US needs to look differently at public health preparedness, says former FDA commissioner Gottlieb

Speaking at CPhI North America, Dr Scott Gottlieb shares insights into how the US should prepare for future pandemics by building out vaccine capacities

The ongoing coronavirus pandemic means the US will need to look at public health preparedness through the lens of national security and treat it on par with other kinds of national security threats, according to former US Food and Drug Administration Commissioner, Dr Scott Gottlieb on Tuesday.

Speaking at the hybrid CPhI North America event, Gottlieb said the pandemic had changed the course of history, reset the global order in many significant ways from a geopolitical standpoint, cost trillions of dollars and superseded all other national priorities for more than a year.

“We’re seeing the outsized impact that pathogens and pandemics can have and it means we have to reset how we look at these kinds of risks,” he told delegates.

Outlining the practical measures to tackle future healthcare crises, Gottlieb said the US needs to build different capacities.

“We clearly didn’t have the capacities we thought we had and that we certainty needed,” he said.

He said that the after US’ pandemic planning in 2003, which was focused on concern around H5N1 flu, the country invested in building out certain capacities such as cell-based manufacturing facilities for vaccines, as well as stockpiles and antivirals.

“What happened over time was those efforts atrophied and we didn’t continue to invest in keeping them ready,” he said. “We had this idea that we would create a warm base of preparedness when really what we needed was a hot base of preparedness. You can’t build a vaccine manufacturing plant and mothball it. You really need to be operating these things at scale; in part, because you need to be able to make continuing investments to keep facilities up to date and in part because the only way you can retain personnel to run these kinds of facilities and be ready to scale them up in the event of an emergency is to be operating them.”

He described the country’s prior focus on flu as a mistake: “Even after SARS and MERS came along and it was apparent that coronaviruses were on the march and represented a different kind of threat, we never pivoted our thinking; we never invested in broader capacities that looked beyond flu.”