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Departments of Education, Health and Human Services, and Homeland Security Release New Resources to Help Schools Improve Active Shooter Drills

Emerging Firearm Threats Task Force Sends President Biden Report on Machinegun Conversion Devices and 3D Printed Firearms

The Biden-Harris Administration has overseen the two largest single-year decreases in homicide ever recorded.  Violence in many cities is at pre-pandemic levels.  The Administration helped contribute to these historic decreases through unprecedented public safety funding for states, cities, law enforcement, and community violence interventions; more executive action on gun violence prevention than any other Administration; passing and implementing the first significant gun safety law in nearly 30 years; and the establishment of the first-ever White House Office of Gun Violence Prevention (OGVP) to coordinate and lead the Administration’s effort to reduce gun crime and other forms of gun violence.

Today, the Biden-Harris Administration announces that it completed the work required under the Executive Order President Biden signed in September 2024, directing federal agencies to: 1) help schools improve school-based active shooter drills; and 2) combat the emerging threats of machinegun conversion devices and unserialized, 3D printed firearms. 

New Federal Resources to Help Schools Improve School-Based Active Shooter Drills

Today, the U.S. Departments of Education, Health and Human Services, and Homeland Security each are releasing new resources to help schools design and deploy school-based active shooter drills.  The majority of schools use drills to prepare for an active shooter situation.  However, there is very limited research on how to design and deploy these drills to maximize their impact and minimize any harms they might cause.

The Biden-Harris Administration has worked to dramatically reduce the impacts of gun violence on our schools, educators, and students.  We have made the largest-ever federal government investment in youth mental health and unprecedented funding and resources for schools to prevent and respond to gun violence.  We have also advanced strategies to keep guns out of the hands of students or those who seek to do harm, including by funding the implementation of red flag laws, enhancing background checks for people under 21 who are trying to buy guns, and equipping school leaders with tools to educate parents about the importance of safely storing any firearms in their homes.

While federal, state, and local leaders must continue these strategies to reduce the prevalence of gun violence in schools and communities, the new resources will help schools improve drills so they can effectively prepare for an active shooter situation while also preventing or minimizing any trauma school communities may experience in performing drills. The new resources are summarized below.

• The U.S. Department of Education’s resource, Considerations for Education Leaders in Preparing for Active Drills in Schools, provides substantive considerations school officials can use to plan for before, during, and after school-based active shooter drills.  School administrators and other leaders may find this resource helpful when they are working to design and deploy school-based active shooter drills to save lives and minimize any unintended consequences.  The information in this resource is based on robust outreach with practitioners, experts, and advocates, and are in line with existing research and evidence even as additional research is underway.  For example, the resource explains that schools should provide advance notice about active shooter drills to school communities, including parents; avoid simulated gun violence (including highly sensorial elements like fake gunfire); be age-appropriate and designed in similar ways that schools teach academic content; address the needs of all staff and students (including those in need of special accommodations) and ensure all students (including those with disabilities and English Learners) are provided an equal opportunity to participate in safety training; and always provide a clear, consistent message accessible to all students that the event is a drill.  This resource can be found here.

• The Department of Health and Human Services’ resource, Active Shooter Drills Research: An Annotated Bibliography, summarizes research on active shooter drills.  While there is a need for additional research, this document compiles relevant research for school administrators and other leaders to reference when making decisions about drill design. Researchers may also find this resource useful when working to identify gaps in the research that need to be filled.  This resource can be found here.

• The Department of Homeland Security’s resource, Active Shooter Landscape Assessment, summarizes the different types of active shooter drills currently in use in K-12 schools.  School administrators and other leaders may find this document helpful when they want a better understanding of their choices when designing school-based active shooter drills. This resource can be found here.

Combatting Emerging Firearm Threats

Emerging firearm threats like machinegun conversion devices (MCDs) and 3D printed firearms are deadly new trends that are taking innocent lives. In September 2024, the President signed an Executive Order to establish the federal Emerging Firearm Threats Task Force and ordered it to deliver to him a report that includes a risk assessment of these new threats and new strategies to stop the proliferation of MCDs and 3D printed firearms. The Task Force submitted this report to the President in December 2024.

There are viable strategies to reduce the proliferation of emerging firearm threats, strategies that must continue if the United States is going to stay ahead of these emerging threats.  Key strategies include:

• Enforcement action that focuses on the source of the threats, including illegal import of physical products and the availability of computer code used for 3D printing.

• Identifying and shutting down websites offering illegal products for sale.

• Investing in promising technological solutions that can impede the ability to 3D print illegal products. 

Below is a summary of key points on the risks compiled by the Task Force and potential strategies for combatting emerging firearms threats.

Potential Strategies for Combatting Emerging Firearms Threats

Following an assessment of the risks and data provided by the Task Force, OGVP identified the following strategies for combatting emerging firearms threats:

Machinegun Conversion Devices 

Federal agencies have a number of capabilities and legal authorities to detect, intercept, and seize MCDs.  The main pathways include: (1) seizing the websites that illegally offer MCDs for sale, (2) identifying MCDs at ports of entry, and (3) using traditional forensic tools and building new methods to trace 3D printed MCDs back to their origin.

• Websites: Recently, federal authorities seized more than 350 Internet domains that foreign companies used to sell and illegally import MCDs into the United States in violation of the National Firearms Act and other laws prohibiting trafficking in counterfeit goods.  The websites’ domains were used to import illegal MCDs and silencers from China.  Foreign sellers are continuing to establish these websites, so continued law enforcement prioritization of tracking and shuttering the illegal websites selling MCDs is essential.  Law enforcement should continue to use traditional investigatory methods and new technology to efficiently identify and quickly shut down websites that illegally sell MCDs.  OGVP supports a civil process for suspending websites, especially foreign-based websites, that are selling MCDs in the United States. 

• Port of Entry: U.S. Customs and Border Protection (CBP) has targeted and tracked illegal MCDs since 2019.  CBP has provided all ports of entry with guidance material that highlights trends in shipping and concealment tactics.  CBP should continuously refresh these trainings and guidance to capture new tactics illegal MCD importers are using to avoid detection.

• Tracing 3D Printed Devices: There are already established traditional forensic toolmark methods to determine the source of a 3D printed MCD.  In addition, digital forensics techniques such as computed tomography and sonication may help identify the producer, the printer, or other specific information on a recovered MCD to help enforcement efforts.  Over time and with advancements in this technology, MCDs could be traced and mapped back to supply chains.  These technology solutions require federal, private sector, and philanthropic investment to become viable.

While there is no current U.S. law regulating the simple possession of computer code that could be used to 3D print MCDs, there are statutory authorities to prevent the illegal import and export of such code. Relevant authorities differentiate whether individuals placing MCD files onto the Internet are based in the United States or abroad. 

• Export: The Department of State (DOS) has jurisdiction over the export of MCDs and related technical data.  Thus, DOS has jurisdiction over a person in the United States who places MCD files onto the Internet. But, unlike the Department of Commerce (DOC), DOS has not published a regulation explaining the contours of its jurisdiction.  DOS should consider regulating computer code in the same fashion DOC regulates the computer code used for 3D printing firearms (which is explained in the next section) or moving jurisdiction for MCDs to DOC. 

• Import: The regulation of firearm imports falls under the jurisdiction of DOJ.  The legal authority to regulate these imports derives from the same statute, the Arms Export Control Act, that grants DOS their authorities. However, while DOJ defines “defense articles” on the U.S. Munitions Import List to include MCDs produced by 3D printers, it does not explicitly cover the computer code used to 3D print MCDs or define “importation” to include downloading computer files from abroad.  OGVP recommends that the interpretation of export and import laws be harmonized and applied to best prevent the distribution of computer code used to print MCDs.

There are also potential emerging software solutions to prevent or impede the 3D printing of MCDs.  Due to the reliance of 3D printers on software to convert MCD 3D designs (.stl files) to G-code, the nature of distribution of software and files for printing, and potential partnerships between the federal government and software companies, there are a range of software-based approaches to addressing this problem.  Members of industry and academia are working together on promising potential avenues to interrupt or block the printing of MCDs, which requires additional federal and philanthropic funding to continue the research and development.  There is significant opportunity for continued collaboration between the federal government, technology companies, philanthropy, and civil society.  Congress should authorize and fund the collaborative effort so it can continue to research live-saving solutions.

One limitation on stopping the proliferation of MCDs is that there are few laws related to the software and technology used to 3D print MCDs.  In a manner consistent with the 1st and 2nd Amendments, OGVP urges Congress to prohibit the possession, distribution, and use of computer code that can be readily used in a 3D printer to make an MCD, and create liability for the websites that permit these files to be accessed.

Unserialized or Undetectable 3D Printed Firearms 

While there is no current U.S. law regulating the simple possession of computer code that could be used to 3D print firearms, there are statutory authorities to prevent the illegal import and export of such code. Relevant authorities differentiate whether individuals placing files onto the Internet are based in the United States or abroad.  OGVP recommends that the interpretation of export and import laws be harmonized and applied to best prevent the distribution of computer code used to print unserialized or undetectable 3D printed firearms.

• Export: The Department of Commerce (DOC) has promulgated a regulation for addressing computer code that can be used to 3D print firearms pursuant to the Export Control Reform Act.[1]  DOC regulates code that is “ready for insertion” into a 3D printer and posted on the Internet.  DOC’s policy covers code that can directly interface with a 3D printer (e.g., G-code) as well as the code of the 3D design that only needs to be converted to G-code through widely available “slicer” software and with minimal additional information or manipulation from the individual.[2]  This provision applies to individuals in the United States who place code on the Internet.  Further interagency collaboration would assist DOC in identifying instances where an individual posts offending code on the Internet.

• Import: The regulation of foreign actors who place computer code on the Internet that could be accessed by individuals in the United States and used to 3D print firearms falls under the jurisdiction of the DOJ.  The legal authority to regulate these imports is substantially similar to the statute that is used by DOC, the Export Control Reform Act.  However, while DOJ defines “defense articles” on the U.S. Munitions Import List to include firearms produced by 3D printers, it does not explicitly cover the computer code used to 3D print firearms or define “importation” to include downloading computer files from abroad.  OGVP notes that these are areas where regulations can be strengthened.

DOJ has not engaged with the additive manufacturing industry on strategies to impede the 3D printing of firearms, but many of the same strategies for addressing 3D printed MCDs may be available.  OGVP suggests that one place to start a collaboration would be on fully plastic firearms that can evade a metal detector.

Like MCDs, one limitation in stopping the proliferation of 3D printed firearms is the lack of laws directly addressing the software and technology related to 3D printing of firearms.  Because of the risk posed by 3D printing firearms to enable prohibited individuals to access firearms, facilitate gun trafficking and illegal gun dealing, and create firearms that evade metal detectors, OGVP proposes that in a manner consistent with the 1st and 2nd Amendments, Congress should prohibit the distribution of software that is ready to be used in a 3D printer to make a firearm, including software that can be easily converted to that form.

Additionally, the Undetectable Firearms Act should be modernized and updated to fully capture the technical specifications of the firearms that can evade security and include prohibitions on the computer code used to 3D print undetectable firearms.

Risk Assessment

Machinegun Conversion Devices 

MCDs are a clear and present danger that pose a substantial threat to public safety and law enforcement because they convert semiautomatic rifles and pistols into fully automatic firearms that fire at rates comparable to military machineguns – up to thousands of rounds per minute.  Often small and difficult to identify, MCDs are inexpensive to make and, due to their size and concealability, much easier to traffic than complete weapons.  The devices are easy to obtain, install, and use. For purposes of federal law, MCDs are classified as machineguns, even when not installed on a firearm, and are subject to all the restrictions in the federal firearm laws applicable to the manufacture, possession, and use of machineguns.[3]

From January 1, 2022, to October 24, 2024, there were approximately 12,374 suspected MCDs recovered by law enforcement agencies and submitted for tracing to the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF).  In that period, the top ten recovery states comprised 64.4% (7,956) of the 12,360 MCDs recovered in the United States.  Florida (1,516), Illinois (1,376), Texas (1,045), Montana (1,030), and North Dakota (999) have submitted nearly half of all domestic recoveries (48.3% of 12,360).[4]  This total count of MCDs is very likely underinclusive as many MCDs are not submitted into the tracing system or are not identified by law enforcement officers at the time of recovery due to their inconspicuous nature.  One reason that so many MCDs are not identified by law enforcement is because they are not illegal under many state laws, and therefore, local law enforcement officers may not have been trained to identify and confiscate them.

The two principal ways that MCDs are currently acquired in the United States are through illegal imports and illegal 3D printing.  Although the MCDs themselves are machineguns and individuals cannot lawfully possess them under federal law and the laws of about half of the states, except under very limited circumstances, possession of the computer code used to produce them is currently unregulated under federal law. 

U.S. Customs and Border Protection (CBP) has targeted and seized an estimated 16,000 MCDs at the ports of entry since 2019, with the number of seizures increasing between FY22 and FY24.  The import trends have changed over time with shipments now containing a higher volume of MCDs.  The shipment size has increased from 1-2 MCDs per shipment to upwards of 50 per shipment.

MCD importers often use websites readily available to the general public to market their illegal products with websites operating like traditional e-commerce sites where products can be compared, purchased, and shipped to a customer.  A recent investigation by federal law enforcement shut down 350 websites and identified that MCD importers were also using social media accounts (Facebook, Instagram, and TikTok) to market their MCD business and run ads that target certain user accounts in the United States.  MCDs imported into the United States are almost exclusively from the People’s Republic of China.  After a purchase is made, MCDs are mislabeled on customs invoices as random parts, toys, and other innocuous items to thwart detection. 

Software files that can be used to 3D print MCDs are available to the public on the Internet for little or no cost and can be downloaded in minutes on any phone or computer with access to the Internet.  Once the design file is converted to G-code (the code necessary to 3D print an item), an inexpensive 3D printer (less than $150 or accessed for free at a public library) can be used to quickly print a functional MCD.  The 3D printed version of an MCD is nearly as reliable as the metal part.

Unserialized or Undetectable 3D Printed Firearms 

The emergence of unserialized, 3D printed firearms pose significant domestic and international threats.  Domestically, 3D printers can produce firearm components that, when assembled, create fully-functional, untraceable firearms.  While it is legal for individuals who are not otherwise prohibited from possessing firearms to make their own firearms, whether using 3D printing or otherwise, these types of firearms can create serious challenges for law enforcement, especially when in the hands of prohibited individuals, gun traffickers or unlicensed sellers.  Unserialized firearms cannot legally be sold by gun dealers nor provided to others otherwise prohibited from receiving or possessing firearms.  Internationally, Canadian authorities report a rise in 3D printed firearms, although illicit handguns in Canada are primarily sourced from stolen or smuggled U.S. weapons.

Unserialized firearms pose unique threats to public safety.  Law enforcement relies on the tracing of firearms recovered at crime scenes to identify the most recent purchaser of a firearm, thereby creating an investigative lead.  It is nearly impossible to trace unserialized firearms because they lack the necessary identification markings upon which tracing relies.  A law enforcement officer who encounters an unserialized firearm at a crime scene will therefore be unable to generate an investigative lead from a firearm trace.  In addition, unserialized firearms may not be traced to their point of origin, precluding firearm trafficking investigations from determining larger illegal trafficking patterns and those responsible for the trafficking.  These public safety concerns are the same whether the firearm is assembled from a ghost gun kit or 3D printed.

Undetectable firearms are not detectable by standard metal detectors and pose a particularly acute threat because they can be smuggled into sensitive areas such as airports, courthouses, government facilities, and large arenas.  Undetectable firearms may be made entirely of polymer, without metal, which is why they are undetectable by standard metal detectors.  While unserialized and undetectable firearms pose distinct threats, they are related because undetectable firearms may be produced by consumers using commercially available 3D printers.  The availability of undetectable firearms presents serious threats to public safety and national security.  The availability of 3D printing and files to print an undetectable firearm enables individuals to bypass background checks, border control, and other security measures, increasing the potential for prohibited persons, terrorists, and criminal organizations to use these weapons.  

Like simple possession of the computer code for 3D printing MCDs, simple possession of the computer code that enables a person to 3D print an undetectable firearm is not currently illegal under U.S. law.  The computer code needed for 3D printing can be downloaded or received from individuals on forums and purchased through web-based marketplaces, including on the dark web.  Though some expertise is needed, 3D printer users with minimal additional technical skills can successfully 3D print a firearm.

Transnational and terrorist criminal organizations, including cartels, have increasingly exploited 3D printing technology to manufacture firearms.  This capability allows them to bypass traditional supply chains and border controls, making it easier to arm their networks without detection.  These groups’ use of 3D printed firearms amplifies violence, disrupts security, and complicates efforts to combat organized crime.  The ease of production and distribution of 3D printed weapons, by or for the use of criminal or terrorist organizations, poses threats not only to the U.S., but also to its partner nations, straining law enforcement and national security measures.  The trend of 3D printed firearms’ use in transnational crime underscores the need for coordinated international regulations and prevention strategies to address the proliferation of these weapons.

[1] 15 C.F.R. § 734.7(c). “The following remains subject to the EAR: “software” or “technology” for the production of a firearm, or firearm frame or receiver, controlled under ECCNs 0A501, 0A506, 0A507, or 0A509, that is made available by posting on the internet in an electronic format, such as AMF or G-code, and is ready for insertion into a computer numerically controlled machine tool, additive manufacturing equipment, or any other equipment that makes use of the “software” or “technology” to produce the firearm frame or receiver or complete firearm.”

[2] In 2020, DOC provided public guidance on what types of files are covered in an FAQ document available on the BIS website. See https://www.bis.doc.gov/index.php/documents/policy-guidance/2572-faqs-for-the-commerce-category-i-iii-firearms-rule-posted-on-bis-website-7-7-20/file. If a person is unsure whether the criteria of section 734.7(c) are met, including whether the “technology” or “software” is ready for insertion into a computer numerically controlled machine tool, additive manufacturing equipment, or any other equipment, persons with such “technology” or “software” can submit an official classification request to BIS using the free online submission system, called SNAP-R, available on the BIS website to receive an official classification.

[3] See, Title 26, U.S.C., Section 5845(b) and Title 18, U.S.C., Section 922(o).

[4] Note that certain of these seizure statistics may include Forced-Reset Triggers, and the legality of certain types of Forced-Reset Triggers is subject to ongoing litigation.  Compare United States v. Rare Breed Triggers, LLC, 690 F. Supp. 3d 51, 88 (E.D.N.Y. 2023) (“[T]he Government is likely to succeed on the merits of its contention that the FRT-15,” a type of Forced-Reset Trigger, “is an illegal machinegun.”) with Nat’l Ass’n for Gun Rts., Inc. v. Garland, No. 4:23-CV-00830-O, 2024 WL 3517504, at *1 (N.D. Tex. July 23, 2024) (holding that the FRT-15 and WOT, a similar type of Forced-Reset Trigger, are not illegal machineguns). 

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The post BIDEN-HARRIS ADMINISTRATION TAKES ACTION TO COMBAT EMERGING FIREARM THREATS AND IMPROVE SCHOOL-BASED ACTIVE SHOOTER DRILLS appeared first on The White House.

Departments of Education, Health and Human Services, and Homeland Security Release New Resources to Help Schools Improve Active Shooter Drills

Emerging Firearm Threats Task Force Sends President Biden Report on Machinegun Conversion Devices and 3D Printed Firearms

The Biden-Harris Administration has overseen the two largest single-year decreases in homicide ever recorded.  Violence in many cities is at pre-pandemic levels.  The Administration helped contribute to these historic decreases through unprecedented public safety funding for states, cities, law enforcement, and community violence interventions; more executive action on gun violence prevention than any other Administration; passing and implementing the first significant gun safety law in nearly 30 years; and the establishment of the first-ever White House Office of Gun Violence Prevention (OGVP) to coordinate and lead the Administration’s effort to reduce gun crime and other forms of gun violence.

Today, the Biden-Harris Administration announces that it completed the work required under the Executive Order President Biden signed in September 2024, directing federal agencies to: 1) help schools improve school-based active shooter drills; and 2) combat the emerging threats of machinegun conversion devices and unserialized, 3D printed firearms. 

New Federal Resources to Help Schools Improve School-Based Active Shooter Drills

Today, the U.S. Departments of Education, Health and Human Services, and Homeland Security each are releasing new resources to help schools design and deploy school-based active shooter drills.  The majority of schools use drills to prepare for an active shooter situation.  However, there is very limited research on how to design and deploy these drills to maximize their impact and minimize any harms they might cause.

The Biden-Harris Administration has worked to dramatically reduce the impacts of gun violence on our schools, educators, and students.  We have made the largest-ever federal government investment in youth mental health and unprecedented funding and resources for schools to prevent and respond to gun violence.  We have also advanced strategies to keep guns out of the hands of students or those who seek to do harm, including by funding the implementation of red flag laws, enhancing background checks for people under 21 who are trying to buy guns, and equipping school leaders with tools to educate parents about the importance of safely storing any firearms in their homes.

While federal, state, and local leaders must continue these strategies to reduce the prevalence of gun violence in schools and communities, the new resources will help schools improve drills so they can effectively prepare for an active shooter situation while also preventing or minimizing any trauma school communities may experience in performing drills. The new resources are summarized below.

