Response capabilities. We will hear from dr. Robert kadlick, assistant secretary for preparedness and response at the department of health and human services. Dr. Steven redd, director of the office of Public Health preparedness and response at the centers for Disease Control and prevention, and dr. Scott g gottlieb, commissioner of the food and Drug Administration. This is the first of two hearings we plan to have on this topic. The second will be noticed for tuesday, january 23rd. Senator murray and i each have an opening statement, then im going to turn to senator alexander and senator casey for any opening remarks they might have. After that, we will introduce our panel of witnesses and hear their testimonies, and then each member will have up to five minutes for any remarks and questions. Finishes first i would like to welcome the chairman and thank him for giving me the opportunity to hold the gavel today. This hearing discusses a topic thats critical to our National Security and has seen many years of bipartisan work in this committee and in this congress. Together, we have developed and strengthened the framework to ensure we are prepared for chemical, biologic, radiolodgic and other tlinhreats. The pandemic and all hazard preparedness act created a framework which has grown and changed as weve learned from each Public Health experience we have been through. We should be proud of the accomplishments and the progress made over the last decade. Our work has resulted in strong partnerships with our states and local counterparts, created greater certainty and accountability to bring forward medical countermeasures and establish a Clear Strategy with which we can combat the full range of Public Health threats we face today, and those we may encounter in the future. Despite this progress, we are not fully prepared and more work remains to accomplish our goal. The Blue Ribbon Panel on defense stated in their 2015 report they are, i quote, serious gaps and inadequacies that continue to leave the nation vulnerable to threats from nature and terrorists alike, unquote. As we move forward, in revisiting the successful and bipartisan law, i want to make it very clear to my colleagues that this is reauthorization of a National Security bill. I look forward to working with each of you on this important issue. The threats we face continue to evolve and its critical that we bring with this discussion the vigilance, urgency and resolve this mission demands. We are in an unprecedented era of technological and biomedical innovation and advancement. In november 2016, the president S Advisory Council on science and technology warned that, i quote, while the ongoing growth of biotechnology is a great boon for society, it also holds serious potential for destruction destructive use by both states and technically competent individuals, unquote. I urge the u. S. Governments past ways of thinking and organizing to meet biological threats threat needs to change to reflect and address this rapidly developing landscape. For this reason, its critical that fostering and advancing innovation, particularly in the development of medical countermeasures, is top of mind and that we work through this reauthorization process to ensure cdc, fda, have what they need to keep pace with these rapidly changing and evolving threats. This committee has worked to push the federal government and hhs in particular to meet these challenges. An hhs that fosters innovation and the development of medical countermeasures and across the framework provides the greatest hope to ensure the safety of the American People. The witnesses we have before us today will be able to provide insight into the urgency of this mission and the promise innovation holds, if properly leveraged. I look forward to hearing from each of you about the progress that weve made and where we can continue to improve policies and programs to realize their full potential to save americans lives. Now i would like to turn to senator murray for any comments she might have. Thank you very much. Thank you to all of you for joining this hearing on our nations preparedness to combat Public Health threats as we look towards now reauthorizing the pandemic and all hazards preparedness act later this year. I especially want to thank senator casey and senator burr for their bipartisan work and leadership on this really important issue. Local Washington State papers show why todays discussion is so important to families across this country. We have headlines like flu deaths and cases increasing in pierce county, and flu outbreak kills five, 50 hospitalized. A bad flu season can be a nightmare for families and too often ends in horrible tragedy. Just as we must continue to improve our Public Health response across the board, to prevent those tragedies on the local level, we have to also make sure we are vigilant against pandemics of a global scale. A pandemic could affect half a billion people, more than the entire population of the United States, and thats not speculation. It happened a hundred years ago. The 1918 influenza epidemic was a tragedy more deadly to the human race than world war i. Today, the threat of pandemic flu is joined by new threats. So what have we learned in the last century . Are we better prepared for the next catastrophe . When you consider ebola and how the centers for Disease