National Health Security Strategy

Objectives

The National Health Security Strategy 2023-2026 provides a whole-of-nation, capability-based framework to prepare for, protect against, respond to and recover from the health effects of public health emergencies and disasters, particularly for at-risk individuals and underserved communities.[1]Its vision is a secure, resilient and adaptive nation that collaborates across sectors to address emerging and evolving health-security threats.[2]

• Strengthen health care and public health systems to manage concurrent, cascading and unknown threats by understanding community needs, improving readiness, infrastructure, workforce capacity, risk communication, continuity of care and surge capabilities.[2][3][4]
• Advance equity by tailoring preparedness, response and recovery to underserved populations; addressing social determinants of health; expanding access for people with disabilities, limited English proficiency and other access or functional needs; and supporting mental and behavioural health recovery and resilience.[5][6][4]
• Protect against emerging and re-emerging threats, especially zoonotic diseases, through a One Health approach that links human, animal, plant, food and environmental health.[2][7]
• Integrate surveillance data and demographic, socioeconomic and social-determinants information to enable prompt threat detection and identify inequities affecting underserved communities and at-risk individuals.[2][8][7]
• Strengthen agricultural safeguards, animal and plant diagnostics, sustainable antibiotic-use practices, wildlife-trade enforcement and food-system surveillance to reduce spillover and antimicrobial-resistance risks.[7][9]
• Improve protection of health systems, patient privacy, health data and medical devices from cyberattacks through stronger cybersecurity standards, workforce capacity, modernised systems and response plans.[10][11]
• Ensure a resilient and sustainable public health industrial base and supply chain capable of rapidly developing, producing and equitably deploying safe diagnostics, therapeutics and vaccines.[2][11][12]
• Build flexible domestic manufacturing, supplier diversity, distribution redundancy, stockpiling capacity and an end-to-end supply-chain workforce to reduce shortages and single-source dependencies.[13][12]
• Accelerate innovation and clinical research to develop adaptable medical countermeasures, including rapid diagnostics, novel antimicrobial therapies and regulatory-ready trials for emerging threats.[12][9]

Implementation

Implementation relies on inclusive partnerships, evidence-based innovation, equity and integrity, using the National Health Security Strategy Implementation Plan to guide federal action and recommend activities for state, local, tribal and territorial partners, industry and communities.[1][2]The supplied material does not specify a single named implementation lead, formal budget or quantified performance framework.[1][2]

• Coordinate federal, state, local, tribal and territorial governments with regional bodies, health care and public health organisations, emergency-management agencies, biomedical researchers, private industry, non-governmental organisations, communities and international partners.[1][9][4]
• Engage diverse communities throughout needs assessment, preparedness, exercises, response and recovery planning, working with trusted local leaders and adapting actions to community-specific circumstances.[14][6]
• Strengthen staffing, specialist training, recruitment, retention, diversity and workforce wellbeing, including training for disaster response, infection control, personal protective equipment, emergency research support and simultaneous multi-threat incidents.[10][6]
• Establish tiered and regionalised networks that connect national expertise with regional, state and local capabilities; support mobile medical assets, flexible surge capacity, specialty care, telehealth and cross-jurisdictional emergency practice arrangements.[14][4]
• Integrate physical health, mental health, infectious-disease mitigation, climate resilience, cyber resilience and supply-chain continuity into preparedness, mitigation, response and recovery plans.[3][14]
• Modernise interoperable, secure and near-real-time data exchange across human, animal, plant, food and environmental health sectors, including electronic health record links and national syndromic surveillance.[13][8]
• Expand data standards and collection of race, ethnicity, disability status and other demographic and socioeconomic information, while improving transparency, privacy and community trust.[7]
• Deliver clear, timely, accessible, transparent, scientifically accurate and culturally appropriate risk communication through trusted messengers, bidirectional community engagement and partnerships with media and technology platforms.[13][6]
• Counter misinformation, disinformation and malinformation by developing tools to identify and address harmful information and by working with communication and behavioural-health experts.[5][8]
• Use government-industry information sharing, supplier partnerships, regulatory policies, production subsidies, tax incentives and quality standards to improve supply-chain visibility, capacity planning, domestic production and emergency distribution.[12]
• Maintain domestic and global clinical research networks, sustained public and private research investment, and partnerships among government, academia, industry, health care, public health, philanthropy and international actors.[12][9]
• Conduct preparedness assessments through drills and exercises, disease situational awareness, containment activities, risk communication, rapid countermeasure distribution and administration, and strengthened surge and fatality-management capabilities.[9]
• Meet statutory review requirements under which the Department of Health and Human Services prepares a National Health Security Strategy, implementation plan and evaluation of progress on the previous strategy every four years.[9]