• The U.S. Department of Education’s resource, Considerations for Education Leaders in Preparing for Active Drills in Schools, provides substantive considerations school officials can use to plan for before, during, and after school-based active shooter drills.  School administrators and other leaders may find this resource helpful when they are working to design and deploy school-based active shooter drills to save lives and minimize any unintended consequences.  The information in this resource is based on robust outreach with practitioners, experts, and advocates, and are in line with existing research and evidence even as additional research is underway.  For example, the resource explains that schools should provide advance notice about active shooter drills to school communities, including parents; avoid simulated gun violence (including highly sensorial elements like fake gunfire); be age-appropriate and designed in similar ways that schools teach academic content; address the needs of all staff and students (including those in need of special accommodations) and ensure all students (including those with disabilities and English Learners) are provided an equal opportunity to participate in safety training; and always provide a clear, consistent message accessible to all students that the event is a drill.  This resource can be found here.

• The Department of Health and Human Services’ resource, Active Shooter Drills Research: An Annotated Bibliography, summarizes research on active shooter drills.  While there is a need for additional research, this document compiles relevant research for school administrators and other leaders to reference when making decisions about drill design. Researchers may also find this resource useful when working to identify gaps in the research that need to be filled.  This resource can be found here.

• The Department of Homeland Security’s resource, Active Shooter Landscape Assessment, summarizes the different types of active shooter drills currently in use in K-12 schools.  School administrators and other leaders may find this document helpful when they want a better understanding of their choices when designing school-based active shooter drills. This resource can be found here.

Combatting Emerging Firearm Threats

Emerging firearm threats like machinegun conversion devices (MCDs) and 3D printed firearms are deadly new trends that are taking innocent lives. In September 2024, the President signed an Executive Order to establish the federal Emerging Firearm Threats Task Force and ordered it to deliver to him a report that includes a risk assessment of these new threats and new strategies to stop the proliferation of MCDs and 3D printed firearms. The Task Force submitted this report to the President in December 2024.

There are viable strategies to reduce the proliferation of emerging firearm threats, strategies that must continue if the United States is going to stay ahead of these emerging threats.  Key strategies include:

• Enforcement action that focuses on the source of the threats, including illegal import of physical products and the availability of computer code used for 3D printing.

• Identifying and shutting down websites offering illegal products for sale.

• Investing in promising technological solutions that can impede the ability to 3D print illegal products. 

Below is a summary of key points on the risks compiled by the Task Force and potential strategies for combatting emerging firearms threats.

Potential Strategies for Combatting Emerging Firearms Threats

Following an assessment of the risks and data provided by the Task Force, OGVP identified the following strategies for combatting emerging firearms threats:

Machinegun Conversion Devices 

Federal agencies have a number of capabilities and legal authorities to detect, intercept, and seize MCDs.  The main pathways include: (1) seizing the websites that illegally offer MCDs for sale, (2) identifying MCDs at ports of entry, and (3) using traditional forensic tools and building new methods to trace 3D printed MCDs back to their origin.

• Websites: Recently, federal authorities seized more than 350 Internet domains that foreign companies used to sell and illegally import MCDs into the United States in violation of the National Firearms Act and other laws prohibiting trafficking in counterfeit goods.  The websites’ domains were used to import illegal MCDs and silencers from China.  Foreign sellers are continuing to establish these websites, so continued law enforcement prioritization of tracking and shuttering the illegal websites selling MCDs is essential.  Law enforcement should continue to use traditional investigatory methods and new technology to efficiently identify and quickly shut down websites that illegally sell MCDs.  OGVP supports a civil process for suspending websites, especially foreign-based websites, that are selling MCDs in the United States. 

• Port of Entry: U.S. Customs and Border Protection (CBP) has targeted and tracked illegal MCDs since 2019.  CBP has provided all ports of entry with guidance material that highlights trends in shipping and concealment tactics.  CBP should continuously refresh these trainings and guidance to capture new tactics illegal MCD importers are using to avoid detection.

• Tracing 3D Printed Devices: There are already established traditional forensic toolmark methods to determine the source of a 3D printed MCD.  In addition, digital forensics techniques such as computed tomography and sonication may help identify the producer, the printer, or other specific information on a recovered MCD to help enforcement efforts.  Over time and with advancements in this technology, MCDs could be traced and mapped back to supply chains.  These technology solutions require federal, private sector, and philanthropic investment to become viable.

While there is no current U.S. law regulating the simple possession of computer code that could be used to 3D print MCDs, there are statutory authorities to prevent the illegal import and export of such code. Relevant authorities differentiate whether individuals placing MCD files onto the Internet are based in the United States or abroad. 

• Export: The Department of State (DOS) has jurisdiction over the export of MCDs and related technical data.  Thus, DOS has jurisdiction over a person in the United States who places MCD files onto the Internet. But, unlike the Department of Commerce (DOC), DOS has not published a regulation explaining the contours of its jurisdiction.  DOS should consider regulating computer code in the same fashion DOC regulates the computer code used for 3D printing firearms (which is explained in the next section) or moving jurisdiction for MCDs to DOC. 

• Import: The regulation of firearm imports falls under the jurisdiction of DOJ.  The legal authority to regulate these imports derives from the same statute, the Arms Export Control Act, that grants DOS their authorities. However, while DOJ defines “defense articles” on the U.S. Munitions Import List to include MCDs produced by 3D printers, it does not explicitly cover the computer code used to 3D print MCDs or define “importation” to include downloading computer files from abroad.  OGVP recommends that the interpretation of export and import laws be harmonized and applied to best prevent the distribution of computer code used to print MCDs.

There are also potential emerging software solutions to prevent or impede the 3D printing of MCDs.  Due to the reliance of 3D printers on software to convert MCD 3D designs (.stl files) to G-code, the nature of distribution of software and files for printing, and potential partnerships between the federal government and software companies, there are a range of software-based approaches to addressing this problem.  Members of industry and academia are working together on promising potential avenues to interrupt or block the printing of MCDs, which requires additional federal and philanthropic funding to continue the research and development.  There is significant opportunity for continued collaboration between the federal government, technology companies, philanthropy, and civil society.  Congress should authorize and fund the collaborative effort so it can continue to research live-saving solutions.

One limitation on stopping the proliferation of MCDs is that there are few laws related to the software and technology used to 3D print MCDs.  In a manner consistent with the 1st and 2nd Amendments, OGVP urges Congress to prohibit the possession, distribution, and use of computer code that can be readily used in a 3D printer to make an MCD, and create liability for the websites that permit these files to be accessed.

Unserialized or Undetectable 3D Printed Firearms 

While there is no current U.S. law regulating the simple possession of computer code that could be used to 3D print firearms, there are statutory authorities to prevent the illegal import and export of such code. Relevant authorities differentiate whether individuals placing files onto the Internet are based in the United States or abroad.  OGVP recommends that the interpretation of export and import laws be harmonized and applied to best prevent the distribution of computer code used to print unserialized or undetectable 3D printed firearms.

• Export: The Department of Commerce (DOC) has promulgated a regulation for addressing computer code that can be used to 3D print firearms pursuant to the Export Control Reform Act.[1]  DOC regulates code that is “ready for insertion” into a 3D printer and posted on the Internet.  DOC’s policy covers code that can directly interface with a 3D printer (e.g., G-code) as well as the code of the 3D design that only needs to be converted to G-code through widely available “slicer” software and with minimal additional information or manipulation from the individual.[2]  This provision applies to individuals in the United States who place code on the Internet.  Further interagency collaboration would assist DOC in identifying instances where an individual posts offending code on the Internet.

• Import: The regulation of foreign actors who place computer code on the Internet that could be accessed by individuals in the United States and used to 3D print firearms falls under the jurisdiction of the DOJ.  The legal authority to regulate these imports is substantially similar to the statute that is used by DOC, the Export Control Reform Act.  However, while DOJ defines “defense articles” on the U.S. Munitions Import List to include firearms produced by 3D printers, it does not explicitly cover the computer code used to 3D print firearms or define “importation” to include downloading computer files from abroad.  OGVP notes that these are areas where regulations can be strengthened.

DOJ has not engaged with the additive manufacturing industry on strategies to impede the 3D printing of firearms, but many of the same strategies for addressing 3D printed MCDs may be available.  OGVP suggests that one place to start a collaboration would be on fully plastic firearms that can evade a metal detector.

Like MCDs, one limitation in stopping the proliferation of 3D printed firearms is the lack of laws directly addressing the software and technology related to 3D printing of firearms.  Because of the risk posed by 3D printing firearms to enable prohibited individuals to access firearms, facilitate gun trafficking and illegal gun dealing, and create firearms that evade metal detectors, OGVP proposes that in a manner consistent with the 1st and 2nd Amendments, Congress should prohibit the distribution of software that is ready to be used in a 3D printer to make a firearm, including software that can be easily converted to that form.

Additionally, the Undetectable Firearms Act should be modernized and updated to fully capture the technical specifications of the firearms that can evade security and include prohibitions on the computer code used to 3D print undetectable firearms.

Risk Assessment

Machinegun Conversion Devices 

MCDs are a clear and present danger that pose a substantial threat to public safety and law enforcement because they convert semiautomatic rifles and pistols into fully automatic firearms that fire at rates comparable to military machineguns – up to thousands of rounds per minute.  Often small and difficult to identify, MCDs are inexpensive to make and, due to their size and concealability, much easier to traffic than complete weapons.  The devices are easy to obtain, install, and use. For purposes of federal law, MCDs are classified as machineguns, even when not installed on a firearm, and are subject to all the restrictions in the federal firearm laws applicable to the manufacture, possession, and use of machineguns.[3]

From January 1, 2022, to October 24, 2024, there were approximately 12,374 suspected MCDs recovered by law enforcement agencies and submitted for tracing to the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF).  In that period, the top ten recovery states comprised 64.4% (7,956) of the 12,360 MCDs recovered in the United States.  Florida (1,516), Illinois (1,376), Texas (1,045), Montana (1,030), and North Dakota (999) have submitted nearly half of all domestic recoveries (48.3% of 12,360).[4]  This total count of MCDs is very likely underinclusive as many MCDs are not submitted into the tracing system or are not identified by law enforcement officers at the time of recovery due to their inconspicuous nature.  One reason that so many MCDs are not identified by law enforcement is because they are not illegal under many state laws, and therefore, local law enforcement officers may not have been trained to identify and confiscate them.

The two principal ways that MCDs are currently acquired in the United States are through illegal imports and illegal 3D printing.  Although the MCDs themselves are machineguns and individuals cannot lawfully possess them under federal law and the laws of about half of the states, except under very limited circumstances, possession of the computer code used to produce them is currently unregulated under federal law. 

U.S. Customs and Border Protection (CBP) has targeted and seized an estimated 16,000 MCDs at the ports of entry since 2019, with the number of seizures increasing between FY22 and FY24.  The import trends have changed over time with shipments now containing a higher volume of MCDs.  The shipment size has increased from 1-2 MCDs per shipment to upwards of 50 per shipment.

MCD importers often use websites readily available to the general public to market their illegal products with websites operating like traditional e-commerce sites where products can be compared, purchased, and shipped to a customer.  A recent investigation by federal law enforcement shut down 350 websites and identified that MCD importers were also using social media accounts (Facebook, Instagram, and TikTok) to market their MCD business and run ads that target certain user accounts in the United States.  MCDs imported into the United States are almost exclusively from the People’s Republic of China.  After a purchase is made, MCDs are mislabeled on customs invoices as random parts, toys, and other innocuous items to thwart detection. 

Software files that can be used to 3D print MCDs are available to the public on the Internet for little or no cost and can be downloaded in minutes on any phone or computer with access to the Internet.  Once the design file is converted to G-code (the code necessary to 3D print an item), an inexpensive 3D printer (less than $150 or accessed for free at a public library) can be used to quickly print a functional MCD.  The 3D printed version of an MCD is nearly as reliable as the metal part.

Unserialized or Undetectable 3D Printed Firearms 

The emergence of unserialized, 3D printed firearms pose significant domestic and international threats.  Domestically, 3D printers can produce firearm components that, when assembled, create fully-functional, untraceable firearms.  While it is legal for individuals who are not otherwise prohibited from possessing firearms to make their own firearms, whether using 3D printing or otherwise, these types of firearms can create serious challenges for law enforcement, especially when in the hands of prohibited individuals, gun traffickers or unlicensed sellers.  Unserialized firearms cannot legally be sold by gun dealers nor provided to others otherwise prohibited from receiving or possessing firearms.  Internationally, Canadian authorities report a rise in 3D printed firearms, although illicit handguns in Canada are primarily sourced from stolen or smuggled U.S. weapons.

Unserialized firearms pose unique threats to public safety.  Law enforcement relies on the tracing of firearms recovered at crime scenes to identify the most recent purchaser of a firearm, thereby creating an investigative lead.  It is nearly impossible to trace unserialized firearms because they lack the necessary identification markings upon which tracing relies.  A law enforcement officer who encounters an unserialized firearm at a crime scene will therefore be unable to generate an investigative lead from a firearm trace.  In addition, unserialized firearms may not be traced to their point of origin, precluding firearm trafficking investigations from determining larger illegal trafficking patterns and those responsible for the trafficking.  These public safety concerns are the same whether the firearm is assembled from a ghost gun kit or 3D printed.

Undetectable firearms are not detectable by standard metal detectors and pose a particularly acute threat because they can be smuggled into sensitive areas such as airports, courthouses, government facilities, and large arenas.  Undetectable firearms may be made entirely of polymer, without metal, which is why they are undetectable by standard metal detectors.  While unserialized and undetectable firearms pose distinct threats, they are related because undetectable firearms may be produced by consumers using commercially available 3D printers.  The availability of undetectable firearms presents serious threats to public safety and national security.  The availability of 3D printing and files to print an undetectable firearm enables individuals to bypass background checks, border control, and other security measures, increasing the potential for prohibited persons, terrorists, and criminal organizations to use these weapons.  

Like simple possession of the computer code for 3D printing MCDs, simple possession of the computer code that enables a person to 3D print an undetectable firearm is not currently illegal under U.S. law.  The computer code needed for 3D printing can be downloaded or received from individuals on forums and purchased through web-based marketplaces, including on the dark web.  Though some expertise is needed, 3D printer users with minimal additional technical skills can successfully 3D print a firearm.

Transnational and terrorist criminal organizations, including cartels, have increasingly exploited 3D printing technology to manufacture firearms.  This capability allows them to bypass traditional supply chains and border controls, making it easier to arm their networks without detection.  These groups’ use of 3D printed firearms amplifies violence, disrupts security, and complicates efforts to combat organized crime.  The ease of production and distribution of 3D printed weapons, by or for the use of criminal or terrorist organizations, poses threats not only to the U.S., but also to its partner nations, straining law enforcement and national security measures.  The trend of 3D printed firearms’ use in transnational crime underscores the need for coordinated international regulations and prevention strategies to address the proliferation of these weapons.

[1] 15 C.F.R. § 734.7(c). “The following remains subject to the EAR: “software” or “technology” for the production of a firearm, or firearm frame or receiver, controlled under ECCNs 0A501, 0A506, 0A507, or 0A509, that is made available by posting on the internet in an electronic format, such as AMF or G-code, and is ready for insertion into a computer numerically controlled machine tool, additive manufacturing equipment, or any other equipment that makes use of the “software” or “technology” to produce the firearm frame or receiver or complete firearm.”

[2] In 2020, DOC provided public guidance on what types of files are covered in an FAQ document available on the BIS website. See https://www.bis.doc.gov/index.php/documents/policy-guidance/2572-faqs-for-the-commerce-category-i-iii-firearms-rule-posted-on-bis-website-7-7-20/file. If a person is unsure whether the criteria of section 734.7(c) are met, including whether the “technology” or “software” is ready for insertion into a computer numerically controlled machine tool, additive manufacturing equipment, or any other equipment, persons with such “technology” or “software” can submit an official classification request to BIS using the free online submission system, called SNAP-R, available on the BIS website to receive an official classification.

[3] See, Title 26, U.S.C., Section 5845(b) and Title 18, U.S.C., Section 922(o).

[4] Note that certain of these seizure statistics may include Forced-Reset Triggers, and the legality of certain types of Forced-Reset Triggers is subject to ongoing litigation.  Compare United States v. Rare Breed Triggers, LLC, 690 F. Supp. 3d 51, 88 (E.D.N.Y. 2023) (“[T]he Government is likely to succeed on the merits of its contention that the FRT-15,” a type of Forced-Reset Trigger, “is an illegal machinegun.”) with Nat’l Ass’n for Gun Rts., Inc. v. Garland, No. 4:23-CV-00830-O, 2024 WL 3517504, at *1 (N.D. Tex. July 23, 2024) (holding that the FRT-15 and WOT, a similar type of Forced-Reset Trigger, are not illegal machineguns). 

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President Biden spoke today with President Abdel-Fattah El Sisi of Egypt. The two leaders discussed the negotiations for a ceasefire and hostage release deal based on the arrangement described by President Biden last year and endorsed unanimously by the UN Security Council. The President thanked President Sisi for his leadership and praised the mediating role of Egypt throughout the process. He emphasized that this deal would never have been possible without Egypt’s essential and historic role in the Middle East and commitment to diplomacy for resolving conflicts. Both leaders emphasized the urgent need for a deal to be implemented to bring immediate relief to the people of Gaza through a surge in humanitarian aid enabled by the ceasefire together with the return of hostages to their families. Both leaders committed to remain in close coordination directly and through their teams over the coming hours.

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President Biden spoke today with President Abdel-Fattah El Sisi of Egypt. The two leaders discussed the negotiations for a ceasefire and hostage release deal based on the arrangement described by President Biden last year and endorsed unanimously by the UN Security Council. The President thanked President Sisi for his leadership and praised the mediating role of Egypt throughout the process. He emphasized that this deal would never have been possible without Egypt’s essential and historic role in the Middle East and commitment to diplomacy for resolving conflicts. Both leaders emphasized the urgent need for a deal to be implemented to bring immediate relief to the people of Gaza through a surge in humanitarian aid enabled by the ceasefire together with the return of hostages to their families. Both leaders committed to remain in close coordination directly and through their teams over the coming hours.

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Dear Mr. Speaker:   (Dear Madam President:)

Consistent with Section 204(e) of the Compact of Free Association Amendments Act of 2024 (Div. G, title II, P.L. 118‑42) and section 101(d)(2) of the Joint Resolution to approve the “Compact of Free Association” between the United States and the Government of Palau, and for other purposes (P.L. 99-658), I transmit here the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of Palau (2024 Palau FPSA).

Consistent with section 101(f) of title I of the Compact of Free Association Amendments Act of 2003 (P.L. 108-188) and Section 204(e) of the Compact of Free Association Amendments Act of 2024 (Div. G, title II, P.L. 118-42) I transmit here the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of the Marshall Islands with Annexes (2024 Marshall Islands FPSA).

The reasons for these agreements with Palau and the Marshall Islands are to assist in their development and maintain our close relationship with each country.  The 2024 FPSA agreements with Palau and the Marshall Islands would continue most of the services specified in those agreements as they have been provided to each country under previous agreements, with some technical updates.  The 2024 FPSAs include significant changes to the provision of postal services for both Palau and the Marshall Islands, including more detailed specifications on the minimum level of services provided, allowing the United States Postal Service (USPS) to reduce the individual services within certain categories.  The 2024 FPSA with Palau would also make FDIC insurance available to Palau-chartered banks for the first time, such that existing and future Palau-chartered depository institutions would be eligible to apply for FDIC insurance.  A new component of the 2024 FPSA with the Marshall Islands would make FDIC insurance available to existing Marshall Islands‑chartered institutions, such that they could apply for FDIC insurance.  In addition, the 2024 FPSAs’ general provisions that apply to all U.S. Federal agencies providing programs and services in Palau and the Marshall Islands — not just those providing programs and services under the FPSAs — would last in perpetuity unless terminated by mutual agreement.  This ensures that benefits for U.S. Federal agencies, personnel, and contractors, including certain privileges and immunities, tax exemptions, and claims and dispute settlement procedures, will continue beyond 2043.  With regard to the 2024 FPSA with the Marshall Islands, significant changes relating to disaster assistance include a revision to the process for declaring disasters, increased contributions to the Disaster Assistance Emergency Fund, and changes to promote disaster preparedness.

I commend to the Congress the 2024 Palau FPSA between the United States of America and the Republic of Palau and the 2024 Marshall Islands FPSA between the United States of America and the Republic of the Marshall Islands.

                              Sincerely,

                              JOSEPH R. BIDEN JR.

The post Letter to the Speaker of the House and President of the Senate on the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of Palau, and the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of the Marshall Islands with Annexes appeared first on The White House.

Dear Mr. Speaker:   (Dear Madam President:)

Consistent with Section 204(e) of the Compact of Free Association Amendments Act of 2024 (Div. G, title II, P.L. 118‑42) and section 101(d)(2) of the Joint Resolution to approve the “Compact of Free Association” between the United States and the Government of Palau, and for other purposes (P.L. 99-658), I transmit here the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of Palau (2024 Palau FPSA).

