What is the National Health Security Strategy (NHSS)? 

The National Health Security Strategy will provide a common vision for how we as a nation achieve health security. The Strategy will bring the patchwork of public health and medical emergency preparedness and response plans under a single strategy in order to strengthen the community role in preparedness, integrate response systems, create a framework for accountability and continuous improvement, and improve coordination at all levels. The NHSS is a quadrennial strategy that will include a plan for how we implement the approaches laid out in the Strategy and evaluate progress toward preparedness. The first Strategy is due to Congress in December 2009.  

What is health security?

Draft definition:

“National health security exists when the nation and its people are prepared for, protected from, and resilient in the face of health threats or events with potentially catastrophic consequences.”

Key points

• The NHSS is a national strategy, not simply a federal strategy. The focus is on the outcome, defining what health security is and how we as a nation can achieve it. The Strategy includes roles and responsibilities for stakeholders – federal, state, tribal, and local governments; community organizations and institutions; the private sector; and individuals.
• The NHSS is a high-level Strategy that will communicate a vision for achieving health security and articulate a set of goals and objectives. The accompanying implementation plan will focus on the various mechanisms that can be used to achieve the goals and objectives contained in the strategy.
• The success of the NHSS will be demonstrated by measurable improvement in community resilience and preparedness.

Frequently asked questions

Q: Will the NHSS determine resource investments and funding?

A:  The NHSS is not a funding-driven or detailed guidance document. The goals of the National Health Security Strategy will inform resource investment and funding decisions.  The Strategy will identify prior resource investments and gaps in preparedness. This will inform the broad tactical efforts that will be utilized to close any such gap and reach the strategic goal.

Q: What is the scope of the NHSS?

A: The NHSS is a strategy for achieving the preparedness goals and outcomes that support the health security of the Nation. It encompasses public health and medical emergency preparedness and response activities.  This includes actions to be taken by individuals, communities, academia, private and non-governmental organizations and all levels of government to achieve those outcomes.

There are some variables that impact health security that are outside the scope and authority of traditional public health and medical emergency preparedness and response -- for example, obesity, chronic disease and universal access to health care. The NHSS will acknowledge the impact and importance of these factors on health security but will not include strategies or implementation plan activities for achieving them.  

Q: Will the NHSS rewrite performance measures for existing programs?

A: No, the NHSS will not rewrite existing programs’ performance measures.  The first step in creating the Strategy’s performance measurement system is to conduct an analysis of preparedness measures currently in use, noting those that could be used to measure the Strategy’s outcomes.  Strategic activities that have significant gaps in performance measures or other evaluation tools will be identified. An element of the Strategy’s implementation plan will include deliberate developmental work to be performed in cooperation with partners and stakeholders to create a relevant performance measurement system. Progress toward achieving the goals and preparedness outcomes identified in the Strategy must be measured.  Those results will enable decision-makers among all levels and sectors to make informed decisions regarding asset and activity prioritization and resource allocation.

Q: How does this fit with the National Preparedness Guidelines, National Response Framework, National Strategy for Homeland Security, etc.?

A: The National Health Security Strategy will not replace but will be congruent with existing national strategy and guidance.  The National Health Security Strategy will nest into national strategies related to security in that it addresses protecting our nation from health-related impacts critical to national security.   

The National Health Security Strategy provides outcomes for what the health system must “do” in terms of preparedness activities but also for the activities that support or improve the effectiveness of the actions.  Examples include: public health systems research, interoperable surveillance systems (both traditional systems used during a response but also those that contain relevant non-emergency response data), development of countermeasures, adequate financial and asset management systems, innovative technology and other solutions to improve both health outcomes in austere environments and situational awareness.   

Q: Why are you doing this?

A: The NHSS provides the nation with an opportunity to develop a vision for health security by bringing together the variety of strategies and efforts and assessing where we are in achieving health security.  Congress saw the critical need for there to be a strategy guiding practitioners, researchers, citizens, and academicians toward common objectives to achieve national health security. The NHSS is consistent with Congress’ vision and the requirements of PAHPA.

Q: How are stakeholders involved in the Strategy’s development?

A: There are numerous avenues for stakeholder involvement, including the following:

• Five regional stakeholder meetings were held in the spring of 2009.
• Drafts of the Strategy will be posted online for public comment.
• The Strategy is being made available within the federal government through the formal executive interagency process.
• HHS is conducting outreach to stakeholder organizations and associations to get the word out and solicit input.

Comments and suggestions can be emailed to NHSS@hhs.gov

Q: How do you expect us to achieve the items that will ultimately be in the NHSS?

A: Since the stakeholders will be providing input into the strategy, much of the content will be derived from material that stakeholders have seen before, helped create and have been working towards for years. 

The Strategy is meant to highlight roles, gaps, and needs for stakeholders at all levels with goals that are achievable and realistic.