The Pandemic and All-Hazards Preparedness Reauthorization Act

September 5, 2023

The Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) undergoes review and is reauthorized by Congress every 5 years, the first time in 2018 and again at the end of September 2023. Congress has marked up PAHPRA in both the House of Representatives and Senate. The House marked up PAHPRA via two bills—H.R. 4421 and H.R. 4420. The Senate marked up a discussion draft in July.

The House markups include three additional bills that provide greater oversight of the Centers for Disease Control and Prevention (CDC):

1. H.R. 4529—Public Health Guidance Transparency and Accountability Act of 2023: This act would require CDC to develop, establish, and maintain good guidance practices setting forth the policies and procedures of the centers for developing, issuing, disseminating, and using such guidance documents. It would require that the public participates in developing guidance documents and ensures that guidance documents under the jurisdiction of centers within CDC do not create, confer, restrict, or revoke any rights, responsibilities, or liabilities for individuals.
2. H.R. 4381—Public Health Emergency Congressional Review Act: This act grants Congress the authority to terminate a public health emergency starting 6 months after it has been established by the U.S. Department of Health and Human Services (HHS) and every 6 months afterward. It also requires that the secretary of HHS inform Congress of a public health emergency renewal in writing no later than 48 hr after such a determination.
3. H.R. 3813—CDC Leadership Accountability Act of 2023: This act would require Senate confirmation for a CDC director and designates any appointee after June 1, 2023, as an acting director.

The purpose of PAHPRA is to “reauthorize certain programs under the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act with respect to public health security and all-hazards preparedness.”

The act builds on work HHS has undertaken to advance national health security. This work includes authorization of funding for public health and medical preparedness programs such as the Public Health Emergency Preparedness cooperative agreement and amending the Public Health Service Act to grant state health departments additional flexibility to dedicate staff resources for critical community needs in a disaster. PAHPRA also enhances the authority of the Food and Drug Administration to support rapid responses to public health emergencies.

The first reauthorization of PAHPRA was in 2018, when we successfully got public environmental health added to the law, which brought the environmental health community into its jurisdiction. The 2023 reauthorization maintains that authority while enhancing programs emphasizing environmental health.

We submitted comments to both the House and Senate regarding these markups to emphasize the importance of complete integration of environmental health into public health emergency preparedness to promote the highest level of health and safety for individuals and communities affected by disasters. We specifically support the following programs within PAHPRA:

• Sec. 105: Enhancing Domestic Wastewater Surveillance for Pathogen Detection
• Sec. 106: Reauthorization of Mosquito Abatement for Safety and Health Program
• Sec. 201: All-Hazards Emergency Preparedness and Response
• Specific funding streams for environmental public health infrastructure

For more information, contact Government Affairs Director Doug Farquhar.