Consistent with section 101(f) of title I of the Compact of Free Association Amendments Act of 2003 (P.L. 108-188) and Section 204(e) of the Compact of Free Association Amendments Act of 2024 (Div. G, title II, P.L. 118-42) I transmit here the 2024 Federal Programs and Services Agreement between the Government of the United States and the Government of the Republic of the Marshall Islands with Annexes (2024 Marshall Islands FPSA).

The reasons for these agreements with Palau and the Marshall Islands are to assist in their development and maintain our close relationship with each country.  The 2024 FPSA agreements with Palau and the Marshall Islands would continue most of the services specified in those agreements as they have been provided to each country under previous agreements, with some technical updates.  The 2024 FPSAs include significant changes to the provision of postal services for both Palau and the Marshall Islands, including more detailed specifications on the minimum level of services provided, allowing the United States Postal Service (USPS) to reduce the individual services within certain categories.  The 2024 FPSA with Palau would also make FDIC insurance available to Palau-chartered banks for the first time, such that existing and future Palau-chartered depository institutions would be eligible to apply for FDIC insurance.  A new component of the 2024 FPSA with the Marshall Islands would make FDIC insurance available to existing Marshall Islands‑chartered institutions, such that they could apply for FDIC insurance.  In addition, the 2024 FPSAs’ general provisions that apply to all U.S. Federal agencies providing programs and services in Palau and the Marshall Islands — not just those providing programs and services under the FPSAs — would last in perpetuity unless terminated by mutual agreement.  This ensures that benefits for U.S. Federal agencies, personnel, and contractors, including certain privileges and immunities, tax exemptions, and claims and dispute settlement procedures, will continue beyond 2043.  With regard to the 2024 FPSA with the Marshall Islands, significant changes relating to disaster assistance include a revision to the process for declaring disasters, increased contributions to the Disaster Assistance Emergency Fund, and changes to promote disaster preparedness.

I commend to the Congress the 2024 Palau FPSA between the United States of America and the Republic of Palau and the 2024 Marshall Islands FPSA between the United States of America and the Republic of the Marshall Islands.

                              Sincerely,

                              JOSEPH R. BIDEN JR.

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Over the past four years, President Biden and Vice President Harris leveraged the full force of the federal government to advance rights of and opportunities for women and girls across the country and around the globe. From defending reproductive freedom, delivering the highest women’s labor force participation on record, making historic investments in the care economy, and lowering drug prices for women with Medicare to fighting to end violence against women, advancing the human rights of women and girls globally, and promoting women’s political participation and leadership, President Biden and Vice President Harris invested in the future of women and girls.

Defended Reproductive Freedom

With reproductive freedom under attack, President Biden and Vice President Harris fought to ensure that women across the country are able to make deeply personal health care decisions and access the reproductive health care they need. Since Roe v. Wade was overturned, the President and Vice President called on Congress to restore the protections of Roe in federal law. President Biden also signed three Executive Orders and a Presidential Memorandum directing his Administration to protect access to reproductive health care and established the White House Task Force on Reproductive Healthcare Access to coordinate these efforts across agencies.

• Protected Access to Medication Abortion. In 2023, the Food and Drug Administration (FDA) took independent, evidence-based action to allow mifepristone—a safe and effective drug used in medication abortion that FDA first approved more than 20 years ago—to be prescribed by telehealth and sent by mail and to enable interested pharmacies to become certified to dispense the medication. As a result of the new pathway established by FDA, many pharmacies across the country, including major retail pharmacy chains, became certified to dispense medication abortion, giving many women the option to pick up their prescription for medication abortion at a local, certified pharmacy just as they would for any other medication. The FDA and the Department of Justice (DOJ) also defended FDA’s independent, expert judgment, including in a lawsuit before the U.S. Supreme Court that attempted to curtail access to mifepristone nationwide. And the Administration took action to support patients, providers, and pharmacies who wish to legally access, prescribe, or provide medication abortion, consistent with a Presidential Memorandum issued by President Biden on what would have been the 50th anniversary of Roe v. Wade.

• Defended Access to Emergency Abortion Care. The Administration fought to ensure that all patients, including women who are experiencing pregnancy loss and other pregnancy-related emergencies, have access to the full rights and protections for emergency medical care afforded under the Emergency Medical Treatment and Labor Act (EMTALA)—including abortion care when that is the stabilizing treatment required. To educate health care providers on their rights and obligations for emergency medical care, the Department of Health and Human Services (HHS) issued guidance and sent letters to health care provider associations affirming the Administration’s view that EMTALA preempts conflicting state law restricting access to abortion in emergency situations. DOJ defended that interpretation, including in litigation before the Supreme Court.

HHS has enforced EMTALA and helped ensure that patients facing all types of medical emergencies receive the care to which they are entitled. As part of its comprehensive plan to educate all patients about their rights and to help ensure hospitals meet their obligations under federal law, HHS launched a new option on CMS.gov, in both English and Spanish, to enable individuals to more easily file an EMTALA complaint; developed new accessible and understandable resources about patient rights and protections under EMTALA and the process for submitting a complaint; disseminated training materials and new model signage for health care providers; and established a dedicated team of experts to increase HHS’s capacity to support hospitals and providers in complying with federal requirements.

• Defended the Right to Travel. On the day the Supreme Court overturned Roe, President Biden reaffirmed the Attorney General’s statement that women must remain free to travel safely to another state to seek the care they need. DOJ filed statements of interest in litigation challenging the Alabama Attorney General’s threat to prosecute people who provide assistance to women seeking lawful out-of-state abortions. DOJ explained that the threatened Alabama prosecutions infringe the constitutional right to travel and made clear that states may not punish third parties for assisting women in exercising that right. DOJ also monitored states’ efforts to restrict the constitutional right to travel across state lines to receive lawful health care.

• Strengthened Access to Affordable, High-Quality Contraception. In response to directives from President Biden—including an Executive Order issued nearly one year after the Supreme Court’s decision to overturn Roe—the Administration improved contraception access and affordability under the Affordable Care Act, through Medicare and Medicaid, through federal health centers, and for Service members, veterans, federal employees, and college students. For instance, the Departments of the Treasury, Labor, and HHS issued new guidance to support expanded coverage of a broader range of FDA-approved contraceptives at no cost under the Affordable Care Act; proposed rules to strengthen access to contraception for women with private health insurance; and bolstered the standard for inclusion of family planning providers in Marketplace plan provider networks under the Affordable Care Act. HHS issued new guidance and letters to state Medicaid programs and Children’s Health Insurance Programs to outline existing state obligations to help ensure that enrollees can access family planning services; updated the Medicare Part D formulary clinical review process to include additional contraceptive types; and adopted new data measures for federal health centers to help enhance the overall delivery of voluntary family planning and related services. And FDA approved the first daily oral contraceptive for over-the-counter use, which is now widely available nationwide.

• Bolstered Family Planning Services by Rebuilding the Title X Family Planning Program. The Administration rebuilt and grew the Title X Family Planning Program, which has played a critical role in ensuring access to a broad range of high-quality family planning and preventive health services for more than 50 years. During the prior administration, more than 1,000 service sites left the Title X Family Planning Program, leading to a significant decline in people served. The Administration reversed changes that led to those departures, strengthening the Title X Family Planning Program and helping safeguard this critical part of the nation’s health safety net. In 2023, the Administration provided about $287 million to nearly 4,000 Title X providers across the country to provide free or low-cost voluntary planning and related preventive services for 2.8 million women and families—an 80% increase since 2020.

• Safeguarded the Privacy of Patients and Health Care Providers. HHS issued new rules to strengthen privacy protections for information related to reproductive health care under the Health Insurance Portability and Accountability Act (HIPAA) and to support health care providers in protecting patients’ electronic health information. HHS also issued a how-to guide on steps that consumers can take to better protect their data on personal cell phones or tablets and when using mobile health apps, which are generally not protected by HIPAA. The Federal Trade Commission clarified the health breach notification rule’s applicability to health apps and other similar technologies and took enforcement action against companies for disclosing consumers’ personal health information, including highly sensitive reproductive health data, without permission. The Department of Education issued guidance to over 20,000 school officials to remind them of their obligations to protect student privacy and issued a know-your-rights resource to help students understand their privacy rights for health records at school. And the Federal Communications Commission launched a guide for consumers on best practices for protecting their personal data, including geolocation data, on mobile phones and strengthened data breach rules to provide greater protections to personal data.

• Protected Access to Reproductive Health Care for Veterans and Service Members. The Department of Veterans Affairs (VA) revised its regulations to provide abortion counseling and, in certain circumstances, abortion care to veterans and VA beneficiaries and eliminated out-of-pocket costs for certain types of contraception through the Civilian Health and Medical Program. And the Department of Defense (DoD) took action to ensure that Service members and their families can access reproductive health care and that the Department’s health care providers can operate effectively. DoD issued new policies to support Service members and their families’ ability to travel for lawful reproductive health care, to bolster Service members’ privacy, and to afford Service members the time and space needed to make personal health care decisions. DoD also expanded walk-in contraceptive care services for active-duty Service members and other Military Health System beneficiaries and eliminated TRICARE copays for certain contraceptive services.

• Supported Access to Fertility Care, Including IVF. In the face of threats and extreme attacks on fertility services, the Administration supported access to fertility care, including in vitro fertilization (IVF)—an important aspect of reproductive health care. DoD and the VA expanded eligibility for IVF services for certain Service members and veterans. And the Office of Personnel Management significantly expanded access to IVF benefits and coverage to support federal workers in growing their families. For 2025, federal employees and their families—regardless of where they live—were able to choose from multiple nationwide plan options that offer comprehensive IVF coverage.

• Partnered with State Leaders on the Frontlines of Abortion Access. The White House partnered with leaders on the frontlines of protecting access to abortion—both those fighting extreme state legislation and those advancing proactive policies to protect access to reproductive health care, including for patients who are forced to travel out of state for care. The Vice President led these efforts, highlighting the harm of abortion bans to women’s health at more than 100 events in over 20 states and meeting with hundreds of state legislators, health care providers, and advocates. And, on what would have been the 51st anniversary of Roe, the Vice President launched her nationwide Fight for Reproductive Freedoms tour to continue fighting back against extreme attacks throughout America.

• Supported Sexual and Reproductive Health Globally. While defending reproductive freedom domestically, the Administration remained steadfast in supporting sexual and reproductive health and rights globally. The January 2021 Presidential Memorandum on Protecting Women’s Health at Home and Abroad revoked the expanded global gag rule, restored life-saving funding to the United Nations Population Fund (UNFPA), and required that adequate funds be directed to support women’s health needs globally, including for sexual and reproductive health services. During this Administration, the United States remained the largest bilateral donor to global family planning assistance—a commitment spanning more than five decades. And we worked to accelerate access to family planning and prevent maternal mortality—providing over $1.7 billion to support global maternal and child health programs and over $1.8 billion to support global family planning and reproductive health programs from FY 2021 to FY 2023.

Improved Women’s Health and Addressed Health Disparities

The President and Vice President believe that health care is a right, not a privilege, and expanded health care access for millions more Americans while also lowering health care costs. The Administration built on, strengthened, and protected Medicare, Medicaid, and the Affordable Care Act, and the President’s American Rescue Plan and the Inflation Reduction Act lowered prescription drug costs and health insurance premiums. The President and First Lady led the way in fundamentally changing how we approach and fund women’s health research to pioneer the next generation of discoveries in women’s health. And the Vice President led the Administration’s efforts to address the nation’s maternal health crisis.

• Lowered Drug Prices for Millions of Women. The Administration fought to ensure that no American has to choose between paying for medications they need to live, or paying for other basic necessities. President Biden took on Big Pharma to lower prescription drug costs, saving millions of seniors money on health care and reducing the cost of insulin to $35 per monthly prescription for people with Medicare. For the first time in history, Medicare reached agreements on new, lower prices with the manufacturers of ten drugs selected for the first round of drug price negotiation. These drugs are used to treat many common diseases and conditions that affect women, including blood clots, diabetes, cardiovascular disease, heart failure, autoimmune conditions, and chronic kidney disease, and are taken by 9 million seniors, including 4.5 million women. When these lower prices go into effect, people on Medicare will save $1.5 billion in out-of-pocket costs for their prescription drugs, and Medicare will save $6 billion in the first year alone.

• Lowered Health Care Premiums under the Affordable Care Act. Today, more Americans have health insurance than under any previous President, and enrollment in Affordable Care Act Marketplace coverage nearly doubled during the last four years. Ahead of the end of the 2025 open enrollment period, the Administration set an all-time record for Affordable Care Act Marketplace enrollment, with nearly 24 million Americans signing up for coverage. And women made up more than half of the record-breaking number of people with Affordable Care Act coverage for 2025. Thanks to the American Rescue Plan and Inflation Reduction Act, millions of women and working families saved an average of $800 per year on health insurance premiums.

• Closed Gaps in Women’s Health Research. Recognizing that research on women’s health remains underfunded and understudied, President Biden launched the first-ever White House Initiative on Women’s Health Research led by First Lady Jill Biden and the White House Gender Policy Council to spur innovation, unleash transformative investment to close research gaps, and improve women’s health. The First Lady announced nearly $1 billion in new federal investments in women’s health research galvanized by the Initiative, including through the Advanced Research Projects Agency for Health’s first-of-its-kind Sprint for Women’s Health. The President called on Congress in the State of the Union to make a record $12 billion investment in women’s health research, and he signed an Executive Order directing the most comprehensive set of executive actions ever taken to expand and improve research on women’s health. In December, the First Lady convened a White House Conference on Women’s Health Research.

• Improved Maternal Health Outcomes. Under the Vice President’s leadership, the Administration took action to improve maternal health and eliminate racial disparities by reducing pregnancy-related complications and mortality, which disproportionately impact Black, Indigenous, and rural women.

• Addressed the Maternal Health Crisis. In June 2022, the Vice President announced the Blueprint for Addressing the Maternal Health Crisis, a comprehensive effort to combat maternal mortality and morbidity. Since the Blueprint was released, the Administration has made significant strides in improving maternal health for women across the country. Over the past four years, HHS launched a new Birthing-Friendly designation to identify hospitals and health systems that deliver high-quality, evidence-based maternity care; announced a new Transforming Maternal Health Model to help develop and implement a whole-person approach to care; established the first-ever baseline federal health and safety requirements for maternal emergency and obstetric services; expanded funding for Maternal Mortality Review Committees; and took action to grow and support the maternal health workforce.

• Helped Women and Families Access Critical Maternal Health Services. Since Vice President Harris issued a call to action in 2021, to date, 47 states, the District of Columbia, and the U.S. Virgin Islands have extended Medicaid postpartum coverage from two to 12 months of post-pregnancy care. This coverage option was first made possible by President Biden’s American Rescue Plan and then made permanent by the Consolidated Appropriations Act of 2023. In addition, four new states adopted the Affordable Care Act’s expansion of Medicaid, covering over a million people, many for the first time. The Administration also expanded maternity care for veterans, who now have access to maternity care coordinators through 12 months postpartum, helping connect veterans with care after delivery, follow-up screenings, and mental health support.

• Tackled the Mental Health Crisis. As part of the President’s Unity Agenda, the Administration took action to transform how mental health is understood, accessed, treated, and integrated in and out of health care settings. Thanks to the Bipartisan Safer Communities Act, the Administration delivered the largest investment in school-based mental health services ever, providing nearly $1 billion to help train and hire an additional 16,000 mental health professionals to work in America’s K-12 schools. HHS also launched FindSupport.gov and 988, the Nationwide Suicide and Crisis Lifeline, which has connected millions of Americans in crisis to immediate, confidential, and free care from trained counselors. Additionally, HHS prioritized maternal mental health, including by launching the National Maternal Mental Health Hotline (1-833-TLC-MAMA) to help tens of thousands of perinatal women access needed support, the Task Force on Maternal Mental Health, and the Talking Postpartum Depression public education campaign and learning collaborative.

• Addressed Girls’ Risk of HIV/AIDS Globally. Under this Administration, the President’s Emergency Plan for AIDS Relief (PEPFAR) focused on addressing health equity for vulnerable populations globally – including adolescent girls and young women, children and other key populations. The Administration expanded DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) – a public-private partnership launched as part of PEPFAR in 2014 – to reach more adolescent girls and young women with HIV prevention services, investing approximately $360 million to reach over 2.9 million girls and young women across 15 countries.

• Improved Maternal Health Globally. USAID’s maternal and child health and nutrition programs have played a pivotal role in saving millions of lives by driving down mortality rates through improved health care access and delivery. From FY 2021 to FY 2023, the Department of State and USAID invested more than $7 billion in global health programming to prevent child and maternal deaths. In 2023, USAID supported 12 million women to give birth at health facilities receiving U.S. government assistance and reached 11 million pregnant women with nutrition counseling services.

• Invested in the Global Health Worker Initiative. The Administration launched the Global Health Worker Initiative (GHWI), recognizing that a health workforce that is supported, equipped, and protected to provide essential public health functions is integral to reclaiming lost ground from the COVID-19 pandemic and preparing for future health threats. Through the GHWI, we better aligned investments in health workers across the U.S. government, built stronger partnerships on the health workforce with bilateral partners, multilateral institutions, including the World Health Organization, and other philanthropic partners, and reoriented our global health programs toward cohesive efforts that build stronger and more resilient health systems.

Strengthened Women’s Economic Security

The Administration invested in America’s future by ensuring women have access to good jobs and safe workplaces free from discrimination. The President’s economic agenda led to historic gains in women’s labor force participation. Globally, we supported women’s economic security by promoting women’s access to jobs in sectors critical to the future of our planet and closing the gender digital divide.

• Achieved the Lowest Average Women’s Unemployment Rate of Any Administration on Record. The Administration’s economic plan led to an historic recovery in working-age women’s labor force participation in the United States, bringing it to the highest it has ever been on record since 1948. Since President Biden took office in January 2021, the women’s unemployment rate had its fastest calendar-year drop on record that year, dropping to the lowest annual unemployment rate in 70 years in 2023. Under the President’s and Vice President’s leadership, there was a dramatic reduction in Black and Latina women’s unemployment. There are now roughly 2.5 million more Hispanic women and more than 1 million Black women employed than there were at the start of the Administration.

• Ensured Women Have Access to Good-Paying, High-Quality Jobs. The Administration’s once-in-a generation Investing in America agenda is creating millions of good-paying jobs, helping to ensure that women, people of color, and other communities currently underrepresented in the industries of the future have equitable access to these jobs. President Biden signed Executive Orders to invest in America’s workers by directing his Administration to promote strong labor standards; expand and diversify registered apprenticeship programs; help ensure that federal funding applicants provide supportive services for workers; and encourage worker organizing and collective bargaining. For instance, the Department of Commerce launched the Million Women in Construction initiative, which called on chip manufacturers, construction companies, and unions to bring one million women into the construction industry over the next decade, roughly doubling women’s representation in the industry. The Department of Labor (DOL) launched the Mega Construction Project Program, which fosters equal employment opportunities for qualified workers, including women, on certain federally funded construction projects. And the Administration invested more than $730 million in registered apprenticeships, leading to more than 1 million registered apprentices, including over 100,000 women, receiving gold standard earn-as-you-learn training for in-demand jobs.

• Advanced Pay Equity for Federal Workers. President Biden and Vice President Harris know that closing wage gaps is critical to strengthening and growing the economy. To advance pay equity within the federal workforce, the Office of Personnel Management ensured that more than 80 federal agencies no longer consider an individual’s non-federal pay when determining their salary. The consideration of compensation history in pay-setting decisions has exacerbated pay inequities, disproportionately harming women and people of color. Banning this practice is a proven way to curb pay discrimination that often follow workers from job to job.

• Lifted the Burden of Student Debt for 5 Million Americans. From day one of his Administration, President Biden vowed to fix the student loan system and make sure higher education is a pathway to the middle class—not a barrier to opportunity. Over the past four years, the Administration approved debt cancellation for nearly 5 million Americans, totaling over $179 billion in debt relief through various actions. Life-changing relief is especially important for women who carry nearly two-thirds of all student loan debt.

• Supported Women-Owned Small Businesses. In FY 2024, the Small Business Administration (SBA) backed 15,500 loans to businesses that are more than 50% owned by women, for a total of $5.6 billion. The growth in loans reflects a doubling in women-owned business participation from 2020 to 2024. And women’s small business formation surged during the Administration, substantially outpacing overall small business formation. We invested $100 million in the Women Business Centers (WBC) network, expanding it for the first time into all 50 states and tripling the number of WBCs at Historically Black Colleges and Universities, Hispanic-Serving Institutions, and other minority-serving institutions. Through the American Rescue Plan, the Administration invested $10 billion to help states, territories, and Tribal governments leverage even more in matching public and private dollars to support small businesses across the United States, with a particular focus on historically underserved entrepreneurs, including women business owners. And the Administration awarded the highest single year and average annual amount of contracting dollars to women-owned small businesses, including $30.9 billion in FY 2023 alone.

