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 is better equipped in some specific areas than before COVID-19 due to investments and reforms—progress that remains fragile, uneven, and subject to reverse. Expert assessments, government reports, and independent analyses consistently highlight improvements in stockpiles, surveillance, and medical countermeasures (MCMs), alongside persistent gaps in funding sustainability, state/local capacity, workforce, coordination, public trust, and leadership. Recent policy shifts have raised additional concerns about backsliding.[1][2]
Post-COVID Improvements
The COVID-19 pandemic exposed major weaknesses (e.g., PPE shortages, testing delays, fragmented response, and high mortality relative to peers despite high Global Health Security Index rankings pre-2020). Subsequent efforts under the prior administration included:
A 2024 WHO Joint External Evaluation (JEE) of US International Health Regulations capacities (using a post-COVID tool) noted demonstrated strengths in many technical areas but issued overarching recommendations on aligning frameworks across jurisdictions, extending preparedness to state/local/tribal/territorial (SLTT) levels, sustaining the workforce, maintaining funding, building trust, addressing equity, and continuing global solidarity.[9][10]
The Biden administration’s end-of-term roadmap emphasized these gains and left playbooks for successors.[3]
Persistent and Emerging Gaps
Despite progress, multiple authoritative sources conclude the nation remains vulnerable:
ASPR continues operational responses (e.g., deployments for outbreaks, wildfires, MCMs approvals), and some domestic capacities persist.[14]
Recent Developments and Risks of Backsliding (Post-2024/2025)
Policy changes under the current administration have included US withdrawal from the WHO, reduced or redirected global health security funding (e.g., impacts on surveillance partners, CEPI, Pandemic Fund), cuts or wind-downs of certain mRNA/pandemic preparedness R&D at BARDA/NIAID/NIH (shifting some biodefense emphasis), understaffing or temporary emptying of OPPR, rejection of UN pandemic preparedness declarations, and other disruptions to databases, grants, and international coordination. Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.[15][16][17][18][19][20]
Ongoing threats (H5N1 in animals/humans, mpox, measles resurgence, Ebola/Marburg abroad, antimicrobial resistance) continually test systems. Biological threats (natural, accidental, or deliberate) are assessed as real and growing due to climate, travel, tech (e.g., dual-use research), and geopolitics.[1]
Bottom Line
The US has more tools, experience, restocked supplies, better data infrastructure, and some institutional memory than in early 2020, enabling potentially faster MCM development and distribution for certain threats. However, it is not adequately prepared for a severe, novel, or multi-wave crisis due to incomplete reforms, funding instability, variable SLTT capacity, workforce issues, trust deficits, and recent erosions of capabilities and international partnerships. Full preparedness requires sustained, bipartisan investment (beyond crisis cycles), clearer authorities/coordination, resilient domestic manufacturing/supply chains, equity-focused systems, robust SLTT support, and maintenance of scientific/public health expertise—recommendations echoed across GAO, the Biodefense Commission, TFAH, JEE, and independent experts for years. Without addressing these, another crisis could again result in high excess mortality, economic damage, and societal strain. Continuous monitoring of emerging threats and implementation of open recommendations remain critical.
Citations (20)
- https://biodefensecommission.org/reports/the-national-blueprint-for-biodefense/
Backs: “Recent policy shifts have raised additional concerns about backsliding.”
- https://www.gao.gov/products/gao-24-107175
Backs: “Recent policy shifts have raised additional concerns about backsliding.”
- https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2025/01/14/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response/
Backs: “Significantly expanded inventories (e.g., ~70 times more N95 respirators, 34 times more gloves, 50 times more isolation gowns, and 10 times more ventilators than pre-pandemic levels). This supported responses to H5N1, mpox, and other threats.”
- https://www.cdc.gov/washington/testimony/2024/t20241114.htm
Backs: “Modeling and forecasting capabilities (e.g., via CDC’s Center for Forecasting and Outbreak Analytics) advanced.”
