia in the middle-performance tier, and 13 states in the low-performance tier. Crucially, the report's authors stress that national preparedness depends not only on state capacity, but also on strong and stable federal health and preparedness systems, sustained intergovernmental coordination, and long-term investment in public health infrastructure.

There's also a basic infrastructure gap: access to paid sick leave varies widely across U.S. regions—from 98 percent of workers in Pacific states to 67 percent in East South Central states—and gaps are most concentrated among low-wage, part-time, and service-sector workers. This matters because paid leave directly affects disease transmission during outbreaks.

Long-Term Structural Gaps

Beyond current-year budget fights, HHS's own long-range planning documents flag a chronic resourcing shortfall. According to the ASPR's multi-year budget projections, if funding continues at the proposed FY 2026 levels over the projected five-year period, an estimated $33.5 billion funding gap from the total projected need is expected.

Areas of Progress

It's not uniformly bleak. On the scientific/international front, applying lessons learned from COVID-19, WHO, Member States, and partners have delivered significant advances in pandemic preparedness, prevention and response, including the historic WHO Pandemic Agreement adopted in May 2025, setting out a comprehensive approach to pandemic prevention, preparedness and response. The Trump administration has also articulated its own framework — in 2025 it released the "America First Global Health Strategy," which included the stated goals of enabling early detection and containment of outbreaks. The nonpartisan Center for Global Development offered a nuanced take, saying the plan signaled "continued U.S. commitment to global health," including preventing pandemics, but called broader cuts to U.S. global health programming "devastating news."

Vaccine R&D also continues on some fronts, with certain formulations of BPL-1357 poised to be tested in Phase 2 trials in early 2026 while further Phase 1b trials evaluating additional dosing strategies are being developed for pandemic influenza.

Bottom Line

The consensus among public health experts and independent watchdogs (TFAH, PBS Frontline, Johns Hopkins Center for Health Security) is that the U.S. is currently in a period of declining preparedness capacity relative to where it stood a few years ago, driven by:

At the same time, scientific and technical capabilities (vaccine platforms, diagnostics, international agreements) have advanced since COVID-19, and some states remain highly prepared. But experts broadly agree that without stable federal funding, coordinated leadership, and rebuilt public trust, the U.S. risks being caught under-resourced if a fast-moving, novel pathogen emerges — echoing warnings that the next pandemic will begin quietly, somewhere in the world, in a single infection that spreads unnoticed, and by the time it is detected, it may already be moving faster than the systems designed to stop it.