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Strategic Goal 3

National Health Security Strategy (NHSS) 2023-2026

Strategic Goal 3 icon Strategic Goal 3:
Ensure a resilient and sustainable public health industrial base and supply chain that can rapidly develop and deploy safe medical countermeasures

The COVID-19 pandemic exposed vulnerabilities in the nation’s ability to provide public health supplies critical to mitigating the spread of SARS-CoV-2 and reduce morbidity and mortality. Many of these supply chain challenges are not unique to the COVID-19 pandemic. Offshore manufacturing and just-in-time supply chain practices can disrupt the U.S. public health supply chain in the event of extreme weather, shifting geopolitical forces, global competition for resources – especially in times of high demand – and other factors, including concerns related to ethical production. These challenges illustrate the need to build more sustainable domestic manufacturing capacities that are resilient to shifting demand, can be adapted for new and emerging health security threats, and can meet the health needs of the whole population, especially during public health emergencies and disasters.

The public health supply chain is a vital component of U.S. national health security and preparedness and response efforts. However, the United States has inadequate domestic manufacturing capacity to meet U.S. demand for all needed public health supplies, especially during public health emergencies and disasters. In addition, the United States is dependent on foreign sourcing and offshore manufacturing for some critical public health supplies. In some cases, critical supplies are sourced from or manufactured in one location. Given that the public health supply chain is driven by the private sector, incentivization and coordination can help expand domestic manufacturing capacity.

A diversified supply chain with built in redundancies along with increased domestic manufacturing capacity, diversified distribution outlets, and a skilled supply chain workforce[g] will lead to a more flexible and scalable public health supply chain that is able to meet increased demand during large-scale emergencies. Implementing regulatory policies requiring greater supplier diversity, incentives—such as production subsidies and tax incentives—and continued investment in innovation to mitigate vulnerabilities of single-sourced materials is vital to having a nimble supply chain structure. Rapidly produced and accurate standards for quality assurance can increase domestic manufacturing to ensure products not only meet demand but are of sufficient quality to meet the purpose. For example, fast production of standards for diagnostic tests could speed production of at home-testing kits to reduce the strain on the health care system while providing the quality control needed to prevent costly false positives/negatives or wasting supplies in high demand due to product failures.

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g  The public health supply chain workforce includes manufacturing, stockpiling, and distribution workforces, as well others vital to the end-to-end public health supply chain.