• Ensured Pregnant and Postpartum Workers Have Workplaces Free from Discrimination. The President signed into law bipartisan protections for pregnant and post-partum workers. The Pregnant Workers Fairness Act (PWFA) provides basic, long-overdue protections that promote safe, healthy workplaces free from discrimination. The Equal Employment Opportunity Commission (EEOC) issued regulations implementing the PWFA to ensure pregnant and postpartum workers have access to common-sense, reasonable accommodations that enable them to stay in the workforce while pregnant or as a new mother. The President also signed the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act, which provides most nursing workers with the right to reasonable break time and a place, other than a bathroom, that is shielded from view and free from intrusion to express breast milk while at work. DOL is enforcing the PUMP Act and has issued educational resources for workers and employers. EEOC and DOL also issued a joint resource to help ensure that workers and employers understand their rights and responsibilities under the PWFA and PUMP Act.

• Promoted Women’s Economic Security Globally. The Administration mobilized over $3 billion in public and private resources to advance women’s economic security around the world and prioritized closing persistent gaps in women’s economic participation globally that hinder their ability to participate in a 21st century economy. In 2021, the Administration established the Gender Equity and Equality Action Fund to advance economic security for women and girls and address barriers that limit their full economic participation. Through the Fund, which invested $500 million in direct and attributed indirect resources around the world, the Administration committed to three flagship public-private partnerships to tackle persistent barriers to women’s economic participation. These initiatives include:

• $2 Billion to Support Women’s Participation in Green and Blue Industries. Vice President Harris announced the Women in the Sustainable Economy Initiative—a public-private partnership between governments, the private sector, philanthropies, multilateral organizations, and civil society—to promote women’s access to jobs, training, leadership roles, and financial resources in industries that are critical to the fight against climate change. Thirty-three governments, corporations, foundations, and civil society organizations committed over $2 billion to WISE, including more than $900 million committed by the U.S. government.

• $1 Billion to Help Cut the Gender Digital Divide in Half by 2030. In 2023, the United States secured an historic commitment in the G20 New Delhi Leaders’ Declaration and the APEC Leaders’ Golden Gate Declaration to cut the digital gender gap in half by 2030. To help reach this goal, Vice President Harris launched the Women in the Digital Economy Initiative, a public-private partnership with more than $1 billion in commitments from forty-nine government, private sector, and civil society partners to accelerate progress to close the gender digital divide and fully enfranchise women in our globalized, networked economy.

• Supported Job Creation for Women Globally. Vice President Harris and the Partnership for Central America launched “In Her Hands,” a women’s economic empowerment initiative that mobilized $113 million in private sector funding to advance economic security for women. By 2030, the initiative aims to support and provide opportunities for 5 million women across Guatemala, El Salvador, and Honduras by creating jobs, providing training on technical skills, promoting access to financial assistance, and offering programs focused on manufacturing of textiles and apparel and agricultural regeneration.

Invested in Care at Home and Abroad

The Administration took action to increase access to affordable, high-quality care for families and to support caregivers and care workers. When we invest in care, we allow parents— especially women—to participate fully in the workforce; recognize the value of care workers and care providers, who are disproportionately women and women of color; and strengthen the economy. In 2021, the President’s American Rescue Plan helped child care centers and family child care providers, which are mostly small businesses, remain open or reopen during the pandemic. And, since 2021 the Administration secured an additional $4 billion for the Child Care Development Block Grant and Head Start. President Biden also issued an historic Executive Order that directed the most comprehensive set of executive actions ever taken to expand access to affordable, high-quality care, and support care workers and family caregivers. And the President continued to call on Congress to provide guaranteed affordable, high-quality child care from birth until kindergarten and a national, comprehensive paid family and medical leave program.

• Made High-Quality Child Care More Affordable. The Administration helped ensure that families have access to high-quality, affordable care. HHS finalized a rule strengthening the Child Care and Development Block Grant program and lowering child care payments for more than 100,000 families receiving federal child care assistance. Under this landmark rule, families will pay no more than 7% of income, saving families in states that do not yet cap copayments over $200 a month of average. In addition, in implementing the CHIPS and Science Act, the Department of Commerce required applicants for semiconductor incentives requesting over $150 million in direct funding to submit plans to provide accessible, affordable, high-quality child care. This first-of-its kind commitment is helping get more people—especially women—into good-paying manufacturing jobs, and helping more employers recruit and retain a diverse, skilled workforce. More than three-quarters of all companies that have signed CHIPS awards or preliminary memoranda as of December 2024 are working to provide child care offerings for their workforce—including many smaller grant applicants that are doing so voluntarily.

• Improved Long-Term Care and Support Family Caregivers. The Administration remained committed to protecting the health and dignity of older adults and people with disabilities. HHS issued new rules to ensure home care workers get a larger share of Medicaid payments and establish minimum staffing standards in nursing homes receiving Medicare and Medicaid funding. The Administration delivered $37 billion in American Rescue Plan funds across all 50 states to enhance, expand, and strengthen home and community-based care, and $145 million to help the National Family Caregiver Support Program deliver counseling, training, and short-term relief to family and other informal care providers. The Administration also developed the first-ever National Strategy to Support Family Caregivers, which outlines the more than 350 actions being taken by 15 federal agencies in support of family caregivers. HHS published a guide to help older women find programs and services—such as respite care and counseling—to help maintain their health and well-being while being a caregiver for others. And VA launched a program to provide mental health counseling services to family caregivers caring for our nation’s heroes.
• Invested in Care Infrastructure and Supported Caregivers and Care Workers. The Administration helped raise the wages and quality of care worker jobs, and invested in care infrastructure. SBA announced new funding opportunities to support small businesses in the child care sector and launched a lender campaign to highlight SBA resources to support small, minority-owned, and women-owned businesses, including child care businesses; the Department of the Treasury provided resources to address barriers for child care businesses that need to secure financing. The Administration also took action to ensure Service members and military spouses—the vast majority of whom are women—have the support they need to care for themselves and their families while serving our country, including by strengthening the hiring and retention of military spouses across the federal government, and expanding access to child care and other employment resources. And DOL published sample employment agreements so domestic home care, child care, and long-term care workers and their employers can help ensure all parties better understand their rights and responsibilities.

• Leveraged More Than $500 Million in Projected Funding to Boost Women’s Employment by Investing in Child Care. Through the Invest in Childcare Initiative—a public-private partnership with more than $500 million in leveraged funding between the World Bank, the governments of Canada, Germany, Australia, and the United States, domestic government resources, the Bill & Melinda Gates Foundation, and several others—the Administration incentivized investment in child care infrastructure in low- and middle-income countries, which will boost women’s employment and overall economic growth. And in 2024, the United States secured an historic commitment in the G7 Apulia Leaders’ Communiqué to tackle the unequal gender distribution of care work with G7 nations committing to support 200 million more women to join the workforce by 2035 through investment in child care globally.

• Supported Care Workers Globally. At the 68th Session of the Commission on the Status of Women, USAID announced a new Memorandum of Understanding with the Ford Foundation and the Care for All with Respect and Equity (CARE) Fund to partner in advancing decent work for care workers worldwide. USAID, the Ford Foundation, and the CARE Fund are partnering to fund “Together We Care: Partnerships for Equitable Health Systems,” an activity implemented by UNI Global Union. This partnership builds on USAID’s previously pledged $4 million and will advance women’s economic security and resilient health and care systems. USAID is supporting programming in Colombia, the Dominican Republic, Ghana, and the Philippines, with partners supporting additional programming in Brazil.

Addressed Gender-Based Violence

Working to end gender-based violence has been a cornerstone of President Biden and Vice President Harris’ careers, and the Administration has worked to prevent and end gender-based violence wherever it occurs—at home, at work, in the military, in schools, in communities, and online. From signing historic legislation to issuing new Executive Orders and Presidential Memoranda to securing significant funding for domestic violence and sexual assault services to combating conflict-related sexual violence, the Administration made significant progress in reducing violence and supporting survivors. The Administration’s efforts were guided by the first-ever U.S. National Plan to End Gender-Based Violence, a whole-of-government, intersectional approach to preventing and addressing sexual violence, intimate partner violence, stalking, and other forms of gender-based violence.

• Reauthorized the Violence Against Women Act. President Biden strengthened the Violence Against Women Act (VAWA)—landmark bipartisan legislation that he wrote and championed as a U.S. Senator and has worked across the aisle to strengthen ever since—by signing into law the VAWA Reauthorization Act of 2022. This critical legislation expands access to safety and support for survivors, increases prevention efforts, and establishes new federal protections against online harassment and abuse. The President and Vice President also secured the highest-ever funding levels to implement VAWA and increased funding for VAWA programs by over 35% since 2021. The Administration swiftly implemented the VAWA Reauthorization Act of 2022 by:

• Protecting and Supporting Survivors of Gender-Based Violence. DOJ awarded more than $690 million in VAWA grants and cooperative agreements in FY 2024 for more than 40 grant programs and initiatives to help states, Tribes, territories, law enforcement, victim advocates, and community-based organizations address gender-based violence. This includes more than $40 million to implement new grant programs established by the VAWA Reauthorization Act of 2022, including trauma-informed training for law enforcement, pilot programs for serving protection orders electronically, strategies to address technology-facilitated gender-based violence, and victim-centered and trauma-informed restorative practices programs that address gender-based violence.

• Supporting the Housing Needs of Survivors of Domestic Violence, Sexual Assault, Dating Violence, and Stalking. In 2024, five federal agencies issued an interagency statement to affirm VAWA’s housing protections for survivors of domestic violence, sexual assault, dating violence, and stalking as well as other individuals, such as those who assist survivors. The Department of Housing and Urban Development (HUD) also established a new Office on Gender-Based Violence, as directed by the VAWA Reauthorization Act of 2022, to coordinate and implement policies and programs to address the safe housing and economic stability needs of survivors and awarded $10 million to provide VAWA training and technical assistance to housing grantees, owners, and managers. HUD also published a first-of-its-kind report on the housing needs of survivors of human trafficking, as required by the VAWA Reauthorization Act of 2022, and a fact sheet that applies the report’s findings to help assist youth trafficking survivors and youth at risk of trafficking with housing needs.

• Expanding Access to Justice and Strengthening Gender-Based Violence Protections for Tribal Communities. DOJ awarded more than $85 million in FY 2024 VAWA grants and more than $68 million in FY 2023 VAWA grants to provide services and promote justice for survivors in Native communities. In making these awards, DOJ took new measures to increase access to the Tribal Governments Grant Program. DOJ also supported Tribal implementation of new provisions in the VAWA Reauthorization Act of 2022 that recognized expanded special Tribal criminal jurisdiction over non-Native perpetrators of sexual violence, child violence, stalking, assaults on Tribal law enforcement officers, and sex trafficking on Tribal lands, in addition to domestic and dating violence. These efforts included launching a new Special Tribal Criminal Jurisdiction Reimbursement Program and a pilot program to support Alaska Native Tribes that want to exercise special Tribal criminal jurisdiction over non-Indian offenders for certain crimes, including crimes of sexual and domestic violence.

• Addressing Online Harassment and Abuse. To support survivors of image-based abuse, DOJ funded the first-ever national helpline to provide 24/7 support and specialized services for victims of the non-consensual distribution of intimate images. Operated by the Cyber Civil Rights Initiative, the Image Abuse Helpline and Online Safety Center significantly expanded support to survivors of online harassment and abuse, meeting the rising need for services to address the non-consensual creation and distribution of intimate images. DOJ also awarded about $5.5 million in new grant funds to support local law enforcement in prosecuting cybercrimes against individuals and funded a new National Resource Center on Cybercrimes Against Individuals that was authorized by the VAWA Reauthorization Act of 2022 to help law enforcement, prosecutors, and victim services organizations prevent, enforce, and prosecute cybercrimes against individuals. DOJ also distributed resources to United States Attorneys’ Offices and national legal and service organizations to raise awareness of the new provision in the VAWA Reauthorization Act of 2022 that created a federal civil cause of action to address the non-consensual distribution of intimate images.

• Promoting Prevention and Strengthening Services for Survivors of Sexual Assault. The VAWA Reauthorization Act of 2022 improved prevention and response to sexual violence through additional funding and new protections. In FY 2024, the Centers for Disease Control and Prevention provided more than $49 million to more than 110 state health departments and state, territorial, and Tribal sexual assault coalitions for the Rape Prevention and Education Program. DOJ awarded $51.8 million—a nearly 45% increase in funding from the previous year—to provide victims of sexual assault with services in every state and the District of Columbia, as well as American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the Virgin Islands. Separately, DOJ awarded more than $20 million in FY 2024 to support colleges and universities in preventing and responding to sexual assault, domestic violence, dating violence, and stalking.

The VAWA Reauthorization Act of 2022 also enacted the Fairness for Rape Kit Backlog Survivors Act, which requires state victim compensation programs to allow sexual assault survivors to file for compensation without being unfairly penalized due to rape kit backlogs. And, as directed under the VAWA Reauthorization Act of 2022, the Department of Education—in collaboration with DOJ and HHS—launched a Task Force on Sexual Violence in Education that issued recommendations to schools on ways to improve sexual violence prevention and response on campuses.

• Improving Trauma-Informed and Victim-Centered Investigations and Expanding Pathways to Justice. DOJ implemented a new program authorized in the VAWA Reauthorization Act of 2022 to train law enforcement officers on trauma-informed and victim-centered investigations of gender-based violence and released a new Framework for Prosecutors to Strengthen our National Response to Sexual Assault and Domestic Violence Involving Adult Victims. Separately, DOJ implemented a new program, also authorized in the VAWA Reauthorization Act of 2022, to support, enhance, and expand restorative practice programs that prevent or address domestic violence, dating violence, sexual assault, or stalking, as well as build evidence for victim-centered, trauma-informed, and culturally responsive restorative practices addressing these harms.

• Helped Keep Guns Out of the Hands of Domestic Abusers. President Biden signed the historic Bipartisan Safer Communities Act, the most significant legislation to reduce gun violence in nearly 30 years, that narrowed the “boyfriend loophole.” DOJ worked with states to educate them about the scope of this protection, expanded technical assistance and federal funding opportunities for state and local law enforcement programs that remove firearms from domestic abusers, and is actively reporting denied transactions of firearms purchases to state, local, and Tribal law enforcement within 24 hours. President Biden also established the first-ever White House Office of Gun Violence Prevention, which is overseen by Vice President Harris, to lead the Administration’s efforts to end our nation’s gun violence epidemic. And DOJ successfully defended at the Supreme Court the constitutionality of a federal law that helps keep guns out of the hands of individuals subject to domestic violence protective orders.

• Kept Students Safe and Addressed Campus Sexual Assault. The Department of Education restored and strengthened vital Title IX nondiscrimination protections for students and employees. The Department’s rule provided protection from sex-based harassment, including sexual violence; promoted accountability and fundamental fairness through a transparent and reliable process; and provided clarity to ensure that students, employees, and families understand their rights and that institutions know their responsibilities. The new rule also clarified that schools have a responsibility to address sex discrimination and harassment that occurs under its programs and activities whether the conduct takes place online, in person, or both, and strengthened definitions for sex-based harassment under Title IX to address the growth in technology-facilitated gender-based violence, including AI-generated abuse.

• Implemented Historic Military Justice Reforms to Better Protect Survivors. The Administration removed barriers to women’s advancement, opportunity, and well-being in the U.S. military, including by addressing sexual assault, domestic violence, and sexual harassment in the force. One of President Biden’s earliest acts in office was to call for the establishment of the Independent Review Commission on Sexual Assault in the Military to strengthen accountability and inform reforms to the military justice system. Since 2021, President Biden signed three Executive Orders to implement historic, bipartisan reforms to the military justice system, transferring key decision-making authorities from commanders to specialized, independent military prosecutors in cases of sexual assault, domestic violence, murder, and other serious offenses by amending the Uniform Code of Military Justice. Building on these reforms, DoD implemented additional Independent Review Commission recommendations to improve its response to sexual assault and made record investments in sexual assault prevention and survivor support, more than doubling annual funding from $500 million to more than $1 billion in 2024 for these lifesaving services. This work made a difference: for the first time in nearly a decade, rates of sexual assault and harassment within the active-duty force declined—with a nearly 19% drop in the number of service members who reported experiencing unwanted sexual contact since 2021.

• Invested in Communities to Support Survivors and Save Lives. The President’s American Rescue Plan invested nearly $1 billion in supplemental funding for domestic violence and sexual assault services and supports through the Family Violence Prevention and Services Act Program. The President also signed into law the VOCA Fix Act, which provided more than $1.4 billion for the Crime Victims Fund to support local programs and services for survivors. Since the Victims of Crime Act (VOCA) became law in 1984, we have invested more than $38 billion dollars in local programs that provide mental health, housing, legal assistance, victim advocacy, crisis intervention, and other services to help victims of gender-based violence and other crimes.

• Supported Survivors in Accessing Housing, Homeless Assistance, and Community Services. In 2024, HUD awarded $57 million in Domestic Violence Bonus projects serving survivors of domestic violence, dating violence, sexual assault, stalking, and human trafficking and announced an additional $52 million in Domestic Violence Bonus projects, which will be issued in 2025. HUD also directed Homeless Continuum of Care recipients to offer services to people experiencing trauma or a lack of safety related to gender-based violence, consistent with the new definition of “homeless” for survivors included in the VAWA Reauthorization Act of 2022. And Community Development Block Grant (CDBG) grantees used nearly $13 million of CDBG funds and another $8.3 million of CDBG-CV funds in FY 2023 to support services for survivors of domestic violence, dating violence, sexual assault, or stalking. CDBG funds supported crisis intervention, crisis hotline, counseling, emergency shelter and housing assistance, legal assistance, and other community services for adults and children as well as survivors.

• Helped Protect Survivor Privacy. President Biden signed the Safe Connections Act to allow a survivor of domestic abuse to separate a mobile phone line from an account shared with an abuser. He also signed the Joint Consolidation Loan Separation Act, which allows survivors of domestic violence and others who have faced economic abuse to sever joint student loan debt, and the SECURE 2.0 Act, which allows survivors of domestic abuse to elect to receive penalty-free distributions from an employer-sponsored retirement plan.

• Strengthened Protections for Survivors of Sexual Assault and Harassment in the Workplace. President Biden signed into law new bipartisan protections to support survivors and address sexual assault and sexual harassment in the workplace. The Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act empowers survivors of sexual assault and sexual harassment at work by providing a choice to go to court instead of being forced into arbitration. And the Speak Out Act enables survivors to speak out about workplace sexual assault and harassment by prohibiting the enforcement of pre-dispute nondisclosure and non-disparagement clauses regarding allegations of sexual harassment or assault. In addition, the Office of Personnel Management responded to a Presidential Memorandum by issuing new guidance to support federal employees’ access to paid time off and leave without pay for purposes related to seeking safety and recovering from domestic violence, dating violence, sexual assault, and related forms of abuse. DOL continued to award grants under the Fostering Access, Rights and Equity Grant opportunity, which assists underserved and marginalized low-income women workers who have been impacted by gender-based violence and harassment, and helps them understand and access their employment rights, services, and benefits. And EEOC issued new resources to help employers prevent and remedy harassment, including sexual harassment, and create respectful workplaces.

• Addressed Gender-Based Violence in American Indian and Alaska Native Communities. In addition to actions taken to implement the VAWA Reauthorization Act of 2022, President Biden issued an Executive Order directing federal agencies to address the crisis of missing or murdered Indigenous peoples, which significantly impacts women, girls, LGBTQI+ people in the community, and Two-Spirit Native Americans. Pursuant to the Not Invisible Act, DOJ and the Department of the Interior established the Not Invisible Act Commission in 2022, a cross-jurisdictional advisory committee composed of law enforcement, Tribal leaders, federal partners, service providers, family members of missing or murdered individuals, and survivors. The Commission provided recommendations to improve the federal government’s efforts to address violent crime and the high rates of people reported missing in Native communities, which the Departments responded to in 2024. Additionally, the United States relaunched the North American Trilateral Working Group on Violence Against Indigenous Women and Girls, in collaboration with the governments of Canada and Mexico, and with the participation of Indigenous women leaders from all three countries.

• Developed and Implemented National and Global Strategies to End Gender-Based Violence. The White House issued the first-ever U.S. National Plan to End Gender-Based Violence, a comprehensive, government-wide plan to prevent and address sexual violence, intimate partner violence, stalking, and other forms of gender-based violence. The National Plan provided a framework for guiding federal action across each of seven strategic pillars—from prevention to economic security and housing stability to online safety. To address gender-based violence around the world, the United States advanced the U.S. Strategy to Prevent and Respond to Gender-Based Violence Globally, which was updated in 2022 to address 21st century threats, including the rise of gender-based violence during the COVID-19 pandemic; technology-facilitated gender-based violence; and safety risks related to climate migration and displacement. Under this strategy, the Administration secured the first-ever U.S. commitment to the United Nations Global Programme to End Child Marriage and continued our long-standing commitment to the United Nations Joint Programme on the Elimination of Female Genital Mutilation. And over the last two fiscal years, the United States maintained the highest-ever level of investment—$250 million—to address gender-based violence globally.

