Recognizing 20 Years of the Pandemic and All-Hazards Preparedness Act

This year marks the 20th anniversary of the Pandemic and All-Hazards Preparedness Act (PAHPA). Signed into law in 2006, PAHPA established HHS’s lead role in public health emergencies, created the position of the Assistant Secretary for Preparedness and Response who leads the office now called the Administration for Strategic Preparedness and Response (ASPR), and supported critical programs like the Strategic National Stockpile (SNS) and the Biomedical Advanced Research and Development Authority (BARDA).

For two decades, PAHPA has helped the nation prepare for, respond to, and recover from disasters and public health emergencies.

Since ASPR was established, we have faced many challenges—from the Deepwater Horizon oil spill to infectious disease outbreaks that required rapid development of new medical countermeasures, to natural disasters like hurricanes, wildfires, and tornadoes that affected entire regions.

This anniversary is a time to reflect on how far we’ve come—and to prepare for what’s ahead.

As someone who has spent a career in emergency response, I’m proud to serve as Principal Deputy Assistant Secretary (PDAS) for Preparedness and Response. Time and again, ASPR teams have stepped up during crises to protect lives and support communities during some of their most difficult times.

Why PAHPA Matters

PAHPA was signed into law after Hurricane Katrina exposed major weaknesses in the nation’s healthcare infrastructure. Katrina was not just a storm—it caused long-lasting damage across the entire healthcare infrastructure. Hospitals were destroyed, evacuation routes were flooded, supply chains failed, and communities faced overlapping public health, environmental, energy, and safety crises.

PAHPA was designed to fix those gaps by creating a unity of command while consolidating federal nonmilitary public health and medical preparedness and response functions. The goal was simple but critical: help the nation do better when disasters threaten our healthcare system and public health.

During the H1N1 response, ASPR utilized existing authorities to lead coordination efforts across HHS and the interagency. HHS more broadly was analyzing the virus, disseminating information to researchers and public health officials, developing and shipping new tests to diagnose infections, and distributing antiviral drugs from the (SNS). While ASPR and HHS mitigated the potential spread, there were gaps. Local and State capabilities were overwhelmed.

Building Stronger Preparedness

PAHPA has been strengthened over time. In 2013, Congress re-authorized and updated the law based on lessons from the H1N1 flu pandemic, which hit children especially hard. These updates helped improve care for children during emergencies. The law was also expanded to better support older adults and people with disabilities.

The 2013 reauthorization also added important flexibility, allowing federally funded healthcare workers employed by states, localities, or tribes—such as nurses and lab staff—to be reassigned to support communities facing surge needs during declared public health emergencies.

Following major hurricanes that impacted Puerto Rico, the U.S. Virgin Islands, and the East Coast, PAHPA was reauthorized a second time focusing on flexibilities for the deployable response force – the National Disaster Medical System and the Medical Reserve Corps.

The 2019 reauthorization also addressed ongoing threats from Ebola and other highly contagious infectious diseases (HCID). ASPR helped establish what is now the National Special Pathogen System, including 13 regional treatment centers for special pathogen readiness. Because of that readiness, the United States has been able to respond to Ebola and other serious diseases—such as Zika, Marburg virus, and mPox— while citizens continue with their daily lives with minimal disruption.

Looking Ahead

This anniversary is not only a time to reflect—it’s a reminder to stay ready. Today’s threats are increasingly complex, from natural disasters and emerging diseases to cyber risks facing healthcare systems. That’s why PAHPA and ASPR’s mission remain so important.

To meet future challenges, ASPR recently released its 2026–2029 Strategic Plan. The plan supports key Trump Administration priorities like increasing state and local resiliency, enhancing government efficiency, and onshoring pharmaceutical manufacturing and production capabilities to Make America Healthy Again.

The lesson of the past 20 years is clear: strong preparedness today enables effective response tomorrow. As Congress considers reauthorizing PAHPA for the third time, we hope lessons learned continue to strengthen ASPR’s authorities—so we can keep protecting health and saving lives across the nation.