GAO Report: COVID-19: Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The GAO Press Release issued January 28, 2021 coincides with “its fifth comprehensive report examining the ongoing implementation of the CARES Act and other pandemic relief measures in response to our nation’s continued effort to combat the COVID-19 pandemic.

GAO is making 13 new recommendations in the report. It also addresses the status of 27 of GAO’s previous 31 COVID-19 recommendations which remain unimplemented. These include such critical areas as vaccine distribution and communications plans, medical supply chains, and workplace safety. GAO is pleased that the Consolidated Appropriations Act passed by Congress in December required a number of actions that are consistent with several of our open recommendations and we will monitor the implementation of the Act’s requirements.”

“Implementing GAO’s recommendations will be critical to improving the federal government’s ability to effectively respond to this pandemic. This report is a snapshot of where things stood as of January 15, the date we had to complete our audit work in order to meet GAO’s statutory bimonthly reporting deadline. We are monitoring the new Administration’s executive orders and actions, including the release of proposed national strategy documents, and these efforts appear to target many of the concerns we raise in this and previous reports,” said Gene L. Dodaro, Comptroller General of the United States and head of the GAO. “We will evaluate these actions moving forward and continue to monitor any further steps taken by the new administration and Congress.”

The landing page for the report and various components – summary, podcast and additional information – can be found hereThe report in PDF version (346 pages) is found here.

“GAO noted the following key areas for improvement:

Vaccine Rollout. The rollout of the COVID-19 vaccines has not met expectations. In September 2020, GAO stressed the importance of having a plan that focused on coordination and communication and recommended that HHS, with the support of the Department of Defense, establish a time frame for documenting and sharing a national plan for distributing and administering COVID-19 vaccines, and among other things, outline an approach for how efforts would be coordinated across federal agencies and nonfederal entities. To date, this recommendation has not been fully implemented. GAO reiterates the importance of doing so.

Testing. HHS has not issued a comprehensive and publicly available national testing strategy for COVID-19. Stakeholders involved in the response efforts to combat the pandemic have told GAO they were not aware that one exists. Such a strategy could help ensure that federal and state testing authorities have the information they need to accomplish shared goals. GAO recommends that HHS develop and publicly release a national comprehensive testing strategy that incorporates the six characteristics of effective national strategies identified in GAO’s prior strategic planning work.

Data CollectionThe federal government does not have a process to help systematically define and ensure the collection of standardized data across the relevant federal agencies and related stakeholders to help respond to COVID-19, communicate the status of the pandemic with citizens, or prepare for future pandemics. As a result, COVID-19 information that is collected and reported by states and other entities to the federal government is often incomplete and inconsistent. GAO recommends HHS establish an expert committee of professionals from public and private sectors, nonprofits, and academia focused on addressing this issue.

Medical and Drug Supply ChainsGAO found that federal agencies do not have complete and accessible information to identify supply chain vulnerabilities and to report the manufacturing sources of drugs and drug components that they procured. GAO made two new recommendations to address medical and drug supply chain strategy and resilience. In addition, GAO reiterates the importance of three previous recommendations in this area, including the need for a well formulated plan to deal with critical gaps in supplies for the remainder of the pandemic.

Strengthening Program Integrity and Protecting Against Fraud. Among GAO’s many recommendations in this area, of particular concern is the slow response to implementation of GAO’s recommendations to improve program integrity and reduce fraud in SBA’s emergency loan programs. 

With this new report, GAO has now made 44 recommendations since June 2020. As the new Congress and administration establish their policies and priorities for the federal government’s COVID-19 response, GAO urges swift action on these recommendations.”