• Held Perpetrators Accountable for Conflict-Related Sexual Violence. The Administration has condemned sexual violence whenever and wherever it occurs, including in South Sudan, Iraq, Haiti, Ukraine, and the attacks committed by Hamas in Israel on October 7—and in Gaza against hostages. In 2022, President Biden issued an historic Presidential Memorandum on Promoting Accountability for Conflict-Related Sexual Violence committing to fully exercising U.S. authorities—including sanctions, visa restrictions, and security assistance vetting—to impose consequences on perpetrators of this human rights abuse. The Administration has since issued nearly two dozen sanctions against perpetrators of conflict-related sexual violence around the globe—including the largest set of financial sanctions and visa restrictions the United States has issued against individuals connected to this abhorrent human rights abuse. The Vice President also launched the Dignity in Documentation Initiative, which provides support for survivor- and civil society-led efforts to investigate and document conflict-related sexual violence in line with the Murad Code, named for Nobel Laureate and survivor Nadia Murad. This initiative—which includes $18 million in direct and aligned commitments from the Department of State and $4 million in aligned commitments from USAID—will support justice for survivors by promoting accountability for crimes punishable under international law.

• Improved Access to Sexual Assault Forensic Examinations. DOJ dedicated more than $124 million to the National Sexual Assault Kit Initiative, which provides funding to support the inventory, tracking, and testing of previously unsubmitted sexual assault kits; the collection and testing of DNA from arrestees and offenders; and resources to address the cold case sexual assault investigations and prosecutions that result from evidence and Combined DNA Index System hits produced by tested sexual assault kits; among other services. DOJ also provided nearly $18 million to increase access to trained sexual assault medical forensic examiners, improve access to wrap-around care for survivors, and establish regional Sexual Assault Nurse Examiner (SANE) training programs and a Center of Excellence in Forensic Nursing model to prepare current and future SANEs. With $10 million in FY 2024 funding, DOJ implemented a new program to further address nationwide gaps in the availability and quality of post-sexual assault medical forensic care by establishing new SANE/Sexual Assault Forensic Examiner programs, strengthening existing ones, and providing technical assistance to support these programs.

• Expanded Protection Services for Women and Girls in Humanitarian Emergencies. Recognizing that gender-based violence increases dramatically during humanitarian emergencies, the State Department and USAID relaunched the Safe from the Start ReVisioned initiative, which prioritizes improving and expanding GBV prevention, risk mitigation, response efforts, and empowering women and girls in crisis-affected countries. This new iteration, which builds on the original initiative launched in 2013, strengthens the focus on improving and expanding GBV programming and expertise, shifting power to crisis-affected women, and recognizing them as experts, care providers, and leaders.

• Prevented and Responded to Online Harassment and Abuse in the U.S. and Globally. To strengthen support for survivors of online harassment and abuse, the President established and the Vice President launched the White House Task Force to Address Online Harassment and Abuse, which coordinated comprehensive actions from more than a dozen federal agencies and supported a record investment of more than $36 million in dedicated funding to address technology-facilitated gender-based violence in the U.S. and globally. In addition, the President’s Executive Order on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence directed federal agencies to address deepfake image-based abuse. And, following the Vice President’s leadership in underscoring the urgent need to address deepfake image-based sexual abuse and the White House Call to Action to Combat Image-Based Sexual Abuse, the Administration announced a set of voluntary commitments from AI model developers and data providers to curb the creation of image-based sexual abuse and proactively reduce the risk of new images from being generated without someone’s consent as well as ensure that known, verified instances of image-based sexual abuse are excluded from their products and systems.

To strengthen support for survivors globally, the Administration launched and co-leads the 16-country Global Partnership for Action on Gender-Based Online Harassment and Abuse. Through this Global Partnership, the Administration advanced global policies to address online safety for women and girls by shaping a range of multilateral policy instruments tackling online harms through the G7, G20, APEC, and UN. The Administration also invested at least $15 million in targeted funding to prevent and respond to technology-facilitated gender-based violence and counter its chilling effects on women leaders and democratic participation as part of our emphasis on supporting democracies globally, including through new initiatives to provide support to women leaders who have experienced extreme threats or forms of online violence.

• Combat Human Trafficking. The Administration released an updated National Action Plan to Combat Human Trafficking laying out an integrated federal response to human trafficking as well as a National Human Trafficking Prevention Framework. DOJ also disseminated more than $190 million in funding to combat human trafficking and support survivors and released updated guidelines for its employees who work with victims and witnesses of crime to provide enhanced protections for survivors of domestic violence, sexual assault, stalking, and human trafficking and for other vulnerable victims. Separately, the Department of Homeland Security adopted a victim-centered, trauma-informed, and culturally sensitive approach to protecting survivors; finalized a rule to strengthen the integrity of the T nonimmigrant visa process; and established a process to conduct bona fide determinations and provide employment authorization and deferred action to noncitizen victims of crime, including domestic violence, sexual assault, and stalking, with pending petitions for U nonimmigrant status for those who met certain standards.

Promoted Women’s Representation, Leadership, and Political Participation

As Vice President Harris has said, “the status of women is the status of democracy.” We know that the status of women and the stability of nations are inextricably linked and that wherever the rights of women and girls are under threat, so too are democracy, peace, and stability. It is why President Biden established the first-ever White House Gender Policy Council and why the Council developed the National Strategy on Gender Equity and Equality to guide the Administration’s efforts to advance gender equity, defend women’s rights, and elevate women’s civic and political participation and leadership at home and abroad.

• Assembled the First-Ever Gender-Balanced Cabinet in Our Nation’s History. The Administration reached gender parity in the Cabinet for the first time ever. The President appointed a record number of women and people of color—including the first woman to serve as Treasury Secretary, the first woman to serve as Director of National Intelligence, the first Native American woman to serve in the Cabinet, and the first openly transgender Senate-confirmed federal official.

• Appointed Judges Who Reflect the Diversity of Our Country. President Joe Biden set an historic precedent by appointing more non-white and female judges to the federal judiciary than any other president in U.S. history. Since January 2021, the Senate confirmed 235 of President Biden’s nominees to lifetime federal judgeships. This is the largest number of confirmations in a single Presidential term since the 1980s. Of the 235 individuals who have been confirmed to lifetime positions on federal courts, 63% are women, and 60% are people of color. President Biden appointed more women, including more Black women, and more LGBTQ judges than any other administration in history. In April 2022, Ketanji Brown Jackson was confirmed by the United States Senate as Associate Justice of the Supreme Court, the first Black woman to ever serve on the Court.

• Strengthened the Federal Government’s Recognition of Women’s History. In 2024, President Biden established the Frances Perkins National Monument in Newcastle, Maine, to honor the historic contributions of America’s first woman Cabinet Secretary and the longest-serving Secretary of Labor. In addition, the Department of the Interior announced five new National Historic Landmarks that increase the representation of women’s history in historic sites across America; announced $500,000 to support the renovation of the Seneca Falls Knitting Mill, the current site of the National Women’s Hall of Fame; and issued a report on representation of women across sites of national importance, including National Historic Landmarks, national monuments, and national park sites. The President also signed into law the Women’s Suffrage National Monument Location Act, authorizing the placement of a monument honoring women’s suffrage on the National Mall. These actions advanced President Biden’s Executive Order to strengthen the National Park Service’s recognition of women’s history, helping to increase the representation of women’s history in sites across America and honor the legacy and contributions of women and girls to our country.

• Broke Barriers for Servicewomen. President Biden eliminated obstacles to women’s military service, including by advancing historic military justice reforms; updating military hair, dress, and fitness standards; and expanding parental leave policies. Women commanders also rose to unprecedented ranks, including Admiral Lisa Franchetti, the first woman to serve as the Chief of Naval Operations and on the Joint Chiefs of Staff; and Admiral Linda Fagan, the first woman to hold the rank of four-star admiral and serve as Commandant of the U.S. Coast Guard and Service Chief of any U.S. military service.

• Advanced Women’s Political and Civic Participation Globally. Since the first Summit for Democracy in 2021, the Administration prioritized efforts to dismantle barriers to women’s political participation and build the pipeline of women leaders. On the margins of the NATO 75th Anniversary Summit, the Administration launched Women Leading Effective and Accountable Democracy in the Digital Age (Women LEAD) to further advance women’s political participation and leadership as a pillar of our efforts to promote security and democratic stability. The United States and partners made over $900 million in commitments to invest in programs that build and sustain a diverse pipeline of women leaders, address barriers to women’s participation in public life online and offline, and establish a global community of practice of leaders and organizations working to advance women’s political and civic participation.

• Promoted Women’s Participation in Peace and Security Efforts. The President and Vice President made historic advances in strengthening women’s meaningful participation in national security, defense, and political leadership and reaffirmed that commitment with the release of the 2023 Women, Peace, and Security (WPS) Strategy and National Action Plan. The strategy reflects critical shifts in our global landscape, including an emphasis on threats to women leaders posed by technology-facilitated gender-based violence and gendered disinformation, which is strategically deployed by state and non-state actors to destabilize democracies. The Department of State also announced and has since invested nearly $2 million to provide technical assistance to WPS Centers of Excellence, which will strengthen relationships and facilitate consultations between governments and civil society stakeholders to develop strategies, approaches, and solutions to implementing WPS principles in practice. The project will also leverage networks of WPS experts and leaders to foster learning, deepen collaboration, and raise awareness of WPS issues through existing and future WPS Centers in Kosovo, Colombia, and The Philippines. In addition, the Administration:

• Updated NATO Policy on Women, Peace, and Security (WPS). As host of the NATO 75th Anniversary Summit, the Administration prioritized WPS, recognizing that the status of women is inextricably linked to the stability of nations—and therefore critical to NATO’s present and future effectiveness. At the Summit, Allies formally endorsed an updated policy to build on NATO’s long-standing commitment to WPS. The 2024 policy addressed new security threats, including technology-facilitated gender-based violence and the misuse of new and emerging technologies, climate security, and conflict-related sexual violence, and also notes Russia’s war of aggression against Ukraine and the threats it poses specifically to women on the frontlines of the conflict.

• Equipped Ukrainian Servicewomen with Military Gear. At the Anniversary Summit, Allies announced historic contributions through the Comprehensive Assistance Package (CAP) to provide women’s body armor, boots, and uniforms to the Ukrainian armed services to further NATO’s non-lethal support to Ukraine and commitment to supporting women’s full and equal participation in defense and security. This action marked the first time Allies directed resources through CAP to advance Women, Peace, and Security objectives.

• Invested in Efforts to End Child Marriage Globally. On International Day of the Girl in 2024, the Administration announced investments of nearly $86 million to prevent and respond to child, early, and forced marriage globally. These programs help equip girls and young women with education and workforce readiness skills; mitigate harmful effects of child marriage through education, health, legal, and economic support; and raise awareness of the risks and harms associated with child marriage. In addition, for the first time, the United States contributed to the United Nations Children’s Fund–UNFPA Global Programme to End Child Marriage, which works in 12 countries in Africa and South Asia to promote the rights of adolescent girls.

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Over the past four years, President Biden and Vice President Harris leveraged the full force of the federal government to advance rights of and opportunities for women and girls across the country and around the globe. From defending reproductive freedom, delivering the highest women’s labor force participation on record, making historic investments in the care economy, and lowering drug prices for women with Medicare to fighting to end violence against women, advancing the human rights of women and girls globally, and promoting women’s political participation and leadership, President Biden and Vice President Harris invested in the future of women and girls.

Defended Reproductive Freedom

With reproductive freedom under attack, President Biden and Vice President Harris fought to ensure that women across the country are able to make deeply personal health care decisions and access the reproductive health care they need. Since Roe v. Wade was overturned, the President and Vice President called on Congress to restore the protections of Roe in federal law. President Biden also signed three Executive Orders and a Presidential Memorandum directing his Administration to protect access to reproductive health care and established the White House Task Force on Reproductive Healthcare Access to coordinate these efforts across agencies.

• Protected Access to Medication Abortion. In 2023, the Food and Drug Administration (FDA) took independent, evidence-based action to allow mifepristone—a safe and effective drug used in medication abortion that FDA first approved more than 20 years ago—to be prescribed by telehealth and sent by mail and to enable interested pharmacies to become certified to dispense the medication. As a result of the new pathway established by FDA, many pharmacies across the country, including major retail pharmacy chains, became certified to dispense medication abortion, giving many women the option to pick up their prescription for medication abortion at a local, certified pharmacy just as they would for any other medication. The FDA and the Department of Justice (DOJ) also defended FDA’s independent, expert judgment, including in a lawsuit before the U.S. Supreme Court that attempted to curtail access to mifepristone nationwide. And the Administration took action to support patients, providers, and pharmacies who wish to legally access, prescribe, or provide medication abortion, consistent with a Presidential Memorandum issued by President Biden on what would have been the 50th anniversary of Roe v. Wade.

• Defended Access to Emergency Abortion Care. The Administration fought to ensure that all patients, including women who are experiencing pregnancy loss and other pregnancy-related emergencies, have access to the full rights and protections for emergency medical care afforded under the Emergency Medical Treatment and Labor Act (EMTALA)—including abortion care when that is the stabilizing treatment required. To educate health care providers on their rights and obligations for emergency medical care, the Department of Health and Human Services (HHS) issued guidance and sent letters to health care provider associations affirming the Administration’s view that EMTALA preempts conflicting state law restricting access to abortion in emergency situations. DOJ defended that interpretation, including in litigation before the Supreme Court.

HHS has enforced EMTALA and helped ensure that patients facing all types of medical emergencies receive the care to which they are entitled. As part of its comprehensive plan to educate all patients about their rights and to help ensure hospitals meet their obligations under federal law, HHS launched a new option on CMS.gov, in both English and Spanish, to enable individuals to more easily file an EMTALA complaint; developed new accessible and understandable resources about patient rights and protections under EMTALA and the process for submitting a complaint; disseminated training materials and new model signage for health care providers; and established a dedicated team of experts to increase HHS’s capacity to support hospitals and providers in complying with federal requirements.

• Defended the Right to Travel. On the day the Supreme Court overturned Roe, President Biden reaffirmed the Attorney General’s statement that women must remain free to travel safely to another state to seek the care they need. DOJ filed statements of interest in litigation challenging the Alabama Attorney General’s threat to prosecute people who provide assistance to women seeking lawful out-of-state abortions. DOJ explained that the threatened Alabama prosecutions infringe the constitutional right to travel and made clear that states may not punish third parties for assisting women in exercising that right. DOJ also monitored states’ efforts to restrict the constitutional right to travel across state lines to receive lawful health care.

• Strengthened Access to Affordable, High-Quality Contraception. In response to directives from President Biden—including an Executive Order issued nearly one year after the Supreme Court’s decision to overturn Roe—the Administration improved contraception access and affordability under the Affordable Care Act, through Medicare and Medicaid, through federal health centers, and for Service members, veterans, federal employees, and college students. For instance, the Departments of the Treasury, Labor, and HHS issued new guidance to support expanded coverage of a broader range of FDA-approved contraceptives at no cost under the Affordable Care Act; proposed rules to strengthen access to contraception for women with private health insurance; and bolstered the standard for inclusion of family planning providers in Marketplace plan provider networks under the Affordable Care Act. HHS issued new guidance and letters to state Medicaid programs and Children’s Health Insurance Programs to outline existing state obligations to help ensure that enrollees can access family planning services; updated the Medicare Part D formulary clinical review process to include additional contraceptive types; and adopted new data measures for federal health centers to help enhance the overall delivery of voluntary family planning and related services. And FDA approved the first daily oral contraceptive for over-the-counter use, which is now widely available nationwide.

• Bolstered Family Planning Services by Rebuilding the Title X Family Planning Program. The Administration rebuilt and grew the Title X Family Planning Program, which has played a critical role in ensuring access to a broad range of high-quality family planning and preventive health services for more than 50 years. During the prior administration, more than 1,000 service sites left the Title X Family Planning Program, leading to a significant decline in people served. The Administration reversed changes that led to those departures, strengthening the Title X Family Planning Program and helping safeguard this critical part of the nation’s health safety net. In 2023, the Administration provided about $287 million to nearly 4,000 Title X providers across the country to provide free or low-cost voluntary planning and related preventive services for 2.8 million women and families—an 80% increase since 2020.

• Safeguarded the Privacy of Patients and Health Care Providers. HHS issued new rules to strengthen privacy protections for information related to reproductive health care under the Health Insurance Portability and Accountability Act (HIPAA) and to support health care providers in protecting patients’ electronic health information. HHS also issued a how-to guide on steps that consumers can take to better protect their data on personal cell phones or tablets and when using mobile health apps, which are generally not protected by HIPAA. The Federal Trade Commission clarified the health breach notification rule’s applicability to health apps and other similar technologies and took enforcement action against companies for disclosing consumers’ personal health information, including highly sensitive reproductive health data, without permission. The Department of Education issued guidance to over 20,000 school officials to remind them of their obligations to protect student privacy and issued a know-your-rights resource to help students understand their privacy rights for health records at school. And the Federal Communications Commission launched a guide for consumers on best practices for protecting their personal data, including geolocation data, on mobile phones and strengthened data breach rules to provide greater protections to personal data.

• Protected Access to Reproductive Health Care for Veterans and Service Members. The Department of Veterans Affairs (VA) revised its regulations to provide abortion counseling and, in certain circumstances, abortion care to veterans and VA beneficiaries and eliminated out-of-pocket costs for certain types of contraception through the Civilian Health and Medical Program. And the Department of Defense (DoD) took action to ensure that Service members and their families can access reproductive health care and that the Department’s health care providers can operate effectively. DoD issued new policies to support Service members and their families’ ability to travel for lawful reproductive health care, to bolster Service members’ privacy, and to afford Service members the time and space needed to make personal health care decisions. DoD also expanded walk-in contraceptive care services for active-duty Service members and other Military Health System beneficiaries and eliminated TRICARE copays for certain contraceptive services.

• Supported Access to Fertility Care, Including IVF. In the face of threats and extreme attacks on fertility services, the Administration supported access to fertility care, including in vitro fertilization (IVF)—an important aspect of reproductive health care. DoD and the VA expanded eligibility for IVF services for certain Service members and veterans. And the Office of Personnel Management significantly expanded access to IVF benefits and coverage to support federal workers in growing their families. For 2025, federal employees and their families—regardless of where they live—were able to choose from multiple nationwide plan options that offer comprehensive IVF coverage.

• Partnered with State Leaders on the Frontlines of Abortion Access. The White House partnered with leaders on the frontlines of protecting access to abortion—both those fighting extreme state legislation and those advancing proactive policies to protect access to reproductive health care, including for patients who are forced to travel out of state for care. The Vice President led these efforts, highlighting the harm of abortion bans to women’s health at more than 100 events in over 20 states and meeting with hundreds of state legislators, health care providers, and advocates. And, on what would have been the 51st anniversary of Roe, the Vice President launched her nationwide Fight for Reproductive Freedoms tour to continue fighting back against extreme attacks throughout America.

• Supported Sexual and Reproductive Health Globally. While defending reproductive freedom domestically, the Administration remained steadfast in supporting sexual and reproductive health and rights globally. The January 2021 Presidential Memorandum on Protecting Women’s Health at Home and Abroad revoked the expanded global gag rule, restored life-saving funding to the United Nations Population Fund (UNFPA), and required that adequate funds be directed to support women’s health needs globally, including for sexual and reproductive health services. During this Administration, the United States remained the largest bilateral donor to global family planning assistance—a commitment spanning more than five decades. And we worked to accelerate access to family planning and prevent maternal mortality—providing over $1.7 billion to support global maternal and child health programs and over $1.8 billion to support global family planning and reproductive health programs from FY 2021 to FY 2023.

Improved Women’s Health and Addressed Health Disparities

The President and Vice President believe that health care is a right, not a privilege, and expanded health care access for millions more Americans while also lowering health care costs. The Administration built on, strengthened, and protected Medicare, Medicaid, and the Affordable Care Act, and the President’s American Rescue Plan and the Inflation Reduction Act lowered prescription drug costs and health insurance premiums. The President and First Lady led the way in fundamentally changing how we approach and fund women’s health research to pioneer the next generation of discoveries in women’s health. And the Vice President led the Administration’s efforts to address the nation’s maternal health crisis.

• Lowered Drug Prices for Millions of Women. The Administration fought to ensure that no American has to choose between paying for medications they need to live, or paying for other basic necessities. President Biden took on Big Pharma to lower prescription drug costs, saving millions of seniors money on health care and reducing the cost of insulin to $35 per monthly prescription for people with Medicare. For the first time in history, Medicare reached agreements on new, lower prices with the manufacturers of ten drugs selected for the first round of drug price negotiation. These drugs are used to treat many common diseases and conditions that affect women, including blood clots, diabetes, cardiovascular disease, heart failure, autoimmune conditions, and chronic kidney disease, and are taken by 9 million seniors, including 4.5 million women. When these lower prices go into effect, people on Medicare will save $1.5 billion in out-of-pocket costs for their prescription drugs, and Medicare will save $6 billion in the first year alone.

• Lowered Health Care Premiums under the Affordable Care Act. Today, more Americans have health insurance than under any previous President, and enrollment in Affordable Care Act Marketplace coverage nearly doubled during the last four years. Ahead of the end of the 2025 open enrollment period, the Administration set an all-time record for Affordable Care Act Marketplace enrollment, with nearly 24 million Americans signing up for coverage. And women made up more than half of the record-breaking number of people with Affordable Care Act coverage for 2025. Thanks to the American Rescue Plan and Inflation Reduction Act, millions of women and working families saved an average of $800 per year on health insurance premiums.

