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

While the United States possesses some of the world's most advanced scientific tools and clinical expertise, public health experts and leading medical associations agree that the U.S. remains underprepared for another widespread health crisis.

According to reports, such as the Ready or Not 2026 report by Trust for America's Health (TFAH), the nation's public health infrastructure has deteriorated since the height of the COVID-19 pandemic due to a "boom-and-bust" funding cycle, federal staffing cuts, and deep-seated political and social divisions.

Assessments of U.S. preparedness reveal several critical vulnerabilities, alongside a few areas of structural resilience:

1. Declining Federal Funding and Workforce Capacity

A major concern among health security experts is the reduction of federal public health capabilities.

•Staffing and Grant Cuts: In the aftermath of the COVID-19 emergency, the Department of Health and Human Services (HHS) terminated more than $12 billion in pandemic-era public health grants and eliminated thousands of roles across the Centers for Disease Control and Prevention (CDC) and the Administration for Strategic Preparedness and Response (ASPR).

•Atrophied Infrastructure: Former public health officials have noted that the rapid-response teams, expertise, and operational structures built during COVID-19 have largely dissolved, leaving the remaining system fragile.

2. Legislative and Funding Gridlock (PAHPA)

The primary legislative engine for American biosecurity—the Pandemic and All-Hazards Preparedness Act (PAHPA)—expired in late 2023. PAHPA is the law that funds the Strategic National Stockpile (SNS) and the Biomedical Advanced Research and Development Authority (BARDA), which helps develop vaccines and therapeutics.

•While critical programs have been kept afloat through temporary spending patches and continuing resolutions, Congress has repeatedly stalled on passing a long-term, five-year reauthorization.

•Industry groups, like the Biotechnology Innovation Organization (BIO), warn that this lack of long-term stability discourages pharmaceutical companies from investing in the decadelong pipeline required to create medical countermeasures.

3. Deep Inequalities in State-Level Readiness

According to TFAH’s Ready or Not 2026 report, emergency readiness varies drastically depending on where you live.

•Only 20 states placed in the "high-performance" tier for public health readiness. Seventeen states (and D.C.) placed in the middle tier, and 13 states fell into the low-performance tier.

•At least 12 states actually reduced their public health budgets.

•Systemic Gaps: Many states continue to struggle with low seasonal flu vaccination coverage, limited hospital surge capacities, and highly unequal access to paid sick leave for low-wage workers (which is a primary driver of disease spread in workplaces).

4. The "Infodemic" and Public Skepticism

A significant non-structural vulnerability is the collapse of public trust. Former federal officials, including Dr. Anthony Fauci, have emphasized that rampant misinformation on social media has severely weakened the government's ability to coordinate a response.
If a new threat emerges, public health agencies are expected to face intense skepticism regarding vaccine uptake, masking, and general health guidelines, making early-stage containment exceptionally difficult.

5. International Isolationism

Global health security relies heavily on international cooperation for early outbreak detection. However, the U.S. has pulled back from several global initiatives. For example, the U.S. blocked a major United Nations General Assembly political declaration on pandemic preparedness, objecting to certain provisions related to intellectual property and vaccine sharing. Experts warn that withdrawing from international coordination efforts risks delaying the identification of emerging pathogens before they reach U.S. shores.

Areas of Progress and Resilience

Despite these major challenges, the U.S. has built several durable defenses since 2020:

•Healthcare Mobility: 41 states have adopted the Nurse Licensure Compact, which allows nurses to practice across state lines during localized surges and emergencies.

•Laboratory Surge Planning: Nearly every state now has a formalized, written plan to scale up diagnostic laboratory testing in the event of an outbreak.

•Biotech Capabilities: The U.S. remains the world leader in biotechnology. mRNA vaccine platforms and therapeutic manufacturing pipelines are highly advanced, meaning that if a pathogen's genetic sequence is identified, scientists can develop a vaccine candidate within days.

Conclusion

Ultimately, the U.S. is highly capable of developing scientific solutions to a health crisis, but currently lacks the sustained funding, federal workforce, and public trust required to deliver those solutions effectively. Without consistent, long-term investments that move away from crisis-driven funding, the nation remains highly vulnerable to the next major biological threat.

