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U.S. Department of Health and Human Services

Frequently Asked Questions

National Health Security | About the NHSS | Achieving Health Security | Evaluating Progress | Learn More and Get Involved

National Health Security

What is national health security?
National health security is a state in which the nation and its people are prepared for, protected from, and resilient in the face of incidents with health consequences.

What are the most serious threats and risks to national health security?
The threats and risks that communities face are diverse— they can be intentional or naturally-occurring and can result from both persistent and emerging threats, including severe weather, infectious diseases, hazardous material exposures, and terrorist attacks.  The impact of these incidents can be exacerbated by vulnerabilities that vary from community-to-community, such as a large number of at-risk individuals (i.e., children, senior citizens, pregnant women, and those with disabilities), weak social networks, unprotected critical infrastructure, a lack of training and exercising for health security, lack of available countermeasures for emerging infectious diseases, or an increase in antimicrobial resistance to current countermeasures. 
What are the most pressing challenges to achieving national health security in the short- and long-term?
The greatest challenges to national health security are being prepared and able to address any health-related incident that may arise, whenever and wherever it may occur. Preparing for the known and unknown requires resourcing; national guidance; an enabling environment; broader involvement across society; an ability to measure and improve all aspects of our national health security infrastructure; and sustainability and adaptability into the longer term. It means being ready and able every day to address routine challenges so that we are better ready for extraordinary ones.
How are national and global health security related?
The health of the American people and that of the people around the world are more closely linked than ever before.  Greater movement of people, animals, and goods across international borders increases the risk of exposure to health threats originating outside one’s own country.  In such an interconnected environment, the best way for a country to protect its population is to prevent a health threat from emerging and spreading in the first place.  All nations benefit from attention to their own health security and to global health security.

About the National Health Security Strategy and Implementation Plan

What is the National Health Security Strategy (NHSS)?
In 2006, Congress passed the Pandemic and All-Hazards Preparedness Act, which required that a National Health Security Strategy (NHSS), Implementation Plan (IP), and evaluation of progress be developed every four years. The inaugural NHSS introduced a unified vision and approach to national health security from 2010 to 2014. It contained two goals and ten strategic objectives. The second iteration of the NHSS, known as the NHSS 2015-2018 was delivered to Congress in December 2014.
This second iteration of the NHSS provides strategic direction to ensure that efforts to improve health security nationwide are guided by a common vision, based on sound evidence, and carried out in an efficient, collaborative manner.  It builds on knowledge of the progress made since 2010 as well as awareness of current gaps in national health security and the ever shifting strategic landscape.  The NHSS 2015-2018 describes a vision, goal, principles to guide decision-making for national health security, five strategic objectives, and accompanying priorities.
The NHSS Implementation Plan highlights specific actions, defined as activities, which the nation—including individuals, families, non-government organizations, scientific and academic community, private sector, and government agencies—can take to guide efforts and facilitate collaboration among diverse stakeholders to achieve national health security as envisioned in the NHSS.
Why was an NHSS developed?
One common national vision was needed to achieve national health security; however, prior to the NHSS, one did not exist. Recognizing the significant health component of national security, in 2006 Congress passed the Pandemic and All-Hazards Preparedness Act (Public Law 109-417), which required that a NHSS, implementation plan, and evaluation of progress be developed every four years. In March 2013 Congress passed and the President signed the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA), Public Law No. 113-5. PAHPRA builds on the work HHS has undertaken to advance national health security. The NHSS was among the reauthorized programs to strengthen national preparedness and response for public health emergencies.
What is the goal of the NHSS?
The NHSS has one overarching goal: To strengthen and sustain communities’ abilities to prevent, protect against, mitigate the effects of, respond to, and recover from incidents with negative health consequences.
What are the strategic objectives of the NHSS?
The five strategic objectives that support the two national health security goals are:
  • Build and sustain healthy, resilient communities.
  • Enhance the national capability to produce and effectively use both medical countermeasures and non-pharmaceutical interventions.
  • Ensure comprehensive health situational awareness to support decision-making before incidents and during response and recovery operations.
  • Enhance the integration and effectiveness of the public health, healthcare, and emergency management systems.
  • Strengthen global health security.
How was the NHSS developed?
ASPR led the development of the NHSS in collaboration with federal, state, local, tribal, territorial governments, as well as community partners, the private sector, non-governmental organizations, and academia. Non-federal stakeholders shaped the development of the NHSS through root cause analyses and interviews with subject matter experts, ASPR-hosted public meetings, national conferences, and analysis of Hospital Preparedness Program (HPP) and Public Health Emergency Preparedness (PHEP) cooperative agreement data. Federal stakeholders shaped the development of the NHSS through semi-structured interviews with, HHS partners, and leaders of other quadrennial strategies, updates and lessons learned from other department leaders, and federal prioritization/scoping workgroups and strategic objective workgroups.
What are the similarities and differences between the NHSS 2010-2014 and NHSS 2015-2018?
The NHSS 2010-2014 and NHSS 2015-2018 are similar in many ways. Both documents present a strategic direction to ensure that efforts to improve health security nationwide are guided by a common vision and highlight the critical concepts of prevention, protection, mitigation, response, recovery, and health resilience. However, the NHSS/IP 2015-2018 introduces important new features, including guiding principles, priorities to help focus stakeholders’ implementation efforts, and a streamlined number of objectives from ten to five.  The NHSS/IP 2015-2018 has a more robust inclusion of federal departments and agencies beyond HHS, as well as other national health security stakeholders, including state, local, territorial, and tribal governments, community-based organizations, private sector businesses, the scientific and academic community, and individuals and families.

