Which federal government entity is responsible for the U.S. public health?

The coronavirus pandemic has required the mobilization of tens of thousands of people and coordination among dozens of federal agencies in the United States to deal with the health crisis and work with other countries.

Here’s a rundown of how various federal agencies and organizations contribute to the U.S. government’s response:

Coordinating and Communicating the Federal Response

Launched in late January and currently headed by Vice President Mike Pence, the White House Coronavirus Task Force leads the Donald J. Trump administration’s response. Composed of the country’s top health officials, it issues guidelines for dealing with the virus, including on social-distancing practices, and holds regular briefings. State governments have taken their own aggressive actions, such as declaring public health emergencies, announcing mandatory stay-at-home orders, and restricting travel.

This CFR Backgrounder examines how countries, including the United States, are responding to the economic crisis caused by the pandemic. 

President Trump and Vice President Pence join members of the task force for a meeting at the FEMA headquarters. Evan Vucci/Pool/Reuters

Providing Vital Supplies

The Department of Health and Human Services (HHS), led by Secretary Alex Azar, manages the Strategic National Stockpile, a repository of drugs, medical supplies, and personal protective equipment (PPE) meant to help in a public health crisis. Officials have said the stockpile was nearly depleted by early April, and many states are expected to face shortages as their outbreaks worsen.

The Federal Emergency Management Agency (FEMA), which is part of the Department of Homeland Security, became the primary coordinator of the federal response on the ground on behalf of the HHS after Trump declared a national emergency in March. Known for its actions during natural disasters, FEMA can provide resources to states, including health supplies and personnel. FEMA is also assisting the HHS in determining what states need and working with the White House to charter flights to the United States carrying critical supplies from around the world.

The Trump administration has started using the Defense Production Act, a law that gives the government more control over industrial production during emergencies, to compel companies to produce ventilators and other medical equipment.

Writing for Think Global Health, CFR’s Jennifer A. Hillman says, “G7 and G20 leaders should agree to temporarily suspend all tariffs on needed pharmaceuticals, medical devices and supplies, along with disinfectants and soap. These global leaders should encourage all other countries to follow suit.”

Leading the Medical Response

The HHS oversees the federal public health response. Part of the department, the Centers for Disease Control and Prevention (CDC) has been the main first responder, tracking cases, deploying personnel nationwide, and providing guidance to state and local health departments. It has shared best practices with the public, creating a new coronavirus website with the White House.

Testing

The CDC developed a test to diagnose COVID-19, though because the initial test was faulty, its use throughout the country was delayed for weeks. More than one million tests were given by early April, according to Politico and the COVID-19 Tracking Project. Critics have said that testing is still not widespread enough, as not everyone who wants a test can get one. Several drive-through testing sites have been opened throughout the country.

Comparing the U.S. and South Korean responses, CFR’s Scott A. Snyder writes that “limitations on test availability have hampered U.S. efforts to combat the disease and resulted in less targeted and increasingly draconian public appeals from state officials to restrict social movement.”

Finding a Vaccine

As the nation’s medical research agency, the National Institutes of Health (NIH) is working on the development of a coronavirus vaccine, including by holding clinical trials, testing antivirals, and conducting lab research on the virus. The National Institute of Allergy and Infectious Diseases, one of the NIH’s institutes, has taken the lead on the coronavirus, with its director, Dr. Anthony Fauci serving on the White House’s task force. 

The Food and Drug Administration (FDA) must approve any new coronavirus test kits, drugs, or vaccines. It also monitors potential shortages of other drugs due to supply chain disruptions caused by the coronavirus pandemic.

In Foreign Affairs, CFR’s Yanzhong Huang writes that the United States and China have “robust capacities to manufacture vaccines: they could have mobilized these capabilities in a cooperative effort to develop and produce a vaccine.” 

Boosting Health-Care Personnel and Infrastructure

The Department of Defense has offered military resources. Navy hospital ships are in New York City and Los Angeles to boost hospital capacity. Members of the National Guard in states throughout the country have supported health-care workers by distributing medical supplies and building shelters for coronavirus patients. Army Corps of Engineers teams have converted buildings into makeshift hospitals and care facilities.

Some of the Public Health Service Commissioned Corps’ six thousand officers have been deployed to support coronavirus efforts in Japan and Washington state. The uniformed service is overseen by the surgeon general, who reports to the HHS secretary.

The U.S. Navy hospital ship USNS Comfort arrives in New York City on March 30. Brendan McDermid/Reuters

Enforcing Travel Restrictions

The Department of Homeland Security has conducted health screenings at airports and enforced travel restrictions—including those on China, EU countries, and Iran—and restricted some travel at the U.S. borders with Canada and Mexico. Customs and Border Protection officers are responsible for monitoring coronavirus symptoms at ports of entry and have set up outdoor processing points for migrants who cross the border with Mexico illegally.

Coordinating With Allies

The State Department has worked with other governments to organize a global response to the coronavirus. In coordination with the U.S. Agency for International Development (USAID), it has delivered medical supplies and assistance to affected and at-risk countries. As the pandemic worsened in the United States, however, the White House task force essentially froze USAID assistance after U.S. health workers faced PPE shortages. 

“It is now time for wealthy donor nations including the United States…to step up their global game,” writes CFR’s Stewart M. Patrick. “Though [the Trump administration’s] performance to date has failed to match previous U.S. crisis stewardship, there is still time for it to lead an effective response to this multi-pronged threat.”

A traveler arrives at the nearly deserted Chicago O’Hare International Airport, which typically serves 8.2 million passengers a month, amid the pandemic. Scott Olson/Getty Images

Helping Americans Abroad

The State Department evacuated Americans in China earlier this year and has worked to repatriate Americans in more than fifty countries. It has advised Americans to avoid all travel abroad. The Peace Corps, a separate agency, evacuated more than seven thousand volunteers from over sixty countries.

The Department of Defense has focused on protecting American service members abroad. Secretary of Defense Mark Esper ordered most U.S. military travel to cease for sixty days, and commanders have been working to prevent the virus’s spread on bases and ships worldwide. However, not all efforts have been successful. The Navy fired the captain of an aircraft carrier  who raised alarm about the military’s coronavirus response after more than one hundred sailors on his ship tested positive.

Creative Commons

Creative Commons: Some rights reserved.

Close

This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.

Close

Explore More on COVID-19

Top Stories on CFR