Is the US prepared to deal with another pandemic or widespread health crisis?
No, not fully—though capacities improved in key areas after COVID-19, significant gaps remain in funding, coordination, workforce, equity, trust, and sustained political commitment, with recent policy shifts appearing to reverse some gains.[1]
The US ranked first on the Global Health Security (GHS) Index (score around 83.5 in recent assessments) due to strong laboratory systems, surveillance potential, medical countermeasure development capacity, and biosafety/biosecurity frameworks.[2] However, as COVID-19 demonstrated (and experts repeatedly note), high capacity scores do not guarantee effective performance amid real-world challenges like politicization, fragmented federal-state systems, supply chain issues, and public distrust.[3]
Post-COVID Improvements
Under the Biden administration, notable progress included:
The Biden administration’s roadmaps highlighted reduced COVID deaths/hospitalizations via vaccination (270+ million people with at least one dose) and free tests, framing these as transformative for future readiness.[8]
Persistent and Emerging Gaps
Multiple independent assessments highlight unfinished business:
PAHPA (core authorization for preparedness) has faced funding shortfalls vs. needs (e.g., PHEMCE estimates large gaps for countermeasures) and requires reauthorization/extensions.[12]
Recent Developments and Setbacks (2025 onward)
Policy shifts under the second Trump administration have raised alarms among many public health experts:
Experts describe these as damaging to detection, rapid countermeasure development (especially flexible platforms like mRNA for Disease X or flu), and international early warning—leaving gaps that other countries partially fill but that are hard to rebuild quickly.[14]
Bottom Line
The US is better positioned than in early 2020 in stockpiles, some surveillance/data systems, MCM pipelines (pre-cuts), and institutional knowledge. It retains world-leading scientific and manufacturing potential. However, it is not fully prepared for another major pandemic or widespread crisis due to:
Preparedness is a continuous process requiring bipartisan, multi-level investment far beyond crisis mode—experts estimate billions annually as a fraction of pandemic costs (COVID caused trillions in losses). Without addressing the “poverty of implementation,” political polarization, and underinvestment patterns, performance in a future event (e.g., severe flu, novel pathogen, or biothreat) risks repeating or worsening COVID shortcomings. Ongoing monitoring of H5N1, mpox, measles, and other threats provides real-world tests.[1]
Citations (16)
- https://www.bmj.com/content/384/bmj.q332
Backs: “No, not fully—though capacities improved in key areas after COVID-19, significant gaps remain in funding, coordination, workforce, equity, trust, and sustained political commitment, with recent policy shifts appearing to reverse some gains.”
- https://ghsindex.org/country/united-states/
Backs: “The US ranked first on the Global Health Security (GHS) Index (score around 83.5 in recent assessments) due to strong laboratory systems, surveillance potential, medical countermeasure development capacity, and biosafety/biosecurity frameworks.”
- https://www.nejm.org/doi/full/10.1056/NEJMp2406427
Backs: “The US ranked first on the Global Health Security (GHS) Index (score around 83.5 in recent assessments) due to strong laboratory systems, surveillance potential, medical countermeasure development capacity, and biosafety/biosecurity frameworks.However, as COVID-19 demonstrated (and experts repeatedly note), high…”
- https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2025/01/14/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response/
Backs: “This supported responses to COVID remnants, H5N1, and other threats.”
- https://www.cdc.gov/washington/testimony/2024/t20241114.htm
Backs: “Electronic case reporting expanded from fewer than 200 healthcare facilities pre-COVID to over 45,000–48,000 by 2024; improved syndromic surveillance and wastewater monitoring.”
- https://www.presidency.ucsb.edu/documents/fact-sheet-biden-harris-administration-releases-global-health-security-annual-report
Backs: “Domestic manufacturing and “warm base” lab partnerships were bolstered.”
- https://www.who.int/publications/i/item/9789240105409
Backs: “It praised contributions to global health security while recommending further alignment of frameworks, stronger state/local/tribal/territorial (SLTT) capabilities, workforce monitoring, sustained funding (addressing fragmentation), trust-building/community engagement, equity, and solidarity.”
- https://www.presidency.ucsb.edu/documents/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response
Backs: “The Biden administration’s roadmaps highlighted reduced COVID deaths/hospitalizations via vaccination (270+ million people with at least one dose) and free tests, framing these as transformative for future readiness.”
- https://www.gao.gov/products/gao-24-107175
Backs: “High-risk areas include HHS leadership/coordination of emergencies.”
- https://www.tfah.org/article/new-report-measures-states-preparedness-for-public-health-emergencies-including-infectious-disease-outbreaks-and-extreme-weather-events/
Backs: “Recommendations stress stable CDC/PHEP funding, PAHPA reauthorization, immunization/AMR programs, equity, MCM stockpiling/development, healthcare surge, and climate/extreme weather prep.”
- https://biodefensecommission.org/reports/the-national-blueprint-for-biodefense/
Backs: “Notes some prior recommendations adopted but emphasizes more is needed.”
- https://center-forward.org/basic/pandemic-preparedness-strengthening-the-u-s-response-framework-2/
Backs: “PAHPA (core authorization for preparedness) has faced funding shortfalls vs. needs (e.g., PHEMCE estimates large gaps for countermeasures) and requires reauthorization/extensions.”
- https://www.nytimes.com/2026/09/25/us/politics/us-rejects-un-declaration-on-preparing-for-pandemics.html
Backs: “Withdrawal from WHO; reduced engagement with global instruments (IHR amendments, pandemic agreement negotiations); rejection of a UN political declaration on pandemic preparedness (citing ideological concerns).”
- https://www.science.org/content/article/trump-administration-dismantling-efforts-fight-next-pandemic
Backs: “Focus shifted away from some biodefense/pandemic prep elements.”
- https://www.notus.org/health-science/white-house-pandemic-preparedness
Backs: “OPPR largely emptied (staff left or resigned); minimally restaffed later (one lead + limited support). Critics say this undercuts cross-agency coordination.”
- https://www.aspr.gov/
Backs: “ASPR continues operational work (deployments, MCM approvals, SNS distributions for H5N1/Ebola/mpox/etc.), and some domestic manufacturing pushes continue.”