headshot of Dawn O'Connell
Dawn O’Connell, the Assistant Secretary for Preparedness and Response

In 2019, the Global Health Security Index rated the US as the country best prepared to face a pandemic in the world. But just months later, as the US struggled to contain a novel coronavirus, government agencies such as the Centers for Disease Control and Prevention (CDC) drew criticism with high-profile fumbles, including sending out contaminated tests for the virus. Now, as first reported by The Washington Post, President Joe Biden’s administration aims to improve the government response to pandemics and other health emergencies by handing additional responsibilities to a team within the Department of Health and Human Services called the Office of the Assistant Secretary for Preparedness and Response (ASPR). The move will elevate ASPR to the division level, on par with agencies such as the CDC and the Food and Drug Administration (FDA). 

ASPR, which has about 1,000 staff members, already oversees some aspects of pandemic response, such as the Strategic National Stockpile of medical supplies and the Biomedical Advanced Research and Development Authority (BARDA). In an internal memo announcing the plan that was obtained by the Post, ASPR head Dawn O’Connell wrote that the change would allow the division “to mobilize a coordinated national response more quickly and stably during future disasters and emergencies while equipping us with greater hiring and contracting capabilities.” But the memo does not specify what, if any, new responsibilities ASPR will take on. In comments to The New York Times, former CDC advisor Lawrence Gostin calls it “more than a little vague, which makes it even more frustrating.” 

The Post notes that ASPR has clashed with the CDC in the past, including in 2018 when ASPR took over the responsibility of overseeing the strategic stockpile, and early in the pandemic when HHS entities unclear about their respective roles bungled the evacuation of Americans from Wuhan, as revealed in a later Government Accountability Office report. 

CDC spokesman Kevin Griffis tells the Post that that agency is “supportive of Assistant Secretary O’Connell’s vision for ASPR—a critical partner for us in addressing public health threats.” But some experts who spoke with Times about the move voiced concerns about the prospect of shifting some responsibilities to ASPR. “I’m concerned it will be unclear who’s in charge and it will create more confusion,” Luciana Borio, a former acting chief scientist at the FDA and National Security Council official, tells the Times. “The C.D.C. is essential to the response. Any act that further erodes C.D.C.’s role will be detrimental.” 

Speaking with the Post, O’Connell says that the CDC’s relationship with state public health departments “is critical, and we rely on that as we’re distributing vaccines and therapeutics in a completely collaborative and supportive way. There’s been room, certainly, in this pandemic for each of us to do our own lines of work, while working collaboratively as part of a larger response team.”