Ensuring an Effective Public Health Emergency Medical Countermeasures Enterprise (2021) / Chapter Skim
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2 Delivering on PHEMCE's Mission
2 Delivering on PHEMCE's Mission
Pages 29-40
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From page 29... ...
For example, some individuals considered only therapeutics, such as medicines and vaccines, while others added personal protective equipment (PPE) consistent with the definition of MCMs in federal law.1,2 Some presenters defined MCMs as just the products, while still others included information sharing and distribution to the level of medical providers.
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GUIDING PRINCIPLES FOR PHEMCE Presentations to the committee and a recent GAO report highlighted concerns raised by interagency partners regarding the 2018–2020 restructuring of PHEMCE that resulted in a lack of clarification on how decisions are made, challenges in collaborating effectively, and issues with transparency (GAO, 2021)
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Ethics Guidance documents related to PHEs and response often prominently discuss ethics. Many factors support this practice, but perhaps the most important is that allocating crucial and scarce resources falls to government and institutions; when the population perceives that allocation to be flawed, it may erode trust, which can increase the difficulty of successfully responding to the public's needs.
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. Processes that enhance fairness include proactively engaging with stakeholders who have been underrepresented in policy formation and implementation, including underresourced health providers, public health providers, and community organizations.
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Nonprofit, independent nursing homes serving urban populations with high rates of poverty especially encountered great difficulty in obtaining adequate PPE for staff and patients, many of whom were minorities. This contributed to the high numbers of fatalities among both residents and workers at nursing homes in the earliest phase of the pandemic (McGarry et al., 2020; Seelye et al., 2020)
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. Accountability is enhanced by formal processes and regular reassessment, such as through metrics-based evaluations or unbiased after-action reviews of emergency responses, to learn how to improve practices (see Chapter 3)
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. Taking a systems approach requires considering the life cycle of each MCM asset across the portfolio, including facilities, supply chains, quality management, and workforce, from development to delivery stages, and results in prioritizing across scenarios.
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. As recommended in the National Strategy for a Resilient Public Health Supply Chain, reporting annually will help ensure that Congress remains informed about the most current state of MCM preparedness (HHS, 2021)
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As the costs of both development and procurement are also subject to market forces, negotiations, etc., PHEMCE needs strong authority to negotiate on pricing. The National Strategy for a Resilient Public Health Supply Chain recommends supplementing these reporting requirements with annual budget analysis "to advance MCM preparedness in a fiscally responsible m anner, industrial base expansion, commercial supply chain and inventory solutions, and the SNS" (HHS, 2021)
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From page 38... ...
Given the varied public health threats facing the nation, and the reality that the different federal agencies will continue to work on aspects of MCM preparedness and response, a coordinating body is and will always be needed. PHEMCE is that body, and its scope, authorities, and responsibilities should reflect its original mandate as the nation's primary coordinating body for MCMs.
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2020. Severe staffing and personal protective equipment shortages faced by nursing homes during the COVID-19 pandemic: Study examines staffing and personal protective equipment shortages faced by nursing homes during the COVID-19 pandemic.
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2013. Building community disaster resilience: Perspectives from a large urban county department of public health.
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