Strategic National Stockpile and Local Jurisdictions Ask “Where’s the Money?
May 7, 2024

New GAO Report on Public Health Preparedness Focuses on Navigating Funding Challenges  

The members of the American Medical Manufacturers Association (AMMA) are proud that they answered the US government’s call to expand or launch PPE manufacturing in response to the pandemic. As the nation grapples with the aftermath of the COVID-19 pandemic, the spotlight has turned towards the Strategic National Stockpile (SNS) and its pivotal role in bolstering public health preparedness.

The Government Accountability Office (GAO) recently released a report mandated by the CARES Act. Titled “PUBLIC HEALTH PREPAREDNESS: HHS Should Address Strategic National Stockpile Coordination Challenges,” the report delves into various issues faced by states, jurisdictions, and tribes, particularly concerning the procurement, coordination, retention, replacement, and management of personal protective equipment (PPE).

One central theme in this report is the daunting funding challenges faced by both jurisdictions and the SNS in sustaining their stockpiles of critical medical supplies, particularly personal protective equipment (PPE).

Sixty-two public health jurisdictions responded to the GAO survey and shared that they have been grappling with the financial burden of replenishing their stockpiles. Despite commendable efforts to expand their reserves during the COVID-19 crisis, the need for more sustainable funding looms large.

Nearly all surveyed jurisdictions initiated or expanded their stockpiles during the COVID-19 crisis. However, alongside purchasing PPE from commercial markets, jurisdictions heavily relied on supplies from the federal government, including the Assistant Secretary for Preparedness and Response (ASPR) and the SNS. In fiscal years 2020 and 2021 alone, ASPR allocated a substantial $1.4 billion for direct shipment of products, including PPE, to jurisdictions.

The GAO report underscores the urgent need for federal support to cover the mounting costs of storing, maintaining, and disposing expired PPE. Interviews with jurisdictional officials paint a stark picture of uncertainty regarding their ability to replace vital supplies once they expire, posing a significant threat to future preparedness efforts.

Similarly, the SNS finds itself precarious due to funding constraints. Despite substantial investments in COVID-19 relief funds, the SNS needs help to maintain its current portfolio of medical countermeasures, including essential PPE.

With the cessation of COVID-19-related funding, the SNS has limited base funding and cannot allocate resources to hold large quantities of PPE. The government has made this mistake before, following the H1N1 pandemic, where replenishing PPE levels proved elusive due to financial limitations.

Addressing funding shortfalls is paramount to fortifying the nation’s public health preparedness infrastructure. Soon, the Department of Health and Human Services (HHS) will provide guidance, offering jurisdictions much-needed support and direction in managing their stockpiles.

Washington, DC, has a common refrain. Leaders often say, “There is no more money.” Yet, through ASPR, HHS obligated $6.1 billion for critical COVID-19 supplies delivered directly to the SNS, including $2.4 billion for PPE, during fiscal years 2020 and 2021 using COVID-19 relief funds.

The funding challenges highlighted in the GAO report demand urgent attention from policymakers at both federal and state levels. Funding for PPE, especially PPE manufactured domestically, is a matter of national security and public health resilience. We need to adequately fund the SNS and jurisdictional stockpiles to ensure our ability to respond effectively to future public health emergencies.

AMMA Executive Director Eric Axel said, “This GAO report is yet another signal to policymakers in Congress and the Administration that NOW is the time for decisive action to ensure the health and well-being of our communities for generations to come.”

Funding challenges are a common theme and of paramount importance. The lessons learned from the COVID-19 pandemic underscore the power of investing in our nation’s preparedness infrastructure.

AMMA will advocate for more significant investments in the SNS by calling on policymakers and decision-makers in Congress and the Administration to invest more significant funds in domestic PPE production. AMMA will also work with all parties to ensure we build a resilient healthcare system capable of withstanding future crises by securing sustainable funding and fostering collaboration between jurisdictions and federal agencies.