Control and prevention and so many partners supported nigeria as they instituted evidencebased policies and tracked the path of that disease, and contained it when the outbreak reached lagos, the answer is clearly yes. When you consider our Strategic National stockpile which can deliver 50 tons of emergency medical supplies anywhere in the u. S. In 12 hours, the answer is clearly yes. When you consider the fdas approval of new medical countermeasures to combat anthrax and flu and radiation mrai and plague the answer is clearly yes. However, our track record is far from perfect. We still can do better. We can do better than the president s way too slow response in puerto rico and the u. S. Virgin islands after Hurricane Maria. The storm left Many Americans without access to clean water and electricity and health care for months. We can do better than the administrations response to the opioid epidemic. President trump declared the crisis a Public Health emergency 83 days ago and has taken little meaningful action since. So im glad this committee will continue its bipartisan work to address the Opioid Crisis in another hearing soon. We can also do better than our slow response in improving funding to combat zika in 2016. The World Health Organization declared zika a global Health Emergency in february. Instead of a Fast Response with needed funding, the response got politicized around some republicans who pushed to undermine Womens Health care and access to contraception which was a key requirement to prevent the virus from causing devastating birth defects. As a result, that took Congress Nine months to pass emergency funding for a Public Health crisis that endangered mothers and babies and families across the world. That delay hurt people and it harmed families in ways they are going to carry for the rest of their lives. So we have to do better. We are most successful at protecting our families against pandemic threats when we respond with quick bipartisan action. We need decisions based in science and expert medical opinion, not ideology, especially when it comes to Womens Health. We need federal, state and local agencies to hire the people and capacity and have the funding they need to protect communities. Hiring freezes and funding cuts make us less prepared, not more. We need to plan for everyone. We cant overlook the young or the elderly. We cant forget pregnant women or individuals with disabilities, or those fighting chronic diseases like diabetes. We need innovative medical countermeasures to protect us from todays threats like a universal flu vaccine and antibiotics to combat resistant bacteria. And we must continue strong partnerships with industry that will allow us to rapidly respond to new threats. We need to stop fear and uncertainty before they create panic by getting families helpful and Accurate Information from sources that they trust. We cant allow anyone to undermine the science of Proven Solutions like vaccines. We need to respond to Global Health crises abroad before they travel here to home. Diseases are not stopped by borders or walls. This is a place where the United States can and should lead. We should continue to show our International Partners that we are focused on these issues and will be their ally in preparing for and addressing Public Health threats. Congress has a strong bipartisan track record of addressing these challenges through the laws which strengthed our Publics Health preparedness. Reauthorizing the act in 2013, we built on that record and enhanced medical Surge Capacity, modernized biosurveillance capabilities and increased our focus on atrisk individuals. Im hopeful we can continue that progress with legislation that focuses on the science and evidencebased policies we know work to mitigate Public Health crisis, that considers the needs of everyone and puts families and women before politics, supports state and local Public Health officials, ensures communities dont spend months waiting for needed emergency resources, and enables us to respond to the next crisis with foresight rather than learn from the next tragedy with hindsight. We dont know what the next Public Health threat will be. We dont know where or when or even how it will start. But we do know that being prepared starts now. All of you here today have a Critical Role to play in keeping our communities healthy and safe. The food and Drug Administration helps facilitate the development and review of medical countermeasures and grants emergency use authorizations for products that are needed on the front lines. The assistant secretary of preparedness and response guides our nations preparedness planning. They help ensure our Health Care System is ready to face any emergency, and it invests in medical countermeasures, pipelines through Biomedical Advanced Research and development authority. The centers for Disease Control and prevention is on the front lines supporting state and local Public Health departments, overseeing the national Strategic National stockpile, gathering and analyzing key data and serving as a trusted source of information to the public. Im interested to hear from all of you today about your work to fulfill these Important Roles and keep our country safe. Mr. Chairman, i do want to say i am frustrated that director fitzgerald is once again unable to join us here today due to conflicts of interest presented by investments, our cdc director still has to recuse herself on some of the Important Health issues that we face. Including issues related to Data Collection and information sharing, which are very relevant to the conversation that were having today. Im concerned that she still cant give her full attention to all the pressing Health Threats we face and hope that these conflicts of interest will be resolved soon. Thank you, dr. Redd, for joining us in her place. I look forward to hearing from you and all of our witnesses. Thanks, senator murray. Senator alexander . Thank you, senator burr. Senator burr, thank you for your willingness to chair this hearing. On march 2013, president obama signed into law the bipartisan pandemic and all hazard preparedness reauthorization act. Senator burr was the author of that reauthorization and the original legislation which became law in 2006. He worked with many senators on this committee, both democratic and republican, and i thank them all for that. Senator murray, senator casey and others, senator isakson was another of those. Senator burr is chairing the hearing and i thank him for that. I would also like to welcome senator smith from minnesota, who is joining our committee, replacing senator franken, who was a valuable member of the committee. Senator jones from alabama is also a new member of the committee. We welcome him. He replaced senator whitehead, who was a very valuable member of the committee i mean whitehouse, who has taken a lesser assignment on the finance committee, for some reason, but we will miss sheldon and his work on this committee. Im going to, mr. Chairman, withhold my comments although what i would like to do is call on senator isakson for one minute just to make some comments, and then well go to senator casey. Thank you, mr. Chairman. I just wanted to reference the statements made by the Ranking Member, senator murray, whom i have talked to about dr. Fitzgerald. I talked with dr. Fitzgerald yesterday. As chairman of the ethics committee, i have gotten her in touch with the appropriate people to deal with the issue. She is forthrightly dealing with it to the best i can determine. Im working expeditiously to see if we can get it done as quickly as possible so she will not have any conflict to testify whatsoever. Thats her desire as well. Thank you. Senator casey . Thank you very much, senator burr, im grateful for this hearing. Grateful to be working with you again on this reauthorization and commend your work on this. For many, many years. I i also want to thank chairman alexander and Ranking Member murray for this bipartisan hearing on the nations preparedness and response capabilities in advance of the reauthorization of the pandemic all hazards and response act known as p. A. P. A. I will give you one instructive story on how important preparation is. This is a good example of preparedness infrastructure that the act supports. In this case, in the aftermath of a tragedy, a Train Derailment that occurred in philadelphia in may of 2015. The train was carrying 238 passengers when it derailed, eight people, eight people lost their lives. Over 200 were injured in that derailment. Fortunately through funding from the Hospital Preparedness Program which we know by hpp, the Pennsylvania Department of health and Regional Health care and a Regional HealthCare Coalition had long been working together to prepare local Health Care Systems for emergencies that could cause a surge in patients. When the train derailed, hpp funded systems were tracking bed availability in local hospitals and providing that information in realtime to Emergency Responders, who were at the scene helping them to effectively triage patients, send them to hospitals that had the capacity to accept additional patients so they could begin to receive the care they needed. Because these systems were in place, before the train derailed, they were ready to protect both health and to save lives when seconds, literally seconds counted. Yet security, Health Security threats are increasing at frequently and intensity due to a combination of factors including newly emerging Infectious Diseases, extreme weather events and our aging infrastructure. So now more than ever, we must continue to build our nations resiliency by investing in Countermeasure Development, surveillance and supporting state and local partners to reduce the impact of Health Events in the country. I would like to thank todays witnesses for their service. Its important to mention your service to the country. As well as your commitment to protecting americas Public Health. We look forward to the hearing and grateful for the work that we can do today at this hearing. Thank you, mr. Chairman. Senator casey, thank you. Thank you for your continued help and work on this issue. Let me just remind members that this is the start of the reauthorization of the bill. Now, having been in congress for 24 years, i realize that when you get involved in hhs legislation and fda legislation, there is always a temptation to fix other things. I want to encourage you to fight the urge. Lets keep this focused on perfecting p. A. P. A. Its been successful. We still have work to do but if we become distracted and create a fight over changes within fda that have nothing related to this, or hhs or somewhere else, because the sheer geograph