Citations (15)

1theguardian.comNews and mediaquality 0.75
theguardian.com
Backs: “remains underprepared for another widespread health crisis.”
2bmj.comAcademic
bmj.com
Backs: “remains underprepared for another widespread health crisis.”
3tfah.orgNonprofits and think tanks
tfah.org
Backs: “According to reports, such as the Ready or Not 2026 report by Trust for America's Health (TFAH), the nation's public health infrastructure has deteriorated since the height of the COVID-19 pandemic due to a "boom-and-bust" funding cycle, federal staffing cuts, and deep-seated political and social divisions.”
4tfah.orgNonprofits and think tanks
tfah.org
Backs: “According to reports, such as the Ready or Not 2026 report by Trust for America's Health (TFAH), the nation's public health infrastructure has deteriorated since the height of the COVID-19 pandemic due to a "boom-and-bust" funding cycle, federal staffing cuts, and deep-seated political and social divisions.”
5tfah.orgNonprofits and think tanks
tfah.org
Backs: “According to reports, such as the Ready or Not 2026 report by Trust for America's Health (TFAH), the nation's public health infrastructure has deteriorated since the height of the COVID-19 pandemic due to a "boom-and-bust" funding cycle, federal staffing cuts, and deep-seated political and social divisions.”
6beckershospitalreview.comNews and mediaquality 0.49
beckershospitalreview.com
Backs: “Staffing and Grant Cuts: In the aftermath of the COVID-19 emergency, the Department of Health and Human Services (HHS) terminated more than $12 billion in pandemic-era public health grants and eliminated thousands of roles across the Centers for Disease Control and Prevention (CDC) and the Administration for Strategic…”
7bio.newsNews and media
bio.news
Backs: “Legislative and Funding Gridlock (PAHPA). The primary legislative engine for American biosecurity—the Pandemic and All-Hazards Preparedness Act (PAHPA)—expired in late 2023. PAHPA is the law that funds the Strategic National Stockpile (SNS) and the Biomedical Advanced Research and Development Authority (BARDA), which…”
8ghtcoalition.orgNonprofits and think tanks
ghtcoalition.org
Backs: “Legislative and Funding Gridlock (PAHPA). The primary legislative engine for American biosecurity—the Pandemic and All-Hazards Preparedness Act (PAHPA)—expired in late 2023. PAHPA is the law that funds the Strategic National Stockpile (SNS) and the Biomedical Advanced Research and Development Authority (BARDA), which…”
9naccho.orgNonprofits and think tanks
naccho.org
Backs: “Only 20 states placed in the "high-performance" tier for public health readiness. Seventeen states (and D.C.) placed in the middle tier, and 13 states fell into the low-performance tier.”
10avac.orgNot yet classified
avac.org
Backs: “The "Infodemic" and Public Skepticism. A significant non-structural vulnerability is the collapse of public trust. Former federal officials, including Dr.”
11jhu.eduAcademic
jhu.edu
Backs: “International Isolationism. Global health security relies heavily on international cooperation for early outbreak detection. However, the U.S.”
12theguardian.comNews and mediaquality 0.75
theguardian.com
Backs: “For example, the U.S. blocked a major United Nations General Assembly political declaration on pandemic preparedness, objecting to certain provisions related to intellectual property and vaccine sharing. Experts warn that withdrawing from international coordination efforts risks delaying the identification of emerging…”
13theguardian.comNews and mediaquality 0.75
theguardian.com
Backs: “mRNA vaccine platforms and therapeutic manufacturing pipelines are highly advanced, meaning that if a pathogen's genetic sequence is identified, scientists can develop a vaccine candidate within days. Conclusion”
14nfid.orgNot yet classified
nfid.org
Backs: “Conclusion. Ultimately, the U.S. is highly capable of developing scientific solutions to a health crisis, but currently lacks the sustained funding, federal workforce, and public trust required to deliver those solutions effectively. Without consistent, long-term investments that move away from crisis-driven funding,…”
15bipartisanpolicy.orgNonprofits and think tanks
bipartisanpolicy.org
Backs: “Without consistent, long-term investments that move away from crisis-driven funding, the nation remains highly vulnerable to the next major biological threat. 1.”