Coordination Mechanisms  Mechanisms and networks for collaboration and coordination on  pandemic preparedness between federal and state governments and the  private sector exist, but they could be better utilized. Efforts Are Underway to Improve the Surveillance and Detection Of Pandemic-Related Threats, but Targeting Assistance to Countries at the Greatest Risk Has Been Based on Incomplete Information

International disease surveillance and detection efforts serve as an early  warning system that could prevent the spread of an influenza pandemic  outbreak. Federal Workforce Pandemic Planning

The National Pandemic Implementation Plan required federal agencies to  develop operational plans for protecting their employees and maintaining  essential operations and services in the event of a pandemic. Other state and local  officials have identified similar concerns. Further Actions Are Needed to Address the Capacity to Respond to and Recover from an Influenza Pandemic

Improving the nation’s response capability to catastrophic disasters, such  as an influenza pandemic, is essential. An outbreak will require additional capacity in many areas, including the  procurement of additional patient treatment space and the acquisition and  distribution of medical and other critical supplies, such as antivirals and  vaccines for an influenza pandemic. Federal Agencies Have Provided Considerable Guidance and Pandemic-Related Information, but Could Augment Their Efforts

The National Pandemic Implementation Plan emphasizes that government  and public health officials must communicate clearly and continuously  with the public throughout a pandemic. More recently, CDC has issued  additional guidance on a number of topics related to responding to the  H1N1 outbreak. Performance Monitoring and Accountability for Pandemic Preparedness Needs Strengthening

While the National Pandemic Strategy and Implementation Plan identify  overarching goals and objectives for pandemic planning, the documents  are not altogether clear on the roles, responsibilities, and requirements to  carry out the plan. This action would not directly result in developing, testing, and  preparing to implement infection control campaigns. In addition,  as discussed earlier, the National Pandemic Implementation Plan does not  establish priorities among its 324 action items, which becomes especially  important as agencies and other parties strive to effectively manage scarce  resources and ensure that the most important steps are accomplished. We recently reported, however, that there is no mechanism in  place to monitor and report on agencies’ progress in developing these  plans. Concluding Observations

The current H1N1 influenza pandemic should serve as a powerful  reminder that the threat of a more virulent pandemic, which seemed to  fade from public awareness in recent years, never really disappeared. While federal agencies have taken action on many of our  recommendations, about half the recommendations that we have made  over the past 3 years are still not fully implemented. DHS and HHS should also, in coordination with  other federal agencies, continue to work with states and local  governments to help them address identified gaps in their pandemic  planning. While the current H1N1  pandemic seems to be relatively mild, the virus could become more  virulent this fall or winter. Given this risk, the administration and federal  agencies should use this opportunity to turn their attention to filling in  some of the planning and preparedness gaps our work has pointed out,  while time is still on our side. Attachment I: Open Recommendations from GAO’s Work on an Influenza Pandemic

	Influenza Pandemic: Increased Agency Accountability Could Help Protect Federal Employees Serving the Public in the Event of a Pandemic, GAO-09-404, June 12, 2009

The Homeland Security Council should  request that the Secretary of Homeland  Security monitor and report to the  Executive Office of the President on the  readiness of agencies to continue their  operations while protecting their employees  in the event of an influenza pandemic. Attachment II: Related GAO Products

Influenza Pandemic: Greater Agency Accountability Needed to Protect  Federal Workers in the Event of a Pandemic.
Why GAO Did This Study

As the current H1N1 outbreak underscores, an influenza pandemic remains a real threat to our nation. Over the past 3 years, GAO conducted a body of work, consisting of 12 reports and 4 testimonies, to help the nation better prepare for a possible pandemic. In February 2009, GAO synthesized the results of most of this work and, in June 2009, GAO issued an additional report on agency accountability for protecting the federal workforce in the event of a pandemic. GAO's work points out that while a number of actions have been taken to plan for a pandemic, including developing a national strategy and implementation plan, many gaps in pandemic planning and preparedness still remain. This statement covers six thematic areas: (1) leadership, authority, and coordination; (2) detecting threats and managing risks; (3) planning, training, and exercising; (4) capacity to respond and recover; (5) information sharing and communication; and (6) performance and accountability.

What GAO Found

(1) Leadership roles and responsibilities for an influenza pandemic need to be clarified, tested, and exercised, and existing coordination mechanisms, such as critical infrastructure coordinating councils, could be better utilized to address challenges in coordination between the federal, state, and local governments and the private sector in preparing for a pandemic. (2)Efforts are underway to improve the surveillance and detection of pandemic-related threats, but targeting assistance to countries at the greatest risk has been based on incomplete information, particularly from developing countries. (3) Pandemic planning and exercising has occurred at the federal, state, and local government levels, but important planning gaps remain at all levels of government. At the federal level, agency planning to maintain essential operations and services while protecting their employees in the event of a pandemic is uneven. (4) Further actions are needed to address the capacity to respond to and recover from an influenza pandemic, which will require additional capacity in patient treatment space, and the acquisition and distribution of medical and other critical supplies, such as antivirals and vaccines. (5) Federal agencies have provided considerable guidance and pandemic-related information to state and local governments, but could augment their efforts with additional information on school closures, state border closures, and other topics. (6) Performance monitoring and accountability for pandemic preparedness needs strengthening. For example, the May 2006 National Strategy for Pandemic Influenza Implementation Plan does not establish priorities among its 324 action items and does not provide information on the financial resources needed to implement them. Also, greater agency accountability is needed to protect federal workers in the event of a pandemic because there is no mechanism in place to monitor and report on agencies' progress in developing workforce pandemic plans. The current H1N1 pandemic should serve as a powerful reminder that the threat of a pandemic influenza, which seemed to fade from public awareness in recent years, never really disappeared. While federal agencies have taken action on 13 of GAO's 24 recommendations, 11 of the recommendations that GAO has made over the past 3 years have not been fully implemented. With the possibility that the H1N1 virus could become more virulent this fall or winter, the administration and federal agencies should use this time to turn their attention to filling in the planning and preparedness gaps GAO's work has pointed out.