• Closed Gaps in Women’s Health Research. Recognizing that research on women’s health remains underfunded and understudied, President Biden launched the first-ever White House Initiative on Women’s Health Research led by First Lady Jill Biden and the White House Gender Policy Council to spur innovation, unleash transformative investment to close research gaps, and improve women’s health. The First Lady announced nearly $1 billion in new federal investments in women’s health research galvanized by the Initiative, including through the Advanced Research Projects Agency for Health’s first-of-its-kind Sprint for Women’s Health. The President called on Congress in the State of the Union to make a record $12 billion investment in women’s health research, and he signed an Executive Order directing the most comprehensive set of executive actions ever taken to expand and improve research on women’s health. In December, the First Lady convened a White House Conference on Women’s Health Research.

• Improved Maternal Health Outcomes. Under the Vice President’s leadership, the Administration took action to improve maternal health and eliminate racial disparities by reducing pregnancy-related complications and mortality, which disproportionately impact Black, Indigenous, and rural women.

• Addressed the Maternal Health Crisis. In June 2022, the Vice President announced the Blueprint for Addressing the Maternal Health Crisis, a comprehensive effort to combat maternal mortality and morbidity. Since the Blueprint was released, the Administration has made significant strides in improving maternal health for women across the country. Over the past four years, HHS launched a new Birthing-Friendly designation to identify hospitals and health systems that deliver high-quality, evidence-based maternity care; announced a new Transforming Maternal Health Model to help develop and implement a whole-person approach to care; established the first-ever baseline federal health and safety requirements for maternal emergency and obstetric services; expanded funding for Maternal Mortality Review Committees; and took action to grow and support the maternal health workforce.

• Helped Women and Families Access Critical Maternal Health Services. Since Vice President Harris issued a call to action in 2021, to date, 47 states, the District of Columbia, and the U.S. Virgin Islands have extended Medicaid postpartum coverage from two to 12 months of post-pregnancy care. This coverage option was first made possible by President Biden’s American Rescue Plan and then made permanent by the Consolidated Appropriations Act of 2023. In addition, four new states adopted the Affordable Care Act’s expansion of Medicaid, covering over a million people, many for the first time. The Administration also expanded maternity care for veterans, who now have access to maternity care coordinators through 12 months postpartum, helping connect veterans with care after delivery, follow-up screenings, and mental health support.

• Tackled the Mental Health Crisis. As part of the President’s Unity Agenda, the Administration took action to transform how mental health is understood, accessed, treated, and integrated in and out of health care settings. Thanks to the Bipartisan Safer Communities Act, the Administration delivered the largest investment in school-based mental health services ever, providing nearly $1 billion to help train and hire an additional 16,000 mental health professionals to work in America’s K-12 schools. HHS also launched FindSupport.gov and 988, the Nationwide Suicide and Crisis Lifeline, which has connected millions of Americans in crisis to immediate, confidential, and free care from trained counselors. Additionally, HHS prioritized maternal mental health, including by launching the National Maternal Mental Health Hotline (1-833-TLC-MAMA) to help tens of thousands of perinatal women access needed support, the Task Force on Maternal Mental Health, and the Talking Postpartum Depression public education campaign and learning collaborative.

• Addressed Girls’ Risk of HIV/AIDS Globally. Under this Administration, the President’s Emergency Plan for AIDS Relief (PEPFAR) focused on addressing health equity for vulnerable populations globally – including adolescent girls and young women, children and other key populations. The Administration expanded DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) – a public-private partnership launched as part of PEPFAR in 2014 – to reach more adolescent girls and young women with HIV prevention services, investing approximately $360 million to reach over 2.9 million girls and young women across 15 countries.

• Improved Maternal Health Globally. USAID’s maternal and child health and nutrition programs have played a pivotal role in saving millions of lives by driving down mortality rates through improved health care access and delivery. From FY 2021 to FY 2023, the Department of State and USAID invested more than $7 billion in global health programming to prevent child and maternal deaths. In 2023, USAID supported 12 million women to give birth at health facilities receiving U.S. government assistance and reached 11 million pregnant women with nutrition counseling services.

• Invested in the Global Health Worker Initiative. The Administration launched the Global Health Worker Initiative (GHWI), recognizing that a health workforce that is supported, equipped, and protected to provide essential public health functions is integral to reclaiming lost ground from the COVID-19 pandemic and preparing for future health threats. Through the GHWI, we better aligned investments in health workers across the U.S. government, built stronger partnerships on the health workforce with bilateral partners, multilateral institutions, including the World Health Organization, and other philanthropic partners, and reoriented our global health programs toward cohesive efforts that build stronger and more resilient health systems.

Strengthened Women’s Economic Security

The Administration invested in America’s future by ensuring women have access to good jobs and safe workplaces free from discrimination. The President’s economic agenda led to historic gains in women’s labor force participation. Globally, we supported women’s economic security by promoting women’s access to jobs in sectors critical to the future of our planet and closing the gender digital divide.

• Achieved the Lowest Average Women’s Unemployment Rate of Any Administration on Record. The Administration’s economic plan led to an historic recovery in working-age women’s labor force participation in the United States, bringing it to the highest it has ever been on record since 1948. Since President Biden took office in January 2021, the women’s unemployment rate had its fastest calendar-year drop on record that year, dropping to the lowest annual unemployment rate in 70 years in 2023. Under the President’s and Vice President’s leadership, there was a dramatic reduction in Black and Latina women’s unemployment. There are now roughly 2.5 million more Hispanic women and more than 1 million Black women employed than there were at the start of the Administration.

• Ensured Women Have Access to Good-Paying, High-Quality Jobs. The Administration’s once-in-a generation Investing in America agenda is creating millions of good-paying jobs, helping to ensure that women, people of color, and other communities currently underrepresented in the industries of the future have equitable access to these jobs. President Biden signed Executive Orders to invest in America’s workers by directing his Administration to promote strong labor standards; expand and diversify registered apprenticeship programs; help ensure that federal funding applicants provide supportive services for workers; and encourage worker organizing and collective bargaining. For instance, the Department of Commerce launched the Million Women in Construction initiative, which called on chip manufacturers, construction companies, and unions to bring one million women into the construction industry over the next decade, roughly doubling women’s representation in the industry. The Department of Labor (DOL) launched the Mega Construction Project Program, which fosters equal employment opportunities for qualified workers, including women, on certain federally funded construction projects. And the Administration invested more than $730 million in registered apprenticeships, leading to more than 1 million registered apprentices, including over 100,000 women, receiving gold standard earn-as-you-learn training for in-demand jobs.

• Advanced Pay Equity for Federal Workers. President Biden and Vice President Harris know that closing wage gaps is critical to strengthening and growing the economy. To advance pay equity within the federal workforce, the Office of Personnel Management ensured that more than 80 federal agencies no longer consider an individual’s non-federal pay when determining their salary. The consideration of compensation history in pay-setting decisions has exacerbated pay inequities, disproportionately harming women and people of color. Banning this practice is a proven way to curb pay discrimination that often follow workers from job to job.

• Lifted the Burden of Student Debt for 5 Million Americans. From day one of his Administration, President Biden vowed to fix the student loan system and make sure higher education is a pathway to the middle class—not a barrier to opportunity. Over the past four years, the Administration approved debt cancellation for nearly 5 million Americans, totaling over $179 billion in debt relief through various actions. Life-changing relief is especially important for women who carry nearly two-thirds of all student loan debt.

• Supported Women-Owned Small Businesses. In FY 2024, the Small Business Administration (SBA) backed 15,500 loans to businesses that are more than 50% owned by women, for a total of $5.6 billion. The growth in loans reflects a doubling in women-owned business participation from 2020 to 2024. And women’s small business formation surged during the Administration, substantially outpacing overall small business formation. We invested $100 million in the Women Business Centers (WBC) network, expanding it for the first time into all 50 states and tripling the number of WBCs at Historically Black Colleges and Universities, Hispanic-Serving Institutions, and other minority-serving institutions. Through the American Rescue Plan, the Administration invested $10 billion to help states, territories, and Tribal governments leverage even more in matching public and private dollars to support small businesses across the United States, with a particular focus on historically underserved entrepreneurs, including women business owners. And the Administration awarded the highest single year and average annual amount of contracting dollars to women-owned small businesses, including $30.9 billion in FY 2023 alone.

• Ensured Pregnant and Postpartum Workers Have Workplaces Free from Discrimination. The President signed into law bipartisan protections for pregnant and post-partum workers. The Pregnant Workers Fairness Act (PWFA) provides basic, long-overdue protections that promote safe, healthy workplaces free from discrimination. The Equal Employment Opportunity Commission (EEOC) issued regulations implementing the PWFA to ensure pregnant and postpartum workers have access to common-sense, reasonable accommodations that enable them to stay in the workforce while pregnant or as a new mother. The President also signed the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act, which provides most nursing workers with the right to reasonable break time and a place, other than a bathroom, that is shielded from view and free from intrusion to express breast milk while at work. DOL is enforcing the PUMP Act and has issued educational resources for workers and employers. EEOC and DOL also issued a joint resource to help ensure that workers and employers understand their rights and responsibilities under the PWFA and PUMP Act.

• Promoted Women’s Economic Security Globally. The Administration mobilized over $3 billion in public and private resources to advance women’s economic security around the world and prioritized closing persistent gaps in women’s economic participation globally that hinder their ability to participate in a 21st century economy. In 2021, the Administration established the Gender Equity and Equality Action Fund to advance economic security for women and girls and address barriers that limit their full economic participation. Through the Fund, which invested $500 million in direct and attributed indirect resources around the world, the Administration committed to three flagship public-private partnerships to tackle persistent barriers to women’s economic participation. These initiatives include:

• $2 Billion to Support Women’s Participation in Green and Blue Industries. Vice President Harris announced the Women in the Sustainable Economy Initiative—a public-private partnership between governments, the private sector, philanthropies, multilateral organizations, and civil society—to promote women’s access to jobs, training, leadership roles, and financial resources in industries that are critical to the fight against climate change. Thirty-three governments, corporations, foundations, and civil society organizations committed over $2 billion to WISE, including more than $900 million committed by the U.S. government.

• $1 Billion to Help Cut the Gender Digital Divide in Half by 2030. In 2023, the United States secured an historic commitment in the G20 New Delhi Leaders’ Declaration and the APEC Leaders’ Golden Gate Declaration to cut the digital gender gap in half by 2030. To help reach this goal, Vice President Harris launched the Women in the Digital Economy Initiative, a public-private partnership with more than $1 billion in commitments from forty-nine government, private sector, and civil society partners to accelerate progress to close the gender digital divide and fully enfranchise women in our globalized, networked economy.

• Supported Job Creation for Women Globally. Vice President Harris and the Partnership for Central America launched “In Her Hands,” a women’s economic empowerment initiative that mobilized $113 million in private sector funding to advance economic security for women. By 2030, the initiative aims to support and provide opportunities for 5 million women across Guatemala, El Salvador, and Honduras by creating jobs, providing training on technical skills, promoting access to financial assistance, and offering programs focused on manufacturing of textiles and apparel and agricultural regeneration.

Invested in Care at Home and Abroad

The Administration took action to increase access to affordable, high-quality care for families and to support caregivers and care workers. When we invest in care, we allow parents— especially women—to participate fully in the workforce; recognize the value of care workers and care providers, who are disproportionately women and women of color; and strengthen the economy. In 2021, the President’s American Rescue Plan helped child care centers and family child care providers, which are mostly small businesses, remain open or reopen during the pandemic. And, since 2021 the Administration secured an additional $4 billion for the Child Care Development Block Grant and Head Start. President Biden also issued an historic Executive Order that directed the most comprehensive set of executive actions ever taken to expand access to affordable, high-quality care, and support care workers and family caregivers. And the President continued to call on Congress to provide guaranteed affordable, high-quality child care from birth until kindergarten and a national, comprehensive paid family and medical leave program.

• Made High-Quality Child Care More Affordable. The Administration helped ensure that families have access to high-quality, affordable care. HHS finalized a rule strengthening the Child Care and Development Block Grant program and lowering child care payments for more than 100,000 families receiving federal child care assistance. Under this landmark rule, families will pay no more than 7% of income, saving families in states that do not yet cap copayments over $200 a month of average. In addition, in implementing the CHIPS and Science Act, the Department of Commerce required applicants for semiconductor incentives requesting over $150 million in direct funding to submit plans to provide accessible, affordable, high-quality child care. This first-of-its kind commitment is helping get more people—especially women—into good-paying manufacturing jobs, and helping more employers recruit and retain a diverse, skilled workforce. More than three-quarters of all companies that have signed CHIPS awards or preliminary memoranda as of December 2024 are working to provide child care offerings for their workforce—including many smaller grant applicants that are doing so voluntarily.

• Improved Long-Term Care and Support Family Caregivers. The Administration remained committed to protecting the health and dignity of older adults and people with disabilities. HHS issued new rules to ensure home care workers get a larger share of Medicaid payments and establish minimum staffing standards in nursing homes receiving Medicare and Medicaid funding. The Administration delivered $37 billion in American Rescue Plan funds across all 50 states to enhance, expand, and strengthen home and community-based care, and $145 million to help the National Family Caregiver Support Program deliver counseling, training, and short-term relief to family and other informal care providers. The Administration also developed the first-ever National Strategy to Support Family Caregivers, which outlines the more than 350 actions being taken by 15 federal agencies in support of family caregivers. HHS published a guide to help older women find programs and services—such as respite care and counseling—to help maintain their health and well-being while being a caregiver for others. And VA launched a program to provide mental health counseling services to family caregivers caring for our nation’s heroes.
• Invested in Care Infrastructure and Supported Caregivers and Care Workers. The Administration helped raise the wages and quality of care worker jobs, and invested in care infrastructure. SBA announced new funding opportunities to support small businesses in the child care sector and launched a lender campaign to highlight SBA resources to support small, minority-owned, and women-owned businesses, including child care businesses; the Department of the Treasury provided resources to address barriers for child care businesses that need to secure financing. The Administration also took action to ensure Service members and military spouses—the vast majority of whom are women—have the support they need to care for themselves and their families while serving our country, including by strengthening the hiring and retention of military spouses across the federal government, and expanding access to child care and other employment resources. And DOL published sample employment agreements so domestic home care, child care, and long-term care workers and their employers can help ensure all parties better understand their rights and responsibilities.

• Leveraged More Than $500 Million in Projected Funding to Boost Women’s Employment by Investing in Child Care. Through the Invest in Childcare Initiative—a public-private partnership with more than $500 million in leveraged funding between the World Bank, the governments of Canada, Germany, Australia, and the United States, domestic government resources, the Bill & Melinda Gates Foundation, and several others—the Administration incentivized investment in child care infrastructure in low- and middle-income countries, which will boost women’s employment and overall economic growth. And in 2024, the United States secured an historic commitment in the G7 Apulia Leaders’ Communiqué to tackle the unequal gender distribution of care work with G7 nations committing to support 200 million more women to join the workforce by 2035 through investment in child care globally.

• Supported Care Workers Globally. At the 68th Session of the Commission on the Status of Women, USAID announced a new Memorandum of Understanding with the Ford Foundation and the Care for All with Respect and Equity (CARE) Fund to partner in advancing decent work for care workers worldwide. USAID, the Ford Foundation, and the CARE Fund are partnering to fund “Together We Care: Partnerships for Equitable Health Systems,” an activity implemented by UNI Global Union. This partnership builds on USAID’s previously pledged $4 million and will advance women’s economic security and resilient health and care systems. USAID is supporting programming in Colombia, the Dominican Republic, Ghana, and the Philippines, with partners supporting additional programming in Brazil.

Addressed Gender-Based Violence

Working to end gender-based violence has been a cornerstone of President Biden and Vice President Harris’ careers, and the Administration has worked to prevent and end gender-based violence wherever it occurs—at home, at work, in the military, in schools, in communities, and online. From signing historic legislation to issuing new Executive Orders and Presidential Memoranda to securing significant funding for domestic violence and sexual assault services to combating conflict-related sexual violence, the Administration made significant progress in reducing violence and supporting survivors. The Administration’s efforts were guided by the first-ever U.S. National Plan to End Gender-Based Violence, a whole-of-government, intersectional approach to preventing and addressing sexual violence, intimate partner violence, stalking, and other forms of gender-based violence.

• Reauthorized the Violence Against Women Act. President Biden strengthened the Violence Against Women Act (VAWA)—landmark bipartisan legislation that he wrote and championed as a U.S. Senator and has worked across the aisle to strengthen ever since—by signing into law the VAWA Reauthorization Act of 2022. This critical legislation expands access to safety and support for survivors, increases prevention efforts, and establishes new federal protections against online harassment and abuse. The President and Vice President also secured the highest-ever funding levels to implement VAWA and increased funding for VAWA programs by over 35% since 2021. The Administration swiftly implemented the VAWA Reauthorization Act of 2022 by:

• Protecting and Supporting Survivors of Gender-Based Violence. DOJ awarded more than $690 million in VAWA grants and cooperative agreements in FY 2024 for more than 40 grant programs and initiatives to help states, Tribes, territories, law enforcement, victim advocates, and community-based organizations address gender-based violence. This includes more than $40 million to implement new grant programs established by the VAWA Reauthorization Act of 2022, including trauma-informed training for law enforcement, pilot programs for serving protection orders electronically, strategies to address technology-facilitated gender-based violence, and victim-centered and trauma-informed restorative practices programs that address gender-based violence.

• Supporting the Housing Needs of Survivors of Domestic Violence, Sexual Assault, Dating Violence, and Stalking. In 2024, five federal agencies issued an interagency statement to affirm VAWA’s housing protections for survivors of domestic violence, sexual assault, dating violence, and stalking as well as other individuals, such as those who assist survivors. The Department of Housing and Urban Development (HUD) also established a new Office on Gender-Based Violence, as directed by the VAWA Reauthorization Act of 2022, to coordinate and implement policies and programs to address the safe housing and economic stability needs of survivors and awarded $10 million to provide VAWA training and technical assistance to housing grantees, owners, and managers. HUD also published a first-of-its-kind report on the housing needs of survivors of human trafficking, as required by the VAWA Reauthorization Act of 2022, and a fact sheet that applies the report’s findings to help assist youth trafficking survivors and youth at risk of trafficking with housing needs.

• Expanding Access to Justice and Strengthening Gender-Based Violence Protections for Tribal Communities. DOJ awarded more than $85 million in FY 2024 VAWA grants and more than $68 million in FY 2023 VAWA grants to provide services and promote justice for survivors in Native communities. In making these awards, DOJ took new measures to increase access to the Tribal Governments Grant Program. DOJ also supported Tribal implementation of new provisions in the VAWA Reauthorization Act of 2022 that recognized expanded special Tribal criminal jurisdiction over non-Native perpetrators of sexual violence, child violence, stalking, assaults on Tribal law enforcement officers, and sex trafficking on Tribal lands, in addition to domestic and dating violence. These efforts included launching a new Special Tribal Criminal Jurisdiction Reimbursement Program and a pilot program to support Alaska Native Tribes that want to exercise special Tribal criminal jurisdiction over non-Indian offenders for certain crimes, including crimes of sexual and domestic violence.

• Addressing Online Harassment and Abuse. To support survivors of image-based abuse, DOJ funded the first-ever national helpline to provide 24/7 support and specialized services for victims of the non-consensual distribution of intimate images. Operated by the Cyber Civil Rights Initiative, the Image Abuse Helpline and Online Safety Center significantly expanded support to survivors of online harassment and abuse, meeting the rising need for services to address the non-consensual creation and distribution of intimate images. DOJ also awarded about $5.5 million in new grant funds to support local law enforcement in prosecuting cybercrimes against individuals and funded a new National Resource Center on Cybercrimes Against Individuals that was authorized by the VAWA Reauthorization Act of 2022 to help law enforcement, prosecutors, and victim services organizations prevent, enforce, and prosecute cybercrimes against individuals. DOJ also distributed resources to United States Attorneys’ Offices and national legal and service organizations to raise awareness of the new provision in the VAWA Reauthorization Act of 2022 that created a federal civil cause of action to address the non-consensual distribution of intimate images.

• Promoting Prevention and Strengthening Services for Survivors of Sexual Assault. The VAWA Reauthorization Act of 2022 improved prevention and response to sexual violence through additional funding and new protections. In FY 2024, the Centers for Disease Control and Prevention provided more than $49 million to more than 110 state health departments and state, territorial, and Tribal sexual assault coalitions for the Rape Prevention and Education Program. DOJ awarded $51.8 million—a nearly 45% increase in funding from the previous year—to provide victims of sexual assault with services in every state and the District of Columbia, as well as American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the Virgin Islands. Separately, DOJ awarded more than $20 million in FY 2024 to support colleges and universities in preventing and responding to sexual assault, domestic violence, dating violence, and stalking.

The VAWA Reauthorization Act of 2022 also enacted the Fairness for Rape Kit Backlog Survivors Act, which requires state victim compensation programs to allow sexual assault survivors to file for compensation without being unfairly penalized due to rape kit backlogs. And, as directed under the VAWA Reauthorization Act of 2022, the Department of Education—in collaboration with DOJ and HHS—launched a Task Force on Sexual Violence in Education that issued recommendations to schools on ways to improve sexual violence prevention and response on campuses.

