There is no question that pandemic preparedness requires government-wide responses. However, in 2018, the Trump administration eliminated the government’s entire established pandemic response chain of command, including the White House management systems. The capable and experienced epidemic monitoring and command structures involving the National Security Council (NSC), the Department of Homeland Security (DHS) in coordination with the scientific and public health leads of the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) and the State Department were abolished.
To deal with the Coronavirus pandemic, last week President Trump announced a cobbled-together Task Force. It is headed by Vice President Pence, who has no related epidemiological or medical background, and whose leadership as Indiana Governor was widely criticized by experts for badly bungling his state’s response to a massive HIV outbreak. The Task Force Chair, Secretary of Health & Human Services, Alex Azar, is a lawyer/lobbyist former executive for Big Pharma.
In addition to the lack of credible internal management and weak inter-agency cohesion, there are the associated drastic decreases in funding to the agencies designed to deal with complexities of biothreats--including reducing $15 billion in national health spending, and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. The federal government’s $30 million “Complex Crises Fund” was eliminated. Congress is now scrambling to appropriate band-aide emergency funding to meet these exigent conditions.
America is in a position wherein the experts, policy, funding, and coordinated efforts to take on a world-wide health catastrophe are no longer in place. Such lack of national preparedness is the scenario on which leadership nightmares are based. Our government’s response to meet the coronavirus has been hobbled due to the dismantling of the very capability designed to combat such a pandemic.