Michelle Mello and colleagues argue that state legal reforms have generally exacerbated rather than improved weaknesses in US emergency powers revealed by covid-19, jeopardizing future responses
Covid-19 related mortality in the US was higher than in every western European country.1 Compared with its closest neighbour, Canada, also a federated country with a decentralised health system, the US fared far worse.2 With over 1.1 million dead at the end of 2023,3 leaders and academics have begun a painful postmortem. What went wrong, and what can be done to make authorities in the US better equipped for the next pandemic?
In this article, part of a BMJ series examining US covid-19 lessons (http://bmj.com/collections/us-covid-series), we focus on the role of legal infrastructure, including both the law itself and the capacity to wield it effectively.45 A web of federal, state, and local laws determines what officials can do to respond to emergencies. These laws are helpful only to the exte
Chelsea Cipriano , Kushal Kadakia , and Dave Chokshi argue that the US must end its collective amnesia about public health disasters and act collaboratively to strengthen services
Throughout American history, leaders have stood up in the aftermath of disasters and committed to honoring the past by investing for the future. For example, the Space Shuttle Columbia disaster in 2003 led NASA to overhaul its safety culture and attracted new partnerships that are paving the way to America’s return to the Moon.1 Likewise, after a multistate blackout that same year, the North American Electric Reliability Corporation was charged with ensuring nationwide reliability of the power grid through an innovative multistate model of standardized sharing of data, staffing, and resources among power companies.2
Yet when it comes to public health disasters, the US has consistently chosen to forget instead of futureproof. Consider the repeated cuts to core public health agencies and programs, including
As the United States enters an election year with huge international stakes, it is easy to be pessimistic that the value of continued US leadership in global health, including pandemic preparedness, will be the subject of prominent debate in the 2024 elections. Geopolitical crises in Ukraine, Israel-Palestine, and China-Taiwan dominate attention and policy. Climate, debt overhang, food insecurity, and humanitarian crises compete for attention. The flagship President’s Emergency Plan for AIDS Relief (PEPFAR) has lost prominence. President Biden has said little on the campaign trail about the value of global health to US national interests. If Donald Trump is the Republican candidate, he will certainly say little positive about global health. And, as the BMJ series on lessons from the US covid response lays out (http://bmj.com/collections/us-covid-series), covid-19 exposed and aggravated pre-existing systemic and structural weaknesses in healthcare and public health.
There is little d
Justin Feldman and Mary Bassett describe how diminished political will to use government powers for service provision hampered the US response to the covid-19 pandemic and what needs to change
The US response to the covid-19 pandemic failed in its central task of protecting life. When the government’s public health emergency declaration ended on 11 May 2023, more than 1.1 million people in the US had died, the covid-19 death rate was higher than in comparable wealthy nations,1 and gaping racial and ethnic inequalities in mortality remained.2 In public health circles, chronic underfunding of public health agencies is often used to explain the shortcomings of the US covid-19 pandemic response.3 If only health departments had larger budgets, these arguments go, government could have expanded efforts to prevent SARS-CoV-2 transmission, promote vaccination, and deliver early treatment to medically vulnerable people.
The budgetary concerns are warranted. Only 1% of the country’s total
Pandemic lessons for the 2024 US presidential election bmj.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from bmj.com Daily Mail and Mail on Sunday newspapers.