• Improving Trauma-Informed and Victim-Centered Investigations and Expanding Pathways to Justice. DOJ implemented a new program authorized in the VAWA Reauthorization Act of 2022 to train law enforcement officers on trauma-informed and victim-centered investigations of gender-based violence and released a new Framework for Prosecutors to Strengthen our National Response to Sexual Assault and Domestic Violence Involving Adult Victims. Separately, DOJ implemented a new program, also authorized in the VAWA Reauthorization Act of 2022, to support, enhance, and expand restorative practice programs that prevent or address domestic violence, dating violence, sexual assault, or stalking, as well as build evidence for victim-centered, trauma-informed, and culturally responsive restorative practices addressing these harms.

• Helped Keep Guns Out of the Hands of Domestic Abusers. President Biden signed the historic Bipartisan Safer Communities Act, the most significant legislation to reduce gun violence in nearly 30 years, that narrowed the “boyfriend loophole.” DOJ worked with states to educate them about the scope of this protection, expanded technical assistance and federal funding opportunities for state and local law enforcement programs that remove firearms from domestic abusers, and is actively reporting denied transactions of firearms purchases to state, local, and Tribal law enforcement within 24 hours. President Biden also established the first-ever White House Office of Gun Violence Prevention, which is overseen by Vice President Harris, to lead the Administration’s efforts to end our nation’s gun violence epidemic. And DOJ successfully defended at the Supreme Court the constitutionality of a federal law that helps keep guns out of the hands of individuals subject to domestic violence protective orders.

• Kept Students Safe and Addressed Campus Sexual Assault. The Department of Education restored and strengthened vital Title IX nondiscrimination protections for students and employees. The Department’s rule provided protection from sex-based harassment, including sexual violence; promoted accountability and fundamental fairness through a transparent and reliable process; and provided clarity to ensure that students, employees, and families understand their rights and that institutions know their responsibilities. The new rule also clarified that schools have a responsibility to address sex discrimination and harassment that occurs under its programs and activities whether the conduct takes place online, in person, or both, and strengthened definitions for sex-based harassment under Title IX to address the growth in technology-facilitated gender-based violence, including AI-generated abuse.

• Implemented Historic Military Justice Reforms to Better Protect Survivors. The Administration removed barriers to women’s advancement, opportunity, and well-being in the U.S. military, including by addressing sexual assault, domestic violence, and sexual harassment in the force. One of President Biden’s earliest acts in office was to call for the establishment of the Independent Review Commission on Sexual Assault in the Military to strengthen accountability and inform reforms to the military justice system. Since 2021, President Biden signed three Executive Orders to implement historic, bipartisan reforms to the military justice system, transferring key decision-making authorities from commanders to specialized, independent military prosecutors in cases of sexual assault, domestic violence, murder, and other serious offenses by amending the Uniform Code of Military Justice. Building on these reforms, DoD implemented additional Independent Review Commission recommendations to improve its response to sexual assault and made record investments in sexual assault prevention and survivor support, more than doubling annual funding from $500 million to more than $1 billion in 2024 for these lifesaving services. This work made a difference: for the first time in nearly a decade, rates of sexual assault and harassment within the active-duty force declined—with a nearly 19% drop in the number of service members who reported experiencing unwanted sexual contact since 2021.

• Invested in Communities to Support Survivors and Save Lives. The President’s American Rescue Plan invested nearly $1 billion in supplemental funding for domestic violence and sexual assault services and supports through the Family Violence Prevention and Services Act Program. The President also signed into law the VOCA Fix Act, which provided more than $1.4 billion for the Crime Victims Fund to support local programs and services for survivors. Since the Victims of Crime Act (VOCA) became law in 1984, we have invested more than $38 billion dollars in local programs that provide mental health, housing, legal assistance, victim advocacy, crisis intervention, and other services to help victims of gender-based violence and other crimes.

• Supported Survivors in Accessing Housing, Homeless Assistance, and Community Services. In 2024, HUD awarded $57 million in Domestic Violence Bonus projects serving survivors of domestic violence, dating violence, sexual assault, stalking, and human trafficking and announced an additional $52 million in Domestic Violence Bonus projects, which will be issued in 2025. HUD also directed Homeless Continuum of Care recipients to offer services to people experiencing trauma or a lack of safety related to gender-based violence, consistent with the new definition of “homeless” for survivors included in the VAWA Reauthorization Act of 2022. And Community Development Block Grant (CDBG) grantees used nearly $13 million of CDBG funds and another $8.3 million of CDBG-CV funds in FY 2023 to support services for survivors of domestic violence, dating violence, sexual assault, or stalking. CDBG funds supported crisis intervention, crisis hotline, counseling, emergency shelter and housing assistance, legal assistance, and other community services for adults and children as well as survivors.

• Helped Protect Survivor Privacy. President Biden signed the Safe Connections Act to allow a survivor of domestic abuse to separate a mobile phone line from an account shared with an abuser. He also signed the Joint Consolidation Loan Separation Act, which allows survivors of domestic violence and others who have faced economic abuse to sever joint student loan debt, and the SECURE 2.0 Act, which allows survivors of domestic abuse to elect to receive penalty-free distributions from an employer-sponsored retirement plan.

• Strengthened Protections for Survivors of Sexual Assault and Harassment in the Workplace. President Biden signed into law new bipartisan protections to support survivors and address sexual assault and sexual harassment in the workplace. The Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act empowers survivors of sexual assault and sexual harassment at work by providing a choice to go to court instead of being forced into arbitration. And the Speak Out Act enables survivors to speak out about workplace sexual assault and harassment by prohibiting the enforcement of pre-dispute nondisclosure and non-disparagement clauses regarding allegations of sexual harassment or assault. In addition, the Office of Personnel Management responded to a Presidential Memorandum by issuing new guidance to support federal employees’ access to paid time off and leave without pay for purposes related to seeking safety and recovering from domestic violence, dating violence, sexual assault, and related forms of abuse. DOL continued to award grants under the Fostering Access, Rights and Equity Grant opportunity, which assists underserved and marginalized low-income women workers who have been impacted by gender-based violence and harassment, and helps them understand and access their employment rights, services, and benefits. And EEOC issued new resources to help employers prevent and remedy harassment, including sexual harassment, and create respectful workplaces.

• Addressed Gender-Based Violence in American Indian and Alaska Native Communities. In addition to actions taken to implement the VAWA Reauthorization Act of 2022, President Biden issued an Executive Order directing federal agencies to address the crisis of missing or murdered Indigenous peoples, which significantly impacts women, girls, LGBTQI+ people in the community, and Two-Spirit Native Americans. Pursuant to the Not Invisible Act, DOJ and the Department of the Interior established the Not Invisible Act Commission in 2022, a cross-jurisdictional advisory committee composed of law enforcement, Tribal leaders, federal partners, service providers, family members of missing or murdered individuals, and survivors. The Commission provided recommendations to improve the federal government’s efforts to address violent crime and the high rates of people reported missing in Native communities, which the Departments responded to in 2024. Additionally, the United States relaunched the North American Trilateral Working Group on Violence Against Indigenous Women and Girls, in collaboration with the governments of Canada and Mexico, and with the participation of Indigenous women leaders from all three countries.

• Developed and Implemented National and Global Strategies to End Gender-Based Violence. The White House issued the first-ever U.S. National Plan to End Gender-Based Violence, a comprehensive, government-wide plan to prevent and address sexual violence, intimate partner violence, stalking, and other forms of gender-based violence. The National Plan provided a framework for guiding federal action across each of seven strategic pillars—from prevention to economic security and housing stability to online safety. To address gender-based violence around the world, the United States advanced the U.S. Strategy to Prevent and Respond to Gender-Based Violence Globally, which was updated in 2022 to address 21st century threats, including the rise of gender-based violence during the COVID-19 pandemic; technology-facilitated gender-based violence; and safety risks related to climate migration and displacement. Under this strategy, the Administration secured the first-ever U.S. commitment to the United Nations Global Programme to End Child Marriage and continued our long-standing commitment to the United Nations Joint Programme on the Elimination of Female Genital Mutilation. And over the last two fiscal years, the United States maintained the highest-ever level of investment—$250 million—to address gender-based violence globally.

• Held Perpetrators Accountable for Conflict-Related Sexual Violence. The Administration has condemned sexual violence whenever and wherever it occurs, including in South Sudan, Iraq, Haiti, Ukraine, and the attacks committed by Hamas in Israel on October 7—and in Gaza against hostages. In 2022, President Biden issued an historic Presidential Memorandum on Promoting Accountability for Conflict-Related Sexual Violence committing to fully exercising U.S. authorities—including sanctions, visa restrictions, and security assistance vetting—to impose consequences on perpetrators of this human rights abuse. The Administration has since issued nearly two dozen sanctions against perpetrators of conflict-related sexual violence around the globe—including the largest set of financial sanctions and visa restrictions the United States has issued against individuals connected to this abhorrent human rights abuse. The Vice President also launched the Dignity in Documentation Initiative, which provides support for survivor- and civil society-led efforts to investigate and document conflict-related sexual violence in line with the Murad Code, named for Nobel Laureate and survivor Nadia Murad. This initiative—which includes $18 million in direct and aligned commitments from the Department of State and $4 million in aligned commitments from USAID—will support justice for survivors by promoting accountability for crimes punishable under international law.

• Improved Access to Sexual Assault Forensic Examinations. DOJ dedicated more than $124 million to the National Sexual Assault Kit Initiative, which provides funding to support the inventory, tracking, and testing of previously unsubmitted sexual assault kits; the collection and testing of DNA from arrestees and offenders; and resources to address the cold case sexual assault investigations and prosecutions that result from evidence and Combined DNA Index System hits produced by tested sexual assault kits; among other services. DOJ also provided nearly $18 million to increase access to trained sexual assault medical forensic examiners, improve access to wrap-around care for survivors, and establish regional Sexual Assault Nurse Examiner (SANE) training programs and a Center of Excellence in Forensic Nursing model to prepare current and future SANEs. With $10 million in FY 2024 funding, DOJ implemented a new program to further address nationwide gaps in the availability and quality of post-sexual assault medical forensic care by establishing new SANE/Sexual Assault Forensic Examiner programs, strengthening existing ones, and providing technical assistance to support these programs.

• Expanded Protection Services for Women and Girls in Humanitarian Emergencies. Recognizing that gender-based violence increases dramatically during humanitarian emergencies, the State Department and USAID relaunched the Safe from the Start ReVisioned initiative, which prioritizes improving and expanding GBV prevention, risk mitigation, response efforts, and empowering women and girls in crisis-affected countries. This new iteration, which builds on the original initiative launched in 2013, strengthens the focus on improving and expanding GBV programming and expertise, shifting power to crisis-affected women, and recognizing them as experts, care providers, and leaders.

• Prevented and Responded to Online Harassment and Abuse in the U.S. and Globally. To strengthen support for survivors of online harassment and abuse, the President established and the Vice President launched the White House Task Force to Address Online Harassment and Abuse, which coordinated comprehensive actions from more than a dozen federal agencies and supported a record investment of more than $36 million in dedicated funding to address technology-facilitated gender-based violence in the U.S. and globally. In addition, the President’s Executive Order on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence directed federal agencies to address deepfake image-based abuse. And, following the Vice President’s leadership in underscoring the urgent need to address deepfake image-based sexual abuse and the White House Call to Action to Combat Image-Based Sexual Abuse, the Administration announced a set of voluntary commitments from AI model developers and data providers to curb the creation of image-based sexual abuse and proactively reduce the risk of new images from being generated without someone’s consent as well as ensure that known, verified instances of image-based sexual abuse are excluded from their products and systems.

To strengthen support for survivors globally, the Administration launched and co-leads the 16-country Global Partnership for Action on Gender-Based Online Harassment and Abuse. Through this Global Partnership, the Administration advanced global policies to address online safety for women and girls by shaping a range of multilateral policy instruments tackling online harms through the G7, G20, APEC, and UN. The Administration also invested at least $15 million in targeted funding to prevent and respond to technology-facilitated gender-based violence and counter its chilling effects on women leaders and democratic participation as part of our emphasis on supporting democracies globally, including through new initiatives to provide support to women leaders who have experienced extreme threats or forms of online violence.

• Combat Human Trafficking. The Administration released an updated National Action Plan to Combat Human Trafficking laying out an integrated federal response to human trafficking as well as a National Human Trafficking Prevention Framework. DOJ also disseminated more than $190 million in funding to combat human trafficking and support survivors and released updated guidelines for its employees who work with victims and witnesses of crime to provide enhanced protections for survivors of domestic violence, sexual assault, stalking, and human trafficking and for other vulnerable victims. Separately, the Department of Homeland Security adopted a victim-centered, trauma-informed, and culturally sensitive approach to protecting survivors; finalized a rule to strengthen the integrity of the T nonimmigrant visa process; and established a process to conduct bona fide determinations and provide employment authorization and deferred action to noncitizen victims of crime, including domestic violence, sexual assault, and stalking, with pending petitions for U nonimmigrant status for those who met certain standards.

Promoted Women’s Representation, Leadership, and Political Participation

As Vice President Harris has said, “the status of women is the status of democracy.” We know that the status of women and the stability of nations are inextricably linked and that wherever the rights of women and girls are under threat, so too are democracy, peace, and stability. It is why President Biden established the first-ever White House Gender Policy Council and why the Council developed the National Strategy on Gender Equity and Equality to guide the Administration’s efforts to advance gender equity, defend women’s rights, and elevate women’s civic and political participation and leadership at home and abroad.

• Assembled the First-Ever Gender-Balanced Cabinet in Our Nation’s History. The Administration reached gender parity in the Cabinet for the first time ever. The President appointed a record number of women and people of color—including the first woman to serve as Treasury Secretary, the first woman to serve as Director of National Intelligence, the first Native American woman to serve in the Cabinet, and the first openly transgender Senate-confirmed federal official.

• Appointed Judges Who Reflect the Diversity of Our Country. President Joe Biden set an historic precedent by appointing more non-white and female judges to the federal judiciary than any other president in U.S. history. Since January 2021, the Senate confirmed 235 of President Biden’s nominees to lifetime federal judgeships. This is the largest number of confirmations in a single Presidential term since the 1980s. Of the 235 individuals who have been confirmed to lifetime positions on federal courts, 63% are women, and 60% are people of color. President Biden appointed more women, including more Black women, and more LGBTQ judges than any other administration in history. In April 2022, Ketanji Brown Jackson was confirmed by the United States Senate as Associate Justice of the Supreme Court, the first Black woman to ever serve on the Court.

• Strengthened the Federal Government’s Recognition of Women’s History. In 2024, President Biden established the Frances Perkins National Monument in Newcastle, Maine, to honor the historic contributions of America’s first woman Cabinet Secretary and the longest-serving Secretary of Labor. In addition, the Department of the Interior announced five new National Historic Landmarks that increase the representation of women’s history in historic sites across America; announced $500,000 to support the renovation of the Seneca Falls Knitting Mill, the current site of the National Women’s Hall of Fame; and issued a report on representation of women across sites of national importance, including National Historic Landmarks, national monuments, and national park sites. The President also signed into law the Women’s Suffrage National Monument Location Act, authorizing the placement of a monument honoring women’s suffrage on the National Mall. These actions advanced President Biden’s Executive Order to strengthen the National Park Service’s recognition of women’s history, helping to increase the representation of women’s history in sites across America and honor the legacy and contributions of women and girls to our country.

• Broke Barriers for Servicewomen. President Biden eliminated obstacles to women’s military service, including by advancing historic military justice reforms; updating military hair, dress, and fitness standards; and expanding parental leave policies. Women commanders also rose to unprecedented ranks, including Admiral Lisa Franchetti, the first woman to serve as the Chief of Naval Operations and on the Joint Chiefs of Staff; and Admiral Linda Fagan, the first woman to hold the rank of four-star admiral and serve as Commandant of the U.S. Coast Guard and Service Chief of any U.S. military service.

• Advanced Women’s Political and Civic Participation Globally. Since the first Summit for Democracy in 2021, the Administration prioritized efforts to dismantle barriers to women’s political participation and build the pipeline of women leaders. On the margins of the NATO 75th Anniversary Summit, the Administration launched Women Leading Effective and Accountable Democracy in the Digital Age (Women LEAD) to further advance women’s political participation and leadership as a pillar of our efforts to promote security and democratic stability. The United States and partners made over $900 million in commitments to invest in programs that build and sustain a diverse pipeline of women leaders, address barriers to women’s participation in public life online and offline, and establish a global community of practice of leaders and organizations working to advance women’s political and civic participation.

• Promoted Women’s Participation in Peace and Security Efforts. The President and Vice President made historic advances in strengthening women’s meaningful participation in national security, defense, and political leadership and reaffirmed that commitment with the release of the 2023 Women, Peace, and Security (WPS) Strategy and National Action Plan. The strategy reflects critical shifts in our global landscape, including an emphasis on threats to women leaders posed by technology-facilitated gender-based violence and gendered disinformation, which is strategically deployed by state and non-state actors to destabilize democracies. The Department of State also announced and has since invested nearly $2 million to provide technical assistance to WPS Centers of Excellence, which will strengthen relationships and facilitate consultations between governments and civil society stakeholders to develop strategies, approaches, and solutions to implementing WPS principles in practice. The project will also leverage networks of WPS experts and leaders to foster learning, deepen collaboration, and raise awareness of WPS issues through existing and future WPS Centers in Kosovo, Colombia, and The Philippines. In addition, the Administration:

• Updated NATO Policy on Women, Peace, and Security (WPS). As host of the NATO 75th Anniversary Summit, the Administration prioritized WPS, recognizing that the status of women is inextricably linked to the stability of nations—and therefore critical to NATO’s present and future effectiveness. At the Summit, Allies formally endorsed an updated policy to build on NATO’s long-standing commitment to WPS. The 2024 policy addressed new security threats, including technology-facilitated gender-based violence and the misuse of new and emerging technologies, climate security, and conflict-related sexual violence, and also notes Russia’s war of aggression against Ukraine and the threats it poses specifically to women on the frontlines of the conflict.

• Equipped Ukrainian Servicewomen with Military Gear. At the Anniversary Summit, Allies announced historic contributions through the Comprehensive Assistance Package (CAP) to provide women’s body armor, boots, and uniforms to the Ukrainian armed services to further NATO’s non-lethal support to Ukraine and commitment to supporting women’s full and equal participation in defense and security. This action marked the first time Allies directed resources through CAP to advance Women, Peace, and Security objectives.

• Invested in Efforts to End Child Marriage Globally. On International Day of the Girl in 2024, the Administration announced investments of nearly $86 million to prevent and respond to child, early, and forced marriage globally. These programs help equip girls and young women with education and workforce readiness skills; mitigate harmful effects of child marriage through education, health, legal, and economic support; and raise awareness of the risks and harms associated with child marriage. In addition, for the first time, the United States contributed to the United Nations Children’s Fund–UNFPA Global Programme to End Child Marriage, which works in 12 countries in Africa and South Asia to promote the rights of adolescent girls.

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Dear Mr. Chairman:  (Dear Madam Chair:)

Consistent with section 306(c)(1)(B) of the Cuban Liberty and Democratic Solidarity (LIBERTAD) Act of 1996 (Public Law 104-114) (the “Act”), I hereby determine that suspension for 6 months beyond January 29, 2025, of the right to bring an action under Title III of the Act is necessary to the national interests of the United States and will expedite a transition to democracy in Cuba.

                              Sincerely,

                              JOSEPH R. BIDEN JR.

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NATIONAL SECURITY MEMORANDUM/NSM-29

MEMORANDUM FOR THE VICE PRESIDENT
               THE SECRETARY OF STATE
               THE SECRETARY OF THE TREASURY
               THE SECRETARY OF DEFENSE
               THE ATTORNEY GENERAL
               THE SECRETARY OF COMMERCE
               THE SECRETARY OF ENERGY
               THE SECRETARY OF HOMELAND SECURITY
               THE ASSISTANT TO THE PRESIDENT AND CHIEF OF STAFF
               THE DIRECTOR OF THE OFFICE OF MANANGEMENT AND BUDGET
               THE UNITED STATES TRADE REPRESENTATIVE
               THE REPRESENTATIVE OF THE UNITED STATES OF AMERICA TO THE UNITED NATIONS
               THE DIRECTOR OF NATIONAL INTELLIGENCE
               The DIRECTOR OF THE CENTRAL INTELLIGENCE AGENCY
               THE ASSISTANT TO THE PRESIDENT FOR NATIONAL
                  SECURITY AFFAIRS
               THE COUNSEL TO THE PRESIDENT
               THE ASSISTANT TO THE PRESIDENT FOR ECONOMIC
                  POLICY AND DIRECTOR OF THE NATIONAL ECONOMIC COUNCIL
               THE ASSISTANT TO THE PRESIDENT AND HOMELAND
                  SECURITY ADVISOR AND DEPUTY NATIONAL SECURITY ADVISOR
               THE CHAIR OF THE COUNCIL OF ECONOMIC ADVISERS
               THE DIRECTOR OF THE OFFICE OF SCIENCE AND TECHNOLOGY POLICY
               THE NATIONAL CYBER DIRECTOR
               THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF
               THE DIRECTOR OF THE NATIONAL SECURITY AGENCY
               THE DIRECTOR OF THE FEDERAL BUREAU OF
                  INVESTIGATION
               THE DIRECTOR OF THE NATIONAL COUNTERTERRORISM CENTER
               THE DIRECTOR OF THE NATIONAL COUNTERINTELLIGENCE AND SECURITY CENTER

SUBJECT:            Revocation of National Security Presidential

                    Memorandum 5

The United States maintains as the core objective of our policy the need for more freedom and democracy, improved respect for human rights, and increased free enterprise in Cuba.  Achieving these goals will require practical engagement with Cuba and the Cuban people beyond what is outlined in NSPM-5, and that takes into account recent developments in Cuba and the changing regional and global context.

