Health Heroes Act Addresses Critical COVID-19 Needs, Should be Strengthened

H.R.6800, the Health Heroes Act, includes policies and investments that would bolster the federal response to COVID-19, increase testing capacity and availability of medical supplies and address the disparate impact of COVID-19 on vulnerable populations. The House of Representatives is weighing provisions in the bill, and is expected to negotiate with the Senate in the coming weeks.

While the bill also addresses critical issues that include health care and public health workforces, antibiotics for secondary infections, and preparation for a COVID-19 vaccine, it does not include the additional resources that will be needed to sufficiently strengthen the federal response in these areas. In addition, while a global response remains paramount to controlling this pandemic, the bill does not include adequate resources for the immediate or long-term steps that will be critical to international efforts.

The Infectious Diseases Society of America and its HIV Medicine Association welcome provisions in H.R.6800 that include support for:

Public health infrastructure and testing capacity

With $75 billion in grants to state, local, tribal, and territorial health departments to support testing, contact tracing, and isolation or quarantine;
By requiring the Centers for Disease Control and Prevention to coordinate with states and public health jurisdictions to establish a coordinated, evidence-based testing system, creating a national reporting of testing capacity, and mandating transparency in state testing plans and availability.

Medical Supplies

Expanding federal leadership of medical supply capacity by requiring appointment of a medical supplies coordinator to be point of contact for the health care system, supply chain officials, and states on medical supplies, including personal protective equipment and medical devices.

Supporting infectious diseases and HIV workforces

With $100 billion for the provider relief fund with clear guidance to distribute equitably and efficiently with quarterly provider reimbursements for all COVID-19-related expenses and a portion of their lost revenues;
By establishing the Public Health Workforce Loan Repayment Program to enhance state, local, tribal, and territorial public health department workforce recruitment and retention;
By providing repayment of private student loans up to $10,000;
By permanently reauthorizing the State Conrad J-1 Visa Program while increasing the number of waivers per state from 30 to 35. In addition, the bill allows J-1 physicians to be redeployed, as needed, to COVID-19 response related work.

Vaccines and Therapeutics

With $3.5 billion for Biomedical Advanced Research and Development Authority to support the research and development of COVID-19 treatment and vaccines;

With $500 million in new funding for BARDA to support antibacterial drug research and development;
By investing in vaccine manufacturing capacity and requiring the Department of Health and Human Services to create a plan for vaccine distribution and administration to stop the spread of COVID-19 once such vaccines are developed and authorized;
By providing new funding to improve disease surveillance, including immunization tracking.

Health Care Access

With an enhanced federal matching rate for state Medicaid programs;
With $7.6 billion in emergency funding for community health centers;
With $10 million for the Ryan HIV/AIDS White Program -- although this still falls short of program needs;
With enhanced coverage for COVID-19 treatment and prevention for Medicaid and Medicare patients.

Drug Shortages

By directing the U.S. Food and Drug Administration to designate National Centers of Excellence in Continuous Pharmaceutical Manufacturing, which will work with the FDA and industry to develop a national framework for continuous manufacturing of drugs;
By requiring the National Academies of Science, Engineering, and Medicine to convene experts to recommend incentives toward domestic manufacturing of critical drugs and devices of greatest priority to health care;
With $500 million to BARDA to support U.S.-based next-generation manufacturing facilities.

Research

With $4.745 billion to expand COVID-19-related research on the National Institutes of Health campus and at academic institutions across the country, and to support the shutdown and startup costs of biomedical research laboratories nationwide.

Health Disparities

With new resources specifically to address disproportionate COVID-19 impact on communities of color and to strengthen the response with other vulnerable populations, including people involved with the corrections system and people in nursing homes.

As congressional negotiations on the next COVID-19 bill continue, IDSA and HIVMA call upon Congress to address priorities highlighted by frontline health care providers, including infectious diseases and HIV physicians, specifically with these recommendations:

Secure and support the healthcare workforce necessary for the pandemic response and vaccine distribution, including through additional, targeted student debt relief and appropriate compensation;
Better leverage the J-1 Visa waiver program by creating more additional slots specifically at academic medical centers and for specialties, including infectious diseases, critical to pandemic responses;
Clarify that new BARDA funding for antibacterial innovation should be directed where it is most urgently needed — to support commercialization of new antibiotics; and provide a more sustainable solution to strengthen the antibiotic pipeline, including reimbursement reform and a subscription model for new antibiotics;
Additional funding for global health security activities at the U.S. Centers for Disease Control and Prevention and at USAID to strengthen global capacities to respond to COVID-19 and prevent, detect and respond to future pandemics;
Emergency funding for global health programs at the Department of State to protect fragile gains in global responses to HIV, tuberculosis and malaria epidemics;
$200 million contribution to the Coalition for Epidemic Preparedness Initiatives to support global efforts to advance COVID-19 vaccine candidates;
$1.5 billion for the World Health Organization for coordinating the global response to the COVID-19 pandemic.

IDSA and HIVMA will continue to assess the impacts of H.R. 6800, amendments, and upcoming legislation and provide ongoing feedback.