White House releases $65 billion pandemic preparedness proposal

An ambitious new plan from the White House that has a $65.3 billion price tag and an Apollo program design would transform the way the United States responds to pandemics in part by vastly accelerating vaccine development, testing, and production.

The plan, announced today, hopes to launch with $15 billion set aside in a budget reconciliation bill now before Congress (but not certain to pass). It asks Congress to provide the rest of the funding over the next decade. It calls for an Apollo-like “mission control” center to coordinate the many branches of government already involved with pandemic preparedness. Nearly 40% of the money would go toward vaccines, followed by just under 20% for treatments. The rest would support new diagnostics, early warning systems, improved public health and biosafety measures, and global health efforts.

 Eric Lander, director of the White House’s Office of Science and Technology Policy, says the response to the COVID-19 pandemic built on the previous 5 years of advances in vaccines, treatments, and diagnostics. “Five years from now, we ought to be able to do dramatically better,” says Lander, whose office created the plan with the National Security Council.

Epidemiologist Michael Osterholm of the University of Minnesota, Twin Cities, says the plan is not ambitious enough. “It’s a good down payment, but it hardly will provide enough resources for a real plan,” Osterholm says. “One of the things we’ve not been realistic about is working backward from saying this is what we really want to have.”

The 27-page plan only offers a rough outline of funding needs. But it does suggest several specifics. For vaccines, it calls for more research on 26 families of viruses known to infect humans. It would also lay the groundwork to develop, test, and approve vaccines against new emerging pathogens within 100 days—three times faster than COVID-19 shots—and produce enough vaccine for the United States within 130 days and for the world by 200 days. Vaccinemakers would be funded to maintain excess production capacity at their existing plants. A clinical trials network would be at the ready, set up to enroll 100,000 participants within a few weeks, which would lead to answers more quickly than the 30,000-person studies staged for COVID-19 vaccines. New technologies such as skin patches or nasal sprays would simplify providing vaccines, and more effort would go into developing animal models for all potential viral families.

Nahid Bhadelia, who founded the Center for Emerging Infectious Diseases Policy and Research at Boston University, welcomes the plan, but would like more specifics. “Seeing a unified plan for how we build resilience during the ‘age of epidemics’ is music to my ears,” says Bhadelia, an infectious disease clinician. “It’s not just important that we have drugs and new technologies that are shovel ready, but that we also have the infrastructure to quickly clinically test them,” she says.

The plan stresses that the cost of the COVID-19 pandemic to the United States alone has been an estimated $16 trillion, which makes spending $65.3 billion seem paltry. “It’s hard to imagine a higher economic—or human—return on national investment,” the plan says.

Lander agrees that the aims are ambitious. “They make you gulp a little bit,” he says. “But those are things that could be done.”

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