Accordingly, I hereby revoke NSPM-5.  

     Section 1.  Revocation.  NSPM-5 is hereby revoked.  Accordingly, the Secretary of State shall immediately rescind the list developed in accordance with Section 3(a)(i) of NSPM-5, and the Secretary of the Treasury shall initiate a process to adjust current regulations as a result of this revocation of NSPM-5.  

     Sec. 2.  General Provisions.  (a)  Nothing in this memorandum shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department, agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

     (b)  This memorandum shall be implemented consistent with applicable law and subject to the availability of appropriations.

     (c)  This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.   

                              JOSEPH R. BIDEN JR.

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TO THE CONGRESS OF THE UNITED STATES:

     I transmit herewith a report to the Congress with respect to the proposed recission of Cuba’s designation as a state sponsor of terrorism.

                              JOSEPH R. BIDEN JR.

THE WHITE HOUSE,

    January 14, 2025.

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Certification of Rescission of Cuba’s Designation

as a State Sponsor of Terrorism

Pursuant to the Constitution and the laws of the United States, and consistent with sections 1754(c) and 1768(c) of the National Defense Authorization Act for Fiscal Year 2019 (50 U.S.C. 4813(c) and 4826(c)), I hereby certify with respect to the rescission of the determination of January 12, 2021, regarding Cuba that:

     (i)  The Government of Cuba has not provided any support for international terrorism during the preceding 6-month period; and

     (ii)  The Government of Cuba has provided assurances that it will not support acts of international terrorism in the future.

This certification shall also satisfy the provisions of section 620A(c)(2) of the Foreign Assistance Act of 1961 (22 U.S.C. 2371(c)(2)), section 40(f)(1)(B) of the Arms Export Control Act, Public Law 90-629, as amended (22 U.S.C. 2780 (f)(1)(B)), and, to the extent applicable, section 6(j)(4)(B) of the Export Administration Act of 1979, Public Law 96-72, as amended (50 U.S.C. App.2405(j)), and as continued in effect by Executive Order 13222 of August 17, 2001.

                              JOSEPH R. BIDEN JR.

THE WHITE HOUSE,

    January 14, 2025.

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Dear Mr. Chairman:  (Dear Madam Chair:)

Consistent with section 306(c)(1)(B) of the Cuban Liberty and Democratic Solidarity (LIBERTAD) Act of 1996 (Public Law 104-114) (the “Act”), I hereby determine that suspension for 6 months beyond January 29, 2025, of the right to bring an action under Title III of the Act is necessary to the national interests of the United States and will expedite a transition to democracy in Cuba.

                              Sincerely,

                              JOSEPH R. BIDEN JR.

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NATIONAL SECURITY MEMORANDUM/NSM-29

MEMORANDUM FOR THE VICE PRESIDENT
               THE SECRETARY OF STATE
               THE SECRETARY OF THE TREASURY
               THE SECRETARY OF DEFENSE
               THE ATTORNEY GENERAL
               THE SECRETARY OF COMMERCE
               THE SECRETARY OF ENERGY
               THE SECRETARY OF HOMELAND SECURITY
               THE ASSISTANT TO THE PRESIDENT AND CHIEF OF STAFF
               THE DIRECTOR OF THE OFFICE OF MANANGEMENT AND BUDGET
               THE UNITED STATES TRADE REPRESENTATIVE
               THE REPRESENTATIVE OF THE UNITED STATES OF AMERICA TO THE UNITED NATIONS
               THE DIRECTOR OF NATIONAL INTELLIGENCE
               The DIRECTOR OF THE CENTRAL INTELLIGENCE AGENCY
               THE ASSISTANT TO THE PRESIDENT FOR NATIONAL
                  SECURITY AFFAIRS
               THE COUNSEL TO THE PRESIDENT
               THE ASSISTANT TO THE PRESIDENT FOR ECONOMIC
                  POLICY AND DIRECTOR OF THE NATIONAL ECONOMIC COUNCIL
               THE ASSISTANT TO THE PRESIDENT AND HOMELAND
                  SECURITY ADVISOR AND DEPUTY NATIONAL SECURITY ADVISOR
               THE CHAIR OF THE COUNCIL OF ECONOMIC ADVISERS
               THE DIRECTOR OF THE OFFICE OF SCIENCE AND TECHNOLOGY POLICY
               THE NATIONAL CYBER DIRECTOR
               THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF
               THE DIRECTOR OF THE NATIONAL SECURITY AGENCY
               THE DIRECTOR OF THE FEDERAL BUREAU OF
                  INVESTIGATION
               THE DIRECTOR OF THE NATIONAL COUNTERTERRORISM CENTER
               THE DIRECTOR OF THE NATIONAL COUNTERINTELLIGENCE AND SECURITY CENTER

SUBJECT:            Revocation of National Security Presidential

                    Memorandum 5

The United States maintains as the core objective of our policy the need for more freedom and democracy, improved respect for human rights, and increased free enterprise in Cuba.  Achieving these goals will require practical engagement with Cuba and the Cuban people beyond what is outlined in NSPM-5, and that takes into account recent developments in Cuba and the changing regional and global context.

Accordingly, I hereby revoke NSPM-5.  

     Section 1.  Revocation.  NSPM-5 is hereby revoked.  Accordingly, the Secretary of State shall immediately rescind the list developed in accordance with Section 3(a)(i) of NSPM-5, and the Secretary of the Treasury shall initiate a process to adjust current regulations as a result of this revocation of NSPM-5.  

     Sec. 2.  General Provisions.  (a)  Nothing in this memorandum shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department, agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

     (b)  This memorandum shall be implemented consistent with applicable law and subject to the availability of appropriations.

     (c)  This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.   

                              JOSEPH R. BIDEN JR.

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TO THE CONGRESS OF THE UNITED STATES:

     I transmit herewith a report to the Congress with respect to the proposed recission of Cuba’s designation as a state sponsor of terrorism.

                              JOSEPH R. BIDEN JR.

THE WHITE HOUSE,

    January 14, 2025.

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President Biden has prioritized strengthening America’s food system across every segment of the food supply chain from farm to fork. The Biden-Harris Administration has invested in a food system that is fair, competitive, distributed, and resilient. By taking a whole-of-government approach, the Administration is bringing new revenue to farms and ranches, bolstering local and regional food markets, and supporting workers across the agriculture and food supply chain, while making nutritious food more accessible and affordable for families and ensuring consumers have the information they need to make informed, healthy choices.

Today, the Administration took another significant step to help empower consumers and create a healthier food supply. The Food and Drug Administration (FDA) issued a proposed rule that, if finalized, would require a label on the front of food and beverage packages that indicates if an item is high, medium, or low in added sugars, sodium, and saturated fat. Consumers would then have simplified, at-a-glance nutrition information that helps them quickly and easily make more informed choices.

BUILDING NEW MARKETS AND INCOME FOR FARMERS AND RANCHERS

The Biden-Harris Administration is helping farmers keep farming by removing barriers and supporting opportunities for farmers and ranchers to diversify their income—increasing the resilience and profitability of their operations.

Investing in Climate-Smart Agriculture and Renewable Energy

President Biden knows that agriculture has great potential to fight climate change, and that climate-smart practices offer farmers, ranchers, and foresters new revenue streams.

Through the novel Partnerships for Climate-Smart Commodities program, the Department of Agriculture (USDA) invested over $3 billion in 135 five-year projects that provide farmers a financial incentive to implement climate-smart practices. The program has connected over 14,000 participating farms to climate-smart markets, premiums, and incentives; enrolled more than 3.2 million acres of working land into climate-smart practices, with over half of participants being new adopters of climate-smart agriculture; sequestered over 400,000 metric tons of carbon; and made over 40 climate-smart commodities available to consumers.

Powered by the Inflation Reduction Act’s historic injection of $19.5 billion to support on-farm conservation practices, USDA is addressing its backlog of popular conservation programs for farmers wanting to use water-saving, soil-protecting, carbon-storing practices. Through the Conservation Stewardship Program (CSP) and the Environmental Quality Incentive Program (EQIP), USDA since 2021 has enrolled nearly 190,000 farmers in conservation programs and awarded 28,622 contracts through the Inflation Reduction Act for a total of nearly $2 billion.

Also supported by President’s Inflation Reduction Act, the Empowering Rural America (New ERA) program is the largest investment in rural America’s electric system since President Franklin Delano Roosevelt signed the Rural Electrification Act in 1936. It invests $9.7 billion to help member-owned rural electric cooperatives provide their communities with clean, reliable, and affordable energy. USDA announced approximately $9 billion through New ERA across 24 states so far, with the rural electric cooperatives building or purchasing nearly 12 gigawatts of clean energy.

The Powering Affordable Clean Energy (PACE) funds new clean energy and energy storage projects to make it more affordable for rural Americans to use clean, reliable energy. In 2024, USDA awarded 34 projects totaling $917 million. And since the start of the Biden-Harris Administration, USDA has invested more than $3 billion through the Rural Energy for America Program (REAP) in 9,901 renewable energy and energy efficiency improvements helping farms and small businesses lower their energy costs, generate new income, and strengthen the resilience of their operations.

All five programs advance the Biden-Harris Administration’s Justice40 Initiative, which sets a goal that 40% of the overall benefits of certain federal climate, clean energy, and other investments flow to disadvantaged communities that are marginalized by underinvestment and overburdened by pollution.

The Administration has also galvanized unprecedented science-based investments in climate-smart agriculture on a global scale. Launched by President Biden at COP26, the Agricultural Innovation Mission for Climate (AIM for Climate) has mobilized $29.2 billion for research and innovation, funding nearly 130 projects to advance climate-smart agriculture and strengthen food systems around the world.

Supporting All Types of Food Production

The Biden-Harris Administration has made it a priority to build a more diversified food system that includes a variety of growing operations that meet consumer demand, embrace innovation, and shorten the distance food travels from field to table.

USDA established the Office of Urban Agriculture and Innovative Production to provide technical and financial assistance for a variety of growing operations, including community farms and gardens, rooftop, indoor, and vertical farms, and hydroponic, aeroponic, and aquaponic facilities. In 2024, USDA provided more than $5.2 million in grants to support urban, small-scale, and innovative producers.

To boost access to locally grown fruits and vegetables, USDA has invested more than $357 million through the Specialty Crop Research Initiative for research and extension projects addressing key production challenges and more than $407 million through the Specialty Crop Block Grant Program to support growers through marketing, education and business support. Through its new Marketing Assistance for Specialty Crops initiative, the Department will provide $2 billion to help farmers who grow fruits, vegetables, and nuts overcome market barriers for their products, and $140 million through the Commodity Storage Assistance Program to help farmers access storage for their crops following severe weather events.

And to support the rising demand for organic products, USDA launched the Organic Transition Initiative which has invested $300 million to support farmers transitioning to organic agriculture. USDA’s Organic Market Development Grant program has awarded $85 million to 107 projects, enhancing processing capacity and promoting domestic organic products.

Rebuilding Trust and Advancing Opportunity

On Day One, President Biden issued an Executive Order that charged the federal government with advancing equity for all, including communities that have long been underserved, and addressing systemic barriers and disparities in our Nation’s policies and programs.

USDA is facing its difficult history of discriminating against the people who needed its help the most, convening an independent Equity Commission that issued a report with 66 recommendations to lift barriers to inclusion and access across USDA programs, policies, systems, and practices. USDA has implemented dozens of the Commission’s recommendations and has worked with Congress to advance legislative action necessary to implement the remaining changes.

As a result of President Biden’s American Rescue Plan and Inflation Reduction Act, USDA made additional investments to break down barriers. For example, USDA provided $67 million through its Heirs’ Property Relending Program which allows intermediary lenders to help farmers and landowners resolve heirs’ land ownership and succession issues. USDA invested $300 million in 50 innovative projects to improve access to land, capital, and markets for underserved farmers, ranchers, and forest landowners. USDA also invested $100 million through the Technical Assistance Investment Program to support more than 33 cooperator organizations in providing outreach and tailored resources to underserved farmers and ranchers. To support future food and agriculture leaders, USDA launched the $262.5 million NextGen Program supporting more than 60 institutions of higher education to engage and train a diverse next generation food, agriculture, natural resources and human sciences workforce.

In addition, USDA created the Discrimination Financial Assistance Program which distributed nearly $2 billion to more than 43,000 farmers, ranchers, and landowners who experienced discrimination in USDA farm lending programs. USDA’s distressed borrower assistance program deployed about $2.4 billion to help forgive or offset farm loans for nearly 44,000 farmers. This program has generated or supported nearly 49,000 jobs, increased household income by $2.47 billion, added $3.56 billion to the United States gross domestic product, and increased gross revenues from total sales of final goods and services by $5.66 billion. 

MODERNIZING THE MIDDLE OF THE AGRICULTURE AND FOOD SUPPLY CHAIN: FOOD PROCESSING, AGGREGATION, & DISTRIBUTION

President Biden issued an Executive Order on America’s Supply Chains, directing federal agencies to make food supply chains more resilient to future disruptions. The Administration has since built more distributed, local capacity to increase resiliency in the face of market disruptions, provided more choices for farmers to create value added products and sell locally, and supported job creation in rural communities.

Building Local and Regional Food Processing Capacity and Markets

USDA has invested over $1.4 billion to support new or expanded small and medium sized processing facilities and to create a more diverse and secure U.S. food supply chain. These investments are giving farmers more market options and fairer prices by spurring competition, while providing consumers with more choices and affordable prices at the grocery store. This includes $336 million in grants to about 75 projects through the Meat and Poultry Processing Expansion Program and $275 million to 29 lenders under the Meat and Poultry Intermediary Lending Program, enhancing competition and strengthening the food supply chain. And USDA awarded $48 million in grants to 12 Tribal Nations through the Indigenous Animals Harvesting and Meating Processing Grant Program, supporting traditional harvesting and processing methods for indigenous animals like bison, reindeer, and salmon.

USDA launched the Resilient Food Systems Infrastructure Program, and is committing $420 million to enhance local and regional food supply chains by investing in key supply chain infrastructure including processing and distribution capacity like warehousing and cold storage. To spur private investment in infrastructure, USDA launched the Food Supply Chain Guaranteed Loan Program, leveraging $52 million from the American Rescue Plan to unlock nearly $382 billion in loan guarantees. USDA also funded 12 Regional Food Business Centers across the country to provide technical assistance, market access, and capacity building support for farmers and businesses.

Recognizing the power of institutional purchasing to bolster local food systems, USDA invested $1.3 billion for Local Food Purchasing Agreements with 50 states, 92 Tribes, three territories, and the District of Columbia to purchase local food for food banks, schools, and other nutrition assistance programs. USDA launched the Local Food for Schools Cooperative Agreement Program, allocating over $800 million to state governments to procure local, unprocessed foods for school meal programs. This builds on USDA’s Local Agriculture Market Program, which has funded more than 100 projects to cultivate local and regional food economies across the country through farmers markets, value-added production, and marketing support.

Supporting Food Banks and the Emergency Food System

USDA invested billions of dollars for The Emergency Food Assistance Program (TEFAP), including $2.5 billion for food purchases, enhancing the support the emergency food system provides through organizations like food banks. To expand emergency food assistance to underserved areas, USDA awarded nearly $100 million in TEFAP Reach and Resiliency grants to 42 state agencies. USDA also helped connect surplus food to emergency feeding organizations, investing up to $4 million in annual funding in the Farm to Food Bank Project, with 27 states and territories receiving grant funding in FY 2024.  

CREATING MORE FAIR AND COMPETITIVE MARKETS

President Biden has prioritized boosting competition in agriculture, including signing a landmark Executive Order on Promotion Competition in the American Economy and announcing an Action Plan for a Fairer, More Competitive and More Resilient Meat and Poultry Supply Chain.

Promoting Competition and Transparency

USDA spearheaded several new rules to improve fairness and competition, including final rules to promote transparency in poultry farming contracts and prohibit discrimination and ban retaliation against farmers and ranchers in meat markets, as well as a proposed a rule to protect poultry growers from unfair deductions and variations in pay.

USDA also finalized a new rule that only permits the voluntary “Product of USA” or “Made in the USA” claim to be applied to meat and poultry products that are derived from animals born, raised, slaughtered and processed in the United States, which better aligns with consumer understanding of what the label means. USDA stood up the first-ever Farmer Seed Liaison initiative to work across the Federal government, including with the U.S. Patent Office, to promote transparency, farmers’ and plant breeders’ voice, and researcher access to germplasm.

The Administration also committed to better enforce the laws on the books. USDA stood up an enforcement partnership with 32 state attorneys general. USDA and Department of Justice (DOJ) strengthened their collaboration, and in 2022 created an anonymous reporting tool for unfair and anticompetitive practices. Since then, DOJ brought suit against Agri Stats for using algorithms to fix prices and outputs in meat markets; secured a consent decree with major poultry processors Cargill, Sanderson, and Wayne Farms to limit unfair variations in pay for poultry farmers; secured a consent decree with Koch Foods cracking down on penalties unlawfully imposed on farmers who tried to work for other chicken processors; and blocked a merger of Dole and Fresh Express which would have consolidated vegetable markets.

Meanwhile, the Federal Trade Commission (FTC) successfully challenged the largest grocery merger in US history and brought a case to prevent price discrimination by big brands against independent retailers. The DOJ and FTC also worked to preserve and promote the right of farmers to repair their own tractors, including parts and batteries.

Boosting Trade and Market Access

The Administration has delivered over $26.7 billion in agricultural market access across the globe for America’s farmers and ranchers. The four largest annual export values on record were between 2021 and 2024, including a record-high of $195.7 billion in agricultural exports in 2022.

USDA allocated $600 million to 72 U.S. organizations through the Regional Agricultural Promotion Program (RAPP) to diversify and expand export markets for American agricultural products. USDA also invested $65 million through the Assisting Specialty Crop Exports (ASCE) initiative to help specialty crop producers overcome non-tariff trade barriers. And the Technical Assistance for Specialty Crops (TASC) program continues to fund projects addressing sanitary and phytosanitary challenges that hinder U.S. specialty crop exports.

IMPROVING FOOD ACCESS, NUTRITION SECURITY AND HEALTH

President Biden has been steadfast in ensuring every American family has access to affordable, nutritious foods. The President hosted the first White House Conference on Hunger, Nutrition, and Health in over 50 years; released a National Strategy to end hunger and reduce diet-related diseases by 2030; and cultivated over $10 billion in external commitments, including through the White House Challenge to End Hunger and Build Healthy Communities. More than 20 federal agencies are taking action to implement the National Strategy.

Improving Food and Nutrition Security

A critical step to reduce hunger and associated disparities is helping all Americans become economically secure. The expansion of the Child Tax Credit (CTC) through the American Rescue Plan in 2021 helped cut child poverty nearly in half, reduced food insecurity by roughly 26%, and led to the lowest share of households with children that were food insecure on record. President Biden and Vice President Harris are advocating to restore this expansion and lift nearly three million children back out of poverty.

USDA completed a comprehensive reevaluation of the Thrifty Food Plan—the basis for Supplemental Nutrition Assistance Program (SNAP) benefits—to reflect the current costs of a healthy diet, resulting in a 21% increase in the maximum SNAP benefits for a family of four. This was the first adjustment of its kind since 1975. USDA modernized the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, increasing WIC participation by 5.3% from 2021 to 2023, and permanently funded the bonus package that enabled participants to access more fruits and vegetables.

USDA improved school meals and snacks with a new rule that reduced added sugars and sodium, while also expanding access to free school meals through the Community Eligibility Program (CEP). To ensure kids have meals over the summer months, the Administration established the SUN Bucks program giving families $120 per child—with the amount expected to rise over time with inflation—during summer months to purchase groceries. This is the first permanent nationwide summer grocery benefit and addresses longstanding spikes in hunger when children lose access to school meals. And beginning in the 2027-2028 school year, students eligible for free or reduced-price meals will no longer incur processing fees when using cashless payment systems, alleviating unnecessary financial pressure on low-income families.

The Administration has also strengthened food security for our nation’s military members and families. The Department of Defense (DOD) published the Strengthening Food Security in the Force: Strategy and Roadmap report, outliningmore than 50 actions and subsequent progress made across the Department to improve Service members’ access to nutritious, affordable food. This includes creating Dietitian-Approved Fueling Stations that are increasing healthy food options across DOD dining facilities and vending machines, and enabling online shopping and curbside pickup service at its commissaries to now accept SNