Public Health Preparedness: Experts Identified Actions to Improve Surveillance for Emerging Disease Threats
Fast Facts
Emerging infectious diseases can pose a serious threat to national health and security.
Experts we convened suggested several ways the federal government could better detect and monitor such threats. For example, they suggested unifying animal and public health efforts because emerging diseases often affect both. They also discussed improving leadership among many partners, and more.
These ideas could help the Department of Health and Human Services improve its leadership and coordination of public health emergencies—which has been on our High Risk List since 2022.
Scientists working in a lab wearing face masks, goggles and head coverings.
Highlights
What GAO Found
Emerging infectious diseases are infections that are new (e.g., COVID-19) or have existed but are reappearing in an area (e.g., measles), according to the Department of Health and Human Services (HHS). As the federal lead for public health, HHS partners with thousands of entities at all levels of government to conduct surveillance for emerging infectious diseases; doing so through continuous data collection, analysis, and sharing of health data needed to plan for and respond to such threats.
Experts on a roundtable GAO convened suggested a range of actions that the federal government could take to improve U.S. emerging infectious disease surveillance. GAO categorized experts’ suggestions across four areas related to collaboration, data, methods, and communication (see table).
Four Areas with Examples of Federal Actions Experts Suggested to Improve Emerging Infectious Disease Surveillance
|
Collaboration |
Data Quality and Infrastructure |
Surveillance Methods |
Communication |
|---|---|---|---|
|
Increase coordination by creating a multisectoral, multidisciplinary leadership group |
Strengthen data quality by identifying, developing, and using standards for surveillance data |
Optimize surveillance by evaluating cost-effectiveness of surveillance systems and methods |
Improve awareness and perception of public health and surveillance by developing a communication strategy |
Source: GAO analysis of statements made by a roundtable of 18 experts. | GAO-26-107610
A key theme in experts’ suggested actions for improvement was to unify efforts between animal and human health sectors, in recognition that emerging diseases often affect both. For example, experts suggested that a multisectoral, multidisciplinary leadership group should be created to direct surveillance planning and activities across federal agencies, including those responsible for both human and animal health. Such a group could address a lack of centralized authority to direct cross-agency surveillance activities leading to inconsistent collaboration that hinders the effectiveness of U.S. surveillance for emerging infectious diseases.
Officials from HHS and other federal departments, such as the U.S. Department of Agriculture (USDA), which has responsibility for animal health, highlighted existing efforts that they thought were related to expert-suggested actions. For example, HHS officials cited the U.S. One Health Coordination Unit as an existing effort related to the expert-suggested action to create a multisectoral, multidisciplinary leadership group to improve federal collaboration.
The actions suggested by experts offer HHS and stakeholders a chance to assess tradeoffs and feasibility in expanding current efforts or exploring new approaches for infectious disease surveillance, while considering past recommendations by GAO and others. These actions also provide HHS an opportunity to determine if any of the suggestions assist the department in its leadership and coordination of public health emergencies, an area GAO placed on its High-Risk List in January 2022.
Why GAO Did This Study
Emerging infectious disease outbreaks have increased in incidence and impact, posing an ever-present threat to national health, security, and economic interests. Some emerging infectious diseases can become highly transmissible and capable of wide, uncontrollable spread in human populations potentially leading to pandemics.
With factors such as increased global interconnectedness, animal-to-human disease transmissibility risk, and disease virulence contributing to this threat, there is heightened concern that an emerging infectious disease may develop into a widespread outbreak with significant consequences.
The CARES Act includes a provision for GAO to monitor and report on the federal pandemic response. This report describes (1) how HHS has conducted surveillance of emerging infectious disease threats and (2) actions experts suggested for the federal government to improve surveillance of emerging infectious diseases.
GAO convened a roundtable of 18 experts in April and May 2025 to discuss actions to improve public health surveillance for emerging infectious disease threats. GAO contracted with the National Academies of Sciences, Engineering, and Medicine to help identify experts representing a range of perspectives including former federal officials and animal and human health professions. Their comments reflected solely their views. GAO also reviewed documents and interviewed officials from HHS, USDA, and public health associations, among others.
For more information, contact Mary Deningan-Macauley at deninganmacauleym@gao.gov.