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°®¶¹´«Ã½ (ASM), on behalf of its 30,000 members in the °®¶¹´«Ã½ States and around the world, thanks Chairman Sanders, Ranking Member Cassidy, Senator Casey, Senator Romney and members of the Senate Health, Education, Labor and Pensions (HELP) Committee for moving forward in a bipartisan way to markup S. 2333, the Pandemic and All-Hazards Preparedness and Response Act (PAHPARA). The °®¶¹´«Ã½ States must be prepared to rapidly respond to declared and potential public health emergencies, including infectious disease pandemics such as COVID-19. We have learned a great deal over the past 3 years, and the reauthorization of this legislation is an important opportunity to improve our nation’s ability to respond in a timely and coordinated manner to public health threats. 

We appreciated the opportunity to respond to the original draft legislation, and we offer additional points on PAHPARA in advance of the markup. 

• Support for Innovative Surveillance Tools. ASM reiterates its support for authorizing the Centers for Disease Control and Prevention (CDC) to award grants or cooperative agreements to establish, maintain or improve activities related to the detection and monitoring of infectious diseases through wastewater for public health emergency preparedness and response purposes. (Sec. 106) We also support the bill’s inclusion of research on the use of wastewater surveillance to detect and monitor emerging infectious diseases. Our experience with COVID-19 demonstrates the need to respond quickly and effectively. This means early disease detection and surveillance through the use of cutting-edge genomics technology deployed through the Centers for Disease Control and Prevention (CDC). We encourage an authorization level to be included with this language to ensure the program has the resources it needs to continue this important work. 
• Support for Addressing Antimicrobial Resistance (AMR). ASM strongly supports the inclusion of Sec. 205, which offers continued support for the CARB Task Force and the President’s Advisory Council on Combatting Antibiotic Resistant Bacteria (PACCARB). This language closely tracks recommendations in ASM’s new paper, “Policy Pathways to Combatting the Global Crisis of Antimicrobial Resistance” and language included in the Strategies to Address Antimicrobial Resistance (STAAR) Act of 2021. 

We are disappointed, however, that the PASTEUR Act is not included in the bill, and we encourage consideration of some of its provisions in addition to Sec. 205. The PASTEUR Act would strengthen our nation’s infrastructure to address AMR and provide much needed resources to antimicrobial stewardship programs in health care facilities. Further, the PASTEUR Act’s subscription model is an innovative way to pay for novel antimicrobials that will revitalize the pipeline and support appropriate use. 

• Supporting Research and Laboratory Surge Capacity. ASM maintains our strong support for this language to strengthen the role and authorize funding for the regional biocontainment laboratory network. However, we believe it is important that the bill also recognize the role of our national biocontainment laboratories and authorize robust and sustained funding for these entities, which are also critically important to our response infrastructure and have not been funded at a sustainable level in recent years. The NBLs work in tandem with the RBLs and both are equally important to our research response capacity.
• NSABB Review of Federal Select Agent Program. ASM maintains its support for efforts to harmonize select agent, dual use and enhanced potential pandemic pathogen research policies under a common framework and supports charging the National Science Advisory Board for Biosecurity with making additional recommendations within a specific time period. However, we still encourage you to modify the following language (in bold) to be more inclusive of stakeholders who should be consulted for input: 

(A) be developed in consultation with stakeholders and experts representing institutions of higher education, academic medical centers, scientific societies, industry and other government agencies; 

We are concerned that without this additional language, as currently written the bill may exclude key experts working in other settings who have valuable perspectives to share. 

• We Recommend Reconsidering Expanding Language in Sec. 406. ASM recognizes that safeguarding national security and public health through biosafety and biosecurity measures is of paramount importance. This can be accomplished while also recognizing the global impact of potential pandemic pathogens, the international nature of science, the value and lifesaving potential of research in this area and the need to study these microbes to address current and future threats. Doing otherwise could have serious, negative consequences for potentially lifesaving research and would harm the very ecosystem that developed the novel tests, vaccines and medical countermeasures that brought us through the pandemic. We encourage the committee to reconsider the 5-year moratorium, which is an unnecessary expansion of language that already passed as part of the PREVENT Pandemics Act. However, we do appreciate the inclusion of language that would allow this moratorium to be lifted in the event of another emergency. These international collaborations are essential, not only during times of emergency, but also as part of our ongoing efforts to prevent such situations. They are a key component of protecting the health of Americans and our national security. 

ASM and its members look forward to working with the Committee as it works in a bipartisan manner to reauthorize PAHPA. We stand ready to assist you in this effort.