Business Roundtable Comments on the Reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA)

A PDF of this letter can be viewed here.

March 29, 2023

March 29, 2023

The Honorable Bernard Sanders, Chairman

U.S. Senate Committee on Health, Education, Labor, and Pensions

332 Dirksen Senate Office Building

Washington, DC  20510


The Honorable Bill Cassidy, Ranking Member

U.S. Senate Committee on Health, Education, Labor, and Pensions

455 Dirksen Senate Office Building

Washington, DC  20510

Dear Chairman Sanders and Ranking Member Cassidy: 

On behalf of the CEO Members of Business Roundtable who collectively lead companies with more than 20 million employees, we thank you for the opportunity to comment on the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA).

At the start of the COVID-19 outbreak, Business Roundtable companies immediately responded to address the critical shortage of medical equipment and supplies.  Companies increased production and expanded access to diagnostic testing capacity, kept critical and essential services operating, and supplied day-to-day necessities, such as food and medicine to communities nationwide.  Business Roundtable companies have worked to ensure safe and healthy work environments as more employees returned to their jobs.  At the same time, our companies invested heavily in research and development and helped bring vaccines, therapeutics and antivirals to the market in unprecedented time.

We appreciate the Committee’s expeditious efforts to reauthorize critical programs and improve our systems to be better prepared for and more resilient to pandemics and other public health threats going forward.  This pandemic has exacted a devastating toll in terms of loss of life, health and our economy. Despite the best efforts of so many on the federal, state and local levels, and in the private sector, and through the resilience shown by our fellow citizens and communities, it is clear much more must be done to prevent the devastating loss of life and mitigate the significant economic impacts of another public health emergency going forward.

Our member companies’ experiences responding to COVID-19 have revealed some important lessons, and we provide the following comments on the PAHPA reauthorization based on these lessons.

Public Health Emergency Coordination and Policy:

  1. Modernize the pandemic surveillance and early warning system.  Governments at all levels (federal, state, local) and the private sector will be better prepared to respond to and mitigate the effects of a future pandemic with more warning of the potential risks. The Assistant Secretary for Preparedness and Response (ASPR) should be empowered with the tools and resources to better prepare, track and respond to potential pandemics.
  2. Improve public health data sharing.  To better understand and respond to future pandemics, it is clear that public health data systems must be modernized to provide more accurate and timely information to aid policymakers in decision making on both the front and back ends of any future public health emergency.  Greater coordination across agencies and transparency to the public around public health data is critical for future pandemic preparedness.
  3. Consult with the business community on the next National Health Security Strategy. The current National Health Security Strategy only mentions working with the business community on the resiliency of global supply chains.  The COVID-19 pandemic showed that employers play a critical role in developing necessary tools, therapeutics, and innovations, distributing vaccines and treatments, ensuring health coverage for medical countermeasures, educating employees about the latest scientific developments, creating safe work environments, and ensuring that the effects of the pandemic do not lead to catastrophic economic consequences.  We encourage the next National Health Security Strategy to include more feedback and involvement from the business community to reflect its important role in pandemic response.

Medical Countermeasures Development and Deployment:

  1. Strengthen public-private partnerships to improve medical countermeasures and deployment.  The COVID-19 pandemic has put intense pressure on supply chains for medical supplies, equipment and health care delivery systems.  An improved pandemic response should primarily rely on public-private partnership to drive effective development and deployment of medical countermeasures.  While not perfect, the Biomedical Advanced Research and Development Authority (BARDA) and the Defense Advanced Research Projects Agency (DARPA) provide a foundation for public-private collaborations to develop medical countermeasures.  More of our pandemic preparedness and response systems should leverage public-private partnerships. Business Roundtable encourages the Committee to look at what has made some models more successful than others and incorporate those lessons learned into other programs to enhance their effectiveness.
  2. Emergency Use Authorizations (EUAs) are critical to an agile pandemic response.  The COVID-19 pandemic showed that EUAs are an important tool during a pandemic that enable Americans to get expedited access to life-saving vaccines and treatments.  EUAs should be a model for how government can leverage expedited regulatory processes to ensure a flexible and adaptable response.  Business Roundtable encourages the Committee to apply the lessons learned from EUAs to ensure all of government strikes the right regulatory balance between product safety and a quick response to an always evolving global pandemic.


Our pandemic response is only effective if the private sector is an active partner in the development and deployment of public policy solutions.  The COVID-19 pandemic showed that in some areas the federal government was slow to quickly and effectively engage the private sector on a coordinated response.  As a result, many of the early decisions made lacked input from the business community, including on the economic impacts of proposed public health policies.  The private sector should be an ongoing partner with the government in pandemic preparedness going forward.  To accomplish this, we suggest the following:

  1. The federal government must have a clearly identified leadership structure to manage a “whole of government” pandemic response.
  2. Private sector stakeholders must be included in pandemic preparedness and response plans and exercises on an ongoing basis.
  3. The federal government should continuously update and regularly exercise data-driven, evidence-based pandemic response plans in concert with state and local governments, health care providers and other key stakeholders.
  4. Pandemic preparedness and response plans should address both the public health and economic dimensions of the crisis.

We offer these comments with the understanding that the private sector is one pillar of an effective national—and global—response.  Business Roundtable stands ready to work with the Committee to strengthen both public and private capacity to prevent and respond to future pandemics.


Corey Astill

Vice President, Health and Retirement Committee

Business Roundtable