- https://www.presidency.ucsb.edu/documents/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response
Backs: “Updates to the National Biodefense Strategy and related plans, plus a “roadmap” and internal playbooks for future responses.”
- https://www.presidency.ucsb.edu/documents/fact-sheet-biden-harris-administration-releases-global-health-security-annual-report
Backs: “Global health security investments (over $3 billion since 2020 in some tallies) supported outbreak responses abroad to reduce importation risks.”
- https://center-forward.org/basic/pandemic-preparedness-strengthening-the-u-s-response-framework-2/
Backs: “Global health security investments (over $3 billion since 2020 in some tallies) supported outbreak responses abroad to reduce importation risks.”
- https://www.tfah.org/article/new-report-measures-states-preparedness-for-public-health-emergencies-including-infectious-disease-outbreaks-and-extreme-weather-events/
Backs: “PAHPA reauthorizations and frameworks advanced readiness conceptually; nurse licensure compacts expanded for surge staffing; some workforce investments via American Rescue Plan funds.”
- https://iris.who.int/bitstream/handle/10665/380155/9789240105409-eng.pdf?sequence=1sask
Backs: “A 2024 WHO Joint External Evaluation (JEE) of US International Health Regulations capacities (using a post-COVID tool) noted demonstrated strengths in many technical areas but issued overarching recommendations on aligning frameworks across jurisdictions, extending preparedness to state/local/tribal/territorial (SLTT)…”
- https://www.who.int/publications/i/item/9789240105409
Backs: “A 2024 WHO Joint External Evaluation (JEE) of US International Health Regulations capacities (using a post-COVID tool) noted demonstrated strengths in many technical areas but issued overarching recommendations on aligning frameworks across jurisdictions, extending preparedness to state/local/tribal/territorial (SLTT)…”
- https://biodefensecommission.org/wp-content/uploads/2024/05/National-Blueprint-for-Biodefense-2024_final_.pdf
Backs: “A 2025 follow-on focused on military biodefense. The Commission has long warned of fragmented efforts.”
- https://www.nejm.org/doi/full/10.1056/NEJMp2406427
Backs: “Supply chain vulnerabilities (though improved domestically in places); healthcare surge capacity and inequities; politicization, misinformation, and eroded public trust (affecting compliance); jurisdictional turf battles; and incomplete lessons implementation (e.g., on H5N1 response critiques).”
- https://www.stimson.org/2024/prepare-for-the-next-biothreat-now/
Backs: “Supply chain vulnerabilities (though improved domestically in places); healthcare surge capacity and inequities; politicization, misinformation, and eroded public trust (affecting compliance); jurisdictional turf battles; and incomplete lessons implementation (e.g., on H5N1 response critiques).”
- https://www.aspr.gov/news-updates/blog/2025-12/stand-ready-move-fast-save-lives
Backs: “ASPR continues operational responses (e.g., deployments for outbreaks, wildfires, MCMs approvals), and some domestic capacities persist.”
- https://www.nytimes.com/2026/09/25/us/politics/us-rejects-un-declaration-on-preparing-for-pandemics.html
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”
- https://www.sej.org/publications/backgrounders/are-we-ready-next-pandemic
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”
- https://www.thinkglobalhealth.org/article/the-u-s-vaccine-pullback-is-a-strategic-mistake
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”
- https://www.the-scientist.com/niaid-moves-away-from-biodefense-experts-are-worried-75109
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”
- https://files.kff.org/attachment/fact-sheet-the-trump-administrations-foreign-aid-review-status-of-global-health-security-pandemic-preparedness.pdf
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”
- https://www.science.org/content/article/trump-administration-dismantling-efforts-fight-next-pandemic
Backs: “Experts (including former officials and analyses from CSIS, Stimson, and others) warn these weaken detection, rapid response, innovation, and global early warning—raising importation risks and leaving the US more isolated.”