Apr 3, 2013 (CIDRAP News) – The National Biodefense Science Board (NBSB) today forwarded two sets of recommendations to federal departments that oversee emergency preparedness, one focused on enhancing situational awareness in health emergencies and the other on improving the nation's Strategic National Stockpile (SNS) by 2020.
The group took on the tasks in June 2012, based on a request from Nicole Lurie, MD, MPH, assistant secretary for preparedness and response (ASPR). The NBSB is a 13-member group that advises the Department of Health and Human Services (HHS) on medical countermeasures and other issues that address public health emergencies like pandemics and bioterror attacks.
An NBSB working group on situational awareness presented its draft report and recommendations to the NBSB yesterday, and the full board voted in favor of forwarding it to ASPR.
During today's session, Lurie told the group that new health threats underscore the importance of the group's work. "Watching H7N9 [avian influenza] come on the scene is why situational awareness is so critical," she said.
Authors of the SNS report, which they unveiled today, included members of the NBSB as well as the Board of Scientific Counselors (BSC) from the US Centers for Disease Control and Prevention (CDC) Office of Public Health Preparedness and Response (OPHPR). The full NBSB today voted to forward the SNS recommendations to ASPR and the CDC's OPHPR.
Last June, Lurie told the group that the committee's input would help federal officials craft a common national approach to situational awareness capabilities. She also noted that the two requests went hand in hand, noting that situational awareness isn't useful unless health officials are equipped to do something about it with countermeasures.
In its draft of the situational awareness report, the NBSB's key recommendation was that the HHS secretary designate a central situational awareness authority to coordinate all public health and healthcare situational awareness that has been collected, processed, and analyzed by agencies at the national level. It added that the authority would also be responsible for recommending ways to improve situational awareness and standardize operating procedures.
HHS reviews its countermeasure strategy and progress each year, but it asked the NBSB and BSC to help ASPR anticipate what the responsibilities of the SNS will be in 2020, recommend approaches for efficiently meeting the responsibilities, and propose new ways to measure SNS capabilities and improvements. The group wasn't asked to make recommendations about specific countermeasures.
Representatives from the joint working group said today that the efficiency goal was more important than ever, given federal budget constraints and looming sequestration cuts.
Among the working group's 10 recommendations was using science as a key strategy and management tool. They noted that some countermeasures are costly, and incorporating the latest information about optimal vaccine and medication duration and dosing into SNS planning may help make the best use of resources.
John Parker, MD, NBSB chairman and retired Army major general, said, "We believe the best tool to tone and shape the SNS is science."
Another recommendation was to move to a single appropriation model to boost fiscal management of the SNS—for example, moving toward a single-line budget item that would cover SNS funding for 5-year intervals.
Other recommendations included:
- Articulate an SNS vision for 2020.
- Tailor surge capacity.
- Enhance critical review processes.
- Use cost-benefit decisions as management components.
- Make greater use of computational modeling and simulation.
- Recognize SNS and BARDA as the sole purchaser and SNS as sole distributor of certain countermeasures.
- Improve coordination among federal, state, and local public health partners.
- Apply lab science and animal models to guide SNS requirements.
During discussions today, some NBSB members voiced concerns about "mission creep," noting that the scope of the SNS has grown well beyond its original mission to include all-hazards. Others noted that the NBSB recommendations could help federal officials make difficult decisions in the face of shrinking budget resources.
With the approval of the two reports and nonbinding recommendations, the documents will be forwarded to the ASPR and the BSC.
Apr 2 and 3 NBSB meeting materials
NBSB/BSC working group draft report on situational awareness
Jun 26, 2012, CIDRAP News story "Biodefense board takes on situational awareness, SNS tasks"