Monitoring & Evaluation

The strategy combines statutory progress evaluation with strengthened surveillance, data interoperability, situational awareness and preparedness exercises, but the supplied material does not establish a comprehensive performance-management framework with quantified indicators or regular reporting requirements.[1][13][9]

• Record progress through the National Health Security Strategy Evaluation of Progress, which reviewed federal activities during 2019-2022, including work undertaken with state, local, tribal and territorial partners and the private sector.[1]
• Require the Department of Health and Human Services to prepare a National Health Security Strategy, Implementation Plan and evaluation of progress on the preceding strategy every four years.[9]
• Integrate human, animal, plant, food and environmental surveillance data to enable prompt threat detection and inform emergency response.[2][8]
• Modernise surveillance infrastructure to support interoperable, secure and near-real-time electronic data exchange, including connections between electronic health records, other significant data sources and national syndromic surveillance systems.[13][8]
• Collect and report standardised race, ethnicity, disability, demographic and socioeconomic information to identify inequities affecting underserved communities and at-risk individuals.[7]
• Strengthen pathogen testing, laboratory capacity, diagnostic technologies and timely data availability to reduce delays in containment and mitigation.[10][7]
• Develop global situational awareness, international data-sharing agreements and early-warning capacity, including through the Global Health Security Agenda.[8]
• Monitor supply-chain vulnerabilities, shortages, stockpiling needs and emergency distribution requirements through real-time information sharing between government and industry.[12]
• Conduct periodic federal, state, local and tribal drills and exercises covering disease situational awareness and containment, risk communication, medical-countermeasure distribution and administration, health-care surge capacity and fatality management.[9]
• Establish mechanisms to identify, track and counter health misinformation, supported by analysis of information consumption and susceptibility during crises.[6][8]
• Maintain cybersecurity standards and mitigation and response plans for health technologies, data systems and medical devices.[11]

The material identifies ageing data infrastructure, technology bottlenecks and inconsistent data-management capacity as constraints on detection, situational awareness and coordinated response.[13]It does not specify formal quantitative indicators, indicator baselines or targets, standard evaluation methodologies, reporting schedules, or named accountability bodies beyond statutory Department of Health and Human Services responsibilities and multi-sectoral collaboration.[1][6][7][9]

Costing & Financing

The strategy identifies sustained investment and dedicated resources as essential to preparedness, surveillance, workforce capacity, infrastructure, research, medical countermeasures and supply-chain resilience, but it provides no consolidated budget, monetary funding gap or detailed allocation.[15][6][8][12]

• Provide sufficient and sustained funding for health care, medical research, public health systems and personnel, health and public health infrastructure, and supplies.[15]
• Direct dedicated resources towards mental and behavioural-health recovery, long-term resilience, workforce recruitment, training and retention, telehealth, climate resilience and health-care and public-health infrastructure.[14][6]
• Maintain steady and sustained financing for surveillance modernisation, international health-security capacity-building, and technical and political support.[8]
• Invest in agricultural and animal-health surveillance, applied research, wildlife-trade enforcement, cybersecurity programmes and personnel, legacy-system upgrades, domestic manufacturing and supply-chain resilience.[7][11]
• Sustain public and private funding for basic, translational and clinical research and commercially viable medical-countermeasure development pipelines.[12]
• Use production subsidies, tax incentives and new economic models to encourage supplier diversification, domestic manufacturing and antibiotic development.[12][9]

Resource pressures include workforce shortages, inadequate surge capacity, equipment and infrastructure shortfalls, hospital and laboratory constraints, disrupted supply chains and insufficient domestic manufacturing capacity.[10][13]Before COVID-19, funding for the Public Health Emergency Preparedness programme and the Hospital Preparedness Program declined between 2003 and 2019, while short-term supplemental appropriations increased funding from 2020.[15]Treating six antibiotic-resistance threats incurred more than 4.6 billion US dollars in annual healthcare costs in 2021.[16]The material does not specify total budgets, funding-source amounts, quantified allocations, a monetary funding gap, or economic assumptions.[15][6][11][12]