How does the NHSS benefit the nation?
The NHSS takes a “whole-of-community,” approach and leverages resources at all levels of government and all sectors.  The NHSS integrates across human health, animal health, environmental health, intelligence community, private sector, academia, etc.  The strategy serves as a national framework to drive efforts to strengthen and sustain communities’ abilities to prevent, protect against, mitigate the effects of, respond to, and recover from incidents with negative health consequences.
The NHSS identifies where the national health security, homeland security, and national security missions intersect and helps drive collaboration across these mission spaces and better use of resources to meet common objectives.  The strategy recognizes that national health security, homeland security, and national security are dependent in part on global health security and explicitly draws attention to the actions that our nation can take with our partners abroad to strengthen our security at home.

Achieving Health Security

How will the NHSS goals and objectives be achieved?
Achieving national health security is a responsibility that must be broadly shared throughout society by individuals, families, all sectors of communities, and across governments. The NHSS highlights five strategic objectives to focus and coordinate stakeholders’ efforts to achieve high-priority results. The NHSS Implementation Plan provides prioritized activities for a diverse range of stakeholders to facilitate coordinated efforts to build and sustain the operational capabilities necessary for national health security. While certain implementation plan activities might be more relevant to particular agencies, sectors, communities, or disciplines, the NHSS’ philosophy applies to everyone.

Since there is no appropriation that is specific to NHSS, how will it make a difference in national health security among the states and localities?
The NHSS serves as a national framework to inform health security capability initiatives, and sets the stage for creating a culture of resilience. It informs policies and programs, including those that fund state and community efforts; facilitates coordinated planning and activities; and is a guide for individuals, families, community-based organizations, private sector, academia, and all levels of government to prioritize limited resources and for coordinate policies and programs to avoid duplication of effort.  Communities are making contributions to national health security every day. For example, the Public Health Emergency Preparedness (PHEP) and the Hospital Preparedness Program (HPP) cooperative agreements, administered by HHS’ Centers for Disease Control and Prevention (CDC) and ASPR, respectively, are key federal investments in national health security.  The programs provide both financial and technical to help awardees to strengthen public health and medical response systems and enhance community preparedness.

How does the NHSS relate to and impact other policy and programs?
The NHSS provides strategic guidance to inform programs, policies, budgets, and activities over the next four years to protect people’s health in large-scale emergencies, from natural disasters to emerging infectious diseases. Thus, resources and evidence-based activities are leveraged through policies and programs to facilitate and maximize progress toward national health security. The NHSS complements and supports key national security documents and policies such as the National Security Strategy (May 2010); Quadrennial Homeland Security Review (QHSR) Report: A Strategic Framework for a Secure Homeland (February 2010); and Presidential Policy Directive-8: National Preparedness (March 2011). In recent years, the U.S. Department of Health and Human Services (HHS) has aligned its two major grant programs— the PHEP grant administered by CDC and  HPP administered by ASPR. Alignment of the HHS programs has included such efforts as working with a common set of preparedness capabilities, aligning the grant application process, and use of common performance indicators that support national health security.

Evaluating Progress

How is the government ensuring that progress is made?
​Achieving national health security will require commitments to measurement, accountability and continuous quality improvement. HHS is required to submit a NHSS to Congress every four years, along with an implementation plan and evaluation of progress. The next National Health Security Review will be submitted in 2017. However, progress will be reviewed on an annual basis that involves collecting, analyzing and integrating both qualitative and quantitative data and information from available sources, such as the National Health Security Preparedness Index, Trust for America’s Health reports, the National Snapshot of Public Health Preparedness, and HPP and PHEP performance measures.      ​Cycle diagram with three parts. Part one: Develop Goals and Strategies. Goal 2: Implement Strategies. Goal 3: Evaluate Impact; Reassess Relevance.

Learn More and Get Involved

Where can I find resources (e.g., tools, best practices) related to national health security?
Resources related to national health security can be found in our Resource Library.
How can I get involved?
As a public health professional, clinical or scientific researcher, first-responder, or an individual interested in supporting your community and the advancement of national health security, there are many ways that you can contribute to national health security. For example, you can:
  • Prepare you and your family.  Ensure that you have an emergency plan and stores of food, water, and medicine.
  • Connect with your neighbors and community to plan to assist each other during emergencies.
  • Volunteer in your community and encourage others to be involved and active participants in the community.
  • Get trained in CPR and be ready to be an active bystander who assists when an emergency strikes.
To obtain additional ideas on how you protect health in your community so people bounce back faster, see the National Health Security Strategy.

  • This page last reviewed: February 13, 2015