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1 [1] (August 7, 2025)

handle is hein.crs/gsebui0001 and id is 1 raw text is: Congressional Research Service Inforrning the legislative debate since 1914 S Updated August 7, 2025 Pandemic and All-Hazards Preparedness Act: An Overview In 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA; P.L. 109-417) authorized a suite of programs and authorities within the Department of Health and Human Services (HHS) to focus on public health emergency preparedness and response. Congress has reauthorized PAHPA twice, in 2013 (P.L. 113-5) and in 2019 (P.L. 116- 22), both times with changes prompted by preceding public health emergencies. Many existing PAHPA provisions expired in September 2023. Congress has temporarily extended several provisions until September 30, 2025 (P.L. 119-4) and previously deliberated a reauthorization. Two HHS agencies administer most PAHPA-authorized programs: (1) the Administration for Strategic Preparedness and Response (ASPR), which leads the nation's public health and medical response to emergencies, and (2) the Centers for Disease Control and Prevention (CDC), a leading agency for disease control and prevention and for addressing public health threats. The Trump Administration has proposed significant changes to PAHPA-authorized programs in its FY2026 budget by proposing to eliminate certain ASPR programs and to move other ASPR programs to the CDC and to a new Assistant Secretary for a Healthy Future. Certain proposals may require statutory changes to take effect. What Is Public Health Emergency Management? Many types of emergencies involve a public health and medical response component. To illustrate, during a natural disaster, public health agencies might monitor associated health effects while medical responders coordinate emergency medical services. Alternately, some types of emergencies, such as certain emerging infectious disease outbreaks or bioterrorism events, have a primary impact on human health. Public health emergency management involves a set of specific capabilities tailored to health threats, for example, detection capabilities to identify and monitor new health threats; systems to rapidly develop, regulate, and distribute medical products to address health threats (e.g., vaccines, treatments); policies and systems to manage surges in demand for medical care and supplies; potential use of quarantine and isolation authorities; and leadership and communication functions focused on health. Under the National Response Framework (NRF), HHS coordinates the public health and medical aspects of federal emergency response. As with U.S. emergency management generally, state, local, tribal, and territorial (SLTT) governments are to lead public health emergency preparedness and response efforts in their communities. Federal agencies generally assist when SLTT communities are overwhelmed, need additional expertise and/or federal assets, or when an emergency spans many jurisdictions and prompts a coordinated federally led response. HHS agencies have programs and authorities tailored to the unique needs and challenges posed by public health emergencies-many authorized in PAHPA. PAHPA: An Overview Though PAHPA has changed throughout its history, the law has generally focused on a set of policy categories. The following highlights some key provisions within each category: Leadership, strategy, and planning. In 2006, PAHPA statutorily established that HHS is to lead federal public health and medical response under the NRF. The law also reauthorized and renamed the position of the Assistant Secretary for Preparedness and Response to serve as principal advisor for HHS emergency response. PAHPA required the quadrennial publication of the National Health Security Strategy (NHSS), wherein HHS anticipates health emergency challenges and its planned approach. SLTT emergency capacity. PAHPA has reauthorized two grant programs focused on supporting SLTT public health and medical emergency response capacity: (1) the CDC's Public Health Emergency Preparedness (PHEP) cooperative agreement and (2) the ASPR's Hospital Preparedness Program (HPP). In addition, PAHPA has included related authorities. For example, the 2013 law amended the public health emergency (PHE) declaration authority (Public Health Service Act, PHSA §319) to allow for temporary assignment of some state and local personnel during PHEs. Medical countermeasures. PAHPA has included a suite of programs and authorities aimed at enabling the development, regulation, availability, and distribution of medical countermeasures (MCMs). MCMs are medical products that may be used to mitigate, treat, prevent, or diagnose conditions associated with emerging infectious diseases or chemical, biological, radiological, or nuclear (CBRN) agents. For example, the 2006 law established the Biomedical Advanced Research and Development Authority (BARDA) within ASPR to focus on MCM late- stage development, manufacturing, and purchase. In addition, the 2013 law added a title focused on FDA authorities and activities related to MCMs. Medical response programs. PAHPA authorizes several ASPR medical response programs, such as the National Disaster Medical System, which provides medical personnel, equipment, and other support when requested by states. In addition, the Strategic National Stockpile (SNS) consists of medical products and ancillary supplies that can be deployed to SLTT jurisdictions. The SNS includes products tailored to specific health threats (e.g., smallpox ittps://crsreports.congress.gc