The government is poorly equipped to detect emerging infectious diseases across human and animal populations because federal surveillance efforts remain fragmented, according to a new report.
Agencies rely on informal coordination rather than centralized leadership, prompting experts to recommend sweeping changes to how the government monitors outbreaks before they spread, according to a new Government Accountability Office report.
The report comes amid a growing outbreak of cyclosporiasis and a record-breaking number of measles cases in the U.S.
No agency has centralized authority to direct cross-agency surveillance, as coordination efforts are described as largely informal or based on “personal relationships.”
The U.S. One Health Coordination Unit, a working group on interagency surveillance, was affected by the disorganization during the New World Screwworm response.
Experts recommended creating a centralized, multisectoral One Health leadership group to direct cross-agency surveillance.
They told GAO that the federal lead for public health, the Department of Health and Human Services, can improve U.S. emerging infectious disease surveillance by unifying efforts between animal and human health sectors, as emerging diseases often affect both.
Zoonotic diseases — those that spread between humans and animals — account for 75% of emerging infectious diseases, making animal-human unification central to the surveillance mission, according to the report.
Currently, “public health agencies focus on human disease surveillance while animal health agencies focus on animal disease surveillance,” as each optimizes data collection for their own agency’s needs rather than a shared surveillance goal. Even where informal collaboration exists, it’s ad hoc and not durable.
Experts called for a group that spans public health and animal health agencies with real authority — not just another informal coordinating body.
HHS’ leadership and coordination of public health emergencies has been on GAO’s “High Risk List” since 2022. During COVID-19, the data that HHS relied on was “incomplete and inconsistent,” landing the department on GAO’s list.
During the 2022 mpox outbreak, HHS “did not effectively communicate” the “significantly increased risk of mpox for certain individuals” and failed to adapt messaging for different communities. GAO notes this is the same pattern seen in COVID-19, the 2016 Zika response and 2009 H1N1.
Reduced public trust has made people less willing to get tested or report infections, degrading data quality further, according to the report.
As of January of last year, 83 recommendations related to public health emergency preparedness remained unimplemented.
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