Why It Matters
Emerging infectious disease outbreaks have increased in incidence and impact, and federal surveillance systems have gaps that experts say need to be addressed. A Government Accountability Office (GAO) report published July 30 presents findings from a roundtable of 18 experts convened in April and May 2025 to identify how the federal government can strengthen its surveillance capabilities
The Big Picture
The Department of Health and Human Services (HHS) is the federal lead for public health surveillance and partners with thousands of entities at all levels of government. Still, no centralized authority directs cross-agency surveillance activities. That gap results in inconsistent collaboration among the agencies responsible for detecting and responding to emerging disease threats
Experts identified four areas requiring federal action: collaboration, data quality and infrastructure, surveillance methods, and communication. A recurring theme was the need to unify animal and human health efforts, since emerging diseases frequently affect both sectors. Experts specifically recommended creating a multisectoral, multidisciplinary leadership group to direct surveillance planning across federal agencies, including those responsible for both human and animal health
HHS officials cited the U.S. One Health Coordination Unit as an existing effort related to that recommendation. The U.S. Department of Agriculture (USDA), which holds responsibility for animal health, was among the federal departments whose officials were interviewed for the report
Expert Recommendations
Data standards were a separate problem. Experts recommended identifying, developing, and using standards for surveillance data so that information collected by different agencies and jurisdictions can be integrated and compared. On methods, experts recommended evaluating the cost-effectiveness of surveillance systems. On communication, they recommended developing a strategy to improve public awareness and perception of disease surveillance
HHS leadership and coordination of public health emergencies has been on GAO’s High-Risk List since January 2022. The expert suggestions offer HHS an opportunity to assess whether current efforts address that standing vulnerability
The Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a provision for GAO to monitor and report on the federal pandemic response. This report fulfills part of that mandate, examining both how HHS currently conducts surveillance for emerging infectious disease threats and what experts recommend to improve it
The Bottom Line
GAO contracted with the National Academies of Sciences, Engineering, and Medicine to identify the 18 roundtable experts, who represented a range of perspectives including former federal officials and professionals in animal and human health. Their comments reflected solely their own views. GAO also reviewed documents and interviewed officials from HHS, USDA, and public health associations, among others
Emerging infectious diseases are defined by HHS as new infections, such as COVID-19, or that have existed but are reappearing in an area, such as measles. Factors driving concern include increased global interconnectedness, animal-to-human disease transmissibility risk, and disease virulence. Some emerging infectious diseases can become highly transmissible and capable of wide, uncontrollable spread in human populations, potentially leading to pandemics
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