Have learned during the crisis to better prepare for pandemic or other biological events of this scale in the future. Folks of todays hearing is the Strategic National stockpile. First established with a 51,000 appropriation in 1958, the sns was codified in 2002 and obtained its current name with an expanded mission in 2003. Over the years, management responsibility for the sns has changed between different agencies within hhs and dhs. In developing a plan for this committees oversight for the federal governments response to the coronavirus, the role of the Strategic National stockpile was an obvious area of interest, as is the vulnerability of our supply chain and theyre very interrelated. I assume that staff would be able to quickly obtain the list of items that should be held together with required and actual inventory levels of each item. Once again, i learned it is dangerous to assume. We quickly found out that those lists do not exist or certainly are not made available to congress or the public. As we will hear in testimony, its not from a lack of dedicated individuals working within the agencies or the Strategic National stockpile. Instead, it seems to be a more pervasive problem of a lack of clarity and understanding of exactly what the snss role is and what it should be. As indicated above, to the extent theres been a congressional or executive branch articulated Mission Statement, it has evolved over time and outside the managing Department Agency has not been generally understood. Were paying the price for this lack of articulation and clarity during the current pandemic. The frustration expressed by state, local, tribal, and territorial governments and their elected representatives is largely caused by the reality, the demand for so many of the needed products and supplies has dramatically exceeded supply. The form of available inventory and production capacity. As a manufacturer in the private sector, whenever i was faced with a problem, i always asked what opportunity presented itself in finding a solution. The same dynamic can apply here. As the men and women who are working tirelessly to address the current demand develop models, that information needs to be captured and put immediately to use, updating and redesigning the structure and management of the Strategic National stockpile. I would like to thank our Witnesses Today for their testimony, their past efforts, any future help they can provide to help our nations response to future pandemics. With that, ill turn it over to senator peters. Thank you, mr. Chairman. Thank you to our witnesses for being here today. Over the past several months, the United States has faced an almost unprecedented challenge, fighting a deadly virus that has infected millions and has taken the lives of more than 120,000 americans. A pandemic can overwhelm even the most prepared communities. And that is why we have the Strategic National stockpile. The nations Largest Store of lifesaving pharmaceuticals and medical supplies. To insure the federal government has the resources to help states protect the health and the safety of americans during a Public Health emergency. The scale of the coronavirus pandemic depleted our National Stockpile in just a matter of weeks. Leaving state and local governments scrambling to acquire the masks, the gloves, and other supplies that were so desperately needed in order to keep people safe. Many communities facing the highest rates of infection struggle to obtain the supplies they needed, including my home state of michigan. Instead of providing a coordinated National Approach to effectively using the Strategic National stockpile and other tools to acquire and distribute supplies nationwide, the president told states that they were on their own. That move forced states to compete against each other and the federal government for life saving medical supplies that were already in shortage all across the world. Since the crisis began, congress has passed several supplemental emergency Appropriations Bills to rebuild the stockpile. And while this funding will help provide some stability, theres no question that our nation would have been better positioned to tackle the pandemic if congress and both the current and prior administrations had invested more in the stockpile before this crisis struck. It is abundantly clear that the federal government was not fully prepared to address a crisis on the scale of the coronavirus pandemic. And the result is the tragic loss of 120,000 of our fellow americans and millions of families who have suffered the consequences. Insuring the preparedness of the Strategic National stockpile is an issue of National Security and should be treated as such. We cannot allow a disaster of this magnitude to catch our government off guard again. We must provide steady funding to all our Pandemic Response efforts and insure that the Strategic National stockpile is well maintained and prepared to address a broad range of possible threats. We must improve the communication between states and the federal Government Regarding available resources and strengthen the federal governments role in managing supplies during this and future crises. Finally, we must also take steps to address our overreliance on foreign manufacturers of critical drugs and medical supplies. This is a serious National Security vulnerability, and the pandemic has only further heightened highlighted just how significant this risk is to the health and safety of the american people. So todays discussion will help us identify and prioritize critical decisions and investments to insure we can continue to combat coronavirus as well as emergencies in the future. I look forward to hearing from all of our witnesses and look forward to working alongside each and every one of you to deal with this very daunting challenge. Thank you, mr. Chairman. Thank you, senator peters. It is the tradition of this committee to swear in witnesses. You dont need to stand, but if you raise your right hand. Do you solemnly swear the testimony you will give before this committee will be the truth, the whole truth, and nothing but the truth, so help you god . Thank you. Our first witness is dr. Julie gerbiding, the former director of the centers for Disease Control and prevention and former administrator of the agency for toxic substances and disease registry. The doctor is now the executive Vice President for Strategic Communications, Global Public policy, and Population Health and the chief patient officer at merck. She also cochairs the center for Strategic International studies commission on strengthening Americas Health security. Doctor. Distinguished members of the committee, im really honored to have a chance to talk with you today about the strateging National Stockpile because i know what an incredibly important asset it is and how disappointed some people have been in certain aspects of its deployment and performance this year. Im going to testify in front of you from four perspectives. First and foremost is my background as an Infectious Disease doctor who is a hospital epidemiologi epidemiologist, responsible for Occupational Safety of Health Workers in the early aids era and an expert in personal protective equipment and how to really keep Health Workers safe. As you mentioned, i also cochair with former senator kelly ayotte, and thank you for accepting that into the record. I also am the chief patient officer in evp at merck where we engaged from a manufacturer perspective with various interactions with the u. S. Government in our efforts to bring an ebola vaccine through the licenser process in the drc and west africa, and also other products that are germane to our Overall Health security. And finally, i will say that i was the cdc director during not the very beginning of the stockpile, but in its infancy, and i watched it evolve over time. I visited several of the sites where the stockpile is hidden in plain sight and participated in observing some of the exercises of deployment and so forth, so i have a pretty deep knowledge of whats in there and how it has evolved over time and what we may need to be doing going forward. I do believe this is a Strategic National asset. Were somewhat unique in the world in having such an asset at our disposal, and obviously, its an enormous investment and one we need to make the best of. Its incredibly innovative, and i would say overall, through its entire history, its been reasonably well managed, from a budgetary and fiscal responsibility perspective, and it has been innovative in its approaches to preparing for many challenges. But in spite of that overarching point of view, i recognize that there are important areas where the stockpile needs clarification and improvement. And ill just mention a few. I think the most important thing is the clarification and consistency of the strategic intent of the stockpile. It has gone from being something that was oriented toward bioterrorism, then to all hazards, cbrn preparation, then influenza pandemic. There have been debates and inconsistencies in whether or not it was conceived of something that would be deployed locally, not preparing for a National Crisis of a panamerican scale, if you will, to where we are now today, where we needed it to be able to meet the needs of our Health System across the entire country. Its also not clear whether its an asset that should operate as a standalone entity and be prepared to provide for all the needs or whether or not its there to augment what states and Health Care Settings are already doing and have hardened into their own planning. So that inconsistency has led to somewhat of a pingpong approach to what should be in it and how to make decisions about procurement. I think theres another opportunity for improvement in terms of the Accountable Leadership of the stockpile. As you know, it has moved back and forth from the cdc to dhs to cdc to hhs, and fema has been involved in the logistics of the current deployment, so it has not been consistent and Accountable Leadership for really making sure that number one, there is clarity of strategic intent, but number two, that the stockpile consistently delivers in support of that intent and that theres accountability and measurement of the success. I think a third area for improvement is the budget process. Its impossible for congress or anyone else to be able to budget to the stockpile if there isnt clarity about what its supposed to accomplish at what scale. What has happened all too often is that the tail wags the dog. So we may have ideas about what the stockpile should be capable of supporting, but the budget is the thing that determines what actually gets procured. The current budget going into this event was not adequate to provide for the kind of ppe that we needed for a panamerican Infectious Disease pandemic. In part, that is because there was not consistency in exactly what the requirements were for the stockpile and whether it was supplemental to the states or whether it was intended to be able to supply the full force. I think lastly, theres a real opportunity to improve the engagement with the private sector. As you have said, our supply chains are very problematic, and the people who know the most about that and have the most to contribute are people in the private sector who i believe would be only too willing to engage to think through how can we improve resilience, agility, and Surge Capacity in support of this Strategic National defense. The last point i would make is one that has not come up through the csis process, but as the Commission Moves forward, we would be very willing to take it on. That is that the stockpile is not a warehouse full of stuff. The stockpile is a capability, and it needs to be thought of not just in terms of what do we buy but how do we learn how to deploy and utilize those resources that the state, local, territorial, and tribal level, in collaboration with the Health System and the Public Health end users. That means a strong exercise curriculum, continued deployment, and utilization capability enhancement, and a cycle of planning and improvement that is inclusive of the frontline personnel. Ill stop there, and again, thank you for the opportunity to testify. Looking forward to the comments of my esteemed colleagues. Thank you. Thank you, doctor. Our next witness is dr. Daniel gersteen. Hes a policy researcher at the rand corporation. Prior to his work with rand, he served as the acting undersecretary and deputy undersecretary of the department of Homeland Securitys science and technology directorate. Before his time with dhs, he served in the u. S. Army both in active duty and as a principle director for countering weapons of mass destruction in the office of the secretary of defense. Doctor. Good morning, chairman johnson, Ranking Member peters, and distinguished members of the committee. I thank you for the opportunity to appear today, and discuss the future of the pandemic preparedness response and the Strategic National stockpile. While i will focus a majority of my remarks on looking forward, i do want to briefly assess the u. S. Response to date. In short, covid19 has exposed serious weaknesses in our National Preparedness and response systems. The United States relies on a just in time medical Delivery System that lacks resilience in times of crisis. We are also witnessing an inability to scale at the National Level to meet the demands of a Public Health emergency. Overall, the federal response has been slow and inconsistent, confusing at times, and has deservedly become a target of criticism. We have seen shortfalls in areas from the basic science to our Emergency Management government and doctrine, Strategic Communications with the american people. One particular concern is the Strategic National stockpile. Several key sns issues have been evident, including Unrealistic Expectations for the sns, historical underfunding of the stockpile, lack of timely decisions regarding energizing supply chains, and the federal governments altering of the mission of the sns during this National Emergency. Looking to the future, a Bipartisan Commission should be established to review the nations performance during this pandemic, basic assumptions regarding Emergency Management and Disaster Preparedness and response, including the role of government at all levels, should be on the table. One outcome should be an agreement that Public Health must be elevated to and receive prioritization and funding as a National Security issue. Just as the department of defense and intelligence community. Specifically, i offer five recommendations for improving our nations preparedness and response capabilities. First, reexamine the sns concept. Congress should ask for a complete accounting of the sns performance during this pandemic. The mission of sns should also be reconsidered. A new Mission Statement codified in law and not subject to the whims of any administration should be developed to signal the capacities and limits of the stockpile. The federal government owes this to the state and local authorities. It agreed stockpile concept must be stress tested and optimized through training and exercises to insure it meets the preparedness and response goals that have been set. Second, develop a National Strategic supply chain approach. Rather than consider the sns as a discreet element, it needs to be thought of as part of a broader National Supply chain that combines stockpiling and direct contracting with manufacturers, more production lines for some key commodities, procuring of large quantities at the National Level to take advantage of economies of scale, and shortening supply chains. The goal should be to determine the most effective and efficient methods for insuring critical needs will be met for envisioned areas. This would includ