U.S. government spending on global public health, particularly on the early detection of new pathogens, must be significantly and permanently increased, said one key Senate appropriator on Tuesday.

Moreover, the White House must have a permanent body devoted to detecting and responding to the earliest signs of a major infectious disease outbreak abroad, instead of the informal task forces that came and went under the past four presidencies, added Sen. Christopher S. Murphy, D-Conn.

“We are facing squarely the fact that threats to this nation don’t only come in military garb. The most dangerous threats posed to the United States today are by and large not conventional military threats,” Murphy said in a Tuesday press call organized by National Security Action, a foreign policy advocacy group that includes many former Obama administration officials. “We are seeing that pandemic disease is at the top of that list.”

Murphy said it made no sense that Washington in recent years has been spending roughly $700 billion annually on the Defense Department while the global health budget “barely eclipses $12 billion a year.”

Murphy said he has been talking to his Senate Appropriations colleagues about including funding for a new global health security challenge fund in any new emergency spending bill for coronavirus relief as well as in the fiscal 2021 foreign aid spending bill. Murphy said he envisioned such a global health fund as being modeled on the Millennium Challenge Corporation, an economic development partnership program launched in 2004 under President George W. Bush, in which developing countries receive U.S. funding and technical assistance in exchange for agreeing to implement certain changes.

“We can copy that model to help vulnerable countries build up their public health systems,” Murphy said. “Our health security in the United States is no stronger than the weakest country’s public health system.”

The Foreign Relations member and State-Foreign Operations Subcommittee appropriator also called for the re-establishment of an Obama-era initiative: the U.S. Agency for International Development’s “PREDICT” program.

More foreign aid for pandemics

Established in 2009 with the goal of implementing lessons learned by the Bush administration from the 2005 H5N1 bird flu crisis, PREDICT focused on building global capacity to detect new “zoonotic” (animal-to-human) viruses with the potential to become pandemics. The initiative specifically focused on detecting the emergence of new kinds of coronaviruses, which include SARS, MERS and more recently COVID-19, as well as new strains of influenza and Ebola.

The program, which was active in over 30 countries, helped improve developing countries’ disease surveillance and monitoring capabilities. Before it was quietly allowed to die by the Trump administration last month, the program had detected more than 1,100 unique viruses of public health concern, including new coronaviruses, at a cost to taxpayers of some $207 million.

Shortly after the October announcement that PREDICT would be shut down, Dennis Carroll, the former head of USAID’s emerging threats division, who oversaw the disease surveillance initiative, told the New York Times the program was being closed because some “risk-averse bureaucrats” didn’t see how its hard-core scientific mission of monitoring exotic diseases fit in with USAID’s broader goal under the Trump administration of economic development.

In announcing its intention to shut down PREDICT, USAID said it planned to create a successor initiative that would continue the work of monitoring for new infectious diseases around the world. But months later, details about that follow-on program have yet to be publicized.

“President Trump stood down that program and it has left us badly exposed,” Murphy said. “PREDICT was very involved in China and we shudder to think” what might have been prevented had PREDICT been still operating in China when the SARS-CoV-2 virus that causes COVID-19 first emerged in the city of Wuhan in late 2019.

Romney joins Murphy

Last week, Murphy announced he would introduce bipartisan legislation with Sen. Mitt Romney, R-Utah, that would establish a Global Health Security Interagency Review Council at the White House, to be led by a new coordinator for global health security drawn from the National Security Council. The bill seeks to put into statute biodefense preparedness processes which until now have been subject to the wavering priorities of different White Houses.

Over the past two decades, multiple Democratic and Republican administrations have created specialized task forces to focus on biodefense and preparedness within the National Security Council only to see them disbanded by their successors, who typically didn’t think the topic deserved such high-level political attention. That thinking would change once they experienced their own major outbreak like SARS in 2003 for the George W. Bush administration or the West Africa Ebola outbreak in 2014 during the Obama years.

The Trump administration has been no exception. President Trump’s third national security advisor John Bolton in 2018 did away with the biodefense directorate created by the Obama administration and diluted and dispersed to different NSC offices its portfolio.

Under the Murphy-Romney draft bill and a companion House bill that was introduced in 2019, the responsibilities of the new White House biodefense office would include making interagency policy recommendations for responding to a potential pandemic and helping agencies with their implementation.

“Our experience with coronavirus has exposed some glaring gaps in our nation’s capacity to respond to a pandemic, and it is critical that we are better prepared to coordinate global responses and exert leadership to address future health threats,” Romney, who leads the Foreign Relations Middle East subcommittee with Murphy as his ranking member, said in a statement.

“By establishing a health security council and dedicating a new NSC position to developing global health strategies and coordinating responses, our bill will better prepare us to confront the spread of another infectious disease.”

Companion legislation from Reps. Gerald E. Connolly, D-Va., and Steve Chabot, R-Ohio, was advanced to the House floor in early March by the Foreign Affairs Committee.