In October, the Biden administration issued its National Biodefense Strategy for countering biological threats ranging from natural pandemics to lab accidents and bioterror attacks.

A recent op-ed in JAMA Health Forum said it doesn’t go far enough.

The authors praised the plan’s global approach — it calls for supporting at least 50 countries to build essential public health capacity — but criticized its lack of vision for how to strengthen public health in the U.S.

After billions spent on biodefense since 9/11, the COVID-19 pandemic exposed a patchwork of public health systems riddled with uneven capabilities.

The authors argued that responding effectively to biological emergencies takes day-to-day monitoring and a standing roster of seasoned experts, not occasionally collected data and short-term hires who vanish when crisis aid dries up, as occurred with COVID-19.

But that would require state and federal investment in public health and emergency preparedness that would attract top talent to the field — and retain them. Such funding has been the exception, exemplified by states like Minnesota, not the rule.

Arizona consistently ranks near the bottom in public health spending, drawing relevant funds from voter initiative monies, such as lottery funds, and earmarking federal dollars for family nutrition or child health programs.

The authors said the lack of funding, staff, expertise and monitoring help explain why many health departments are struggling to cope with the current “triple-demic” of COVID-19, influenza and RSV (respiratory syncytial virus).

More broadly, the exodus of tens of thousands of public health workers that began during the 2008 recession has today culminated in a workforce gap of more than 80,000.

The op-ed also said mistrust of experts and vaccines will not abate until the U.S. addresses root causes like inequity, political polarization, mistreatment, poor access to health care, and false and misleading narratives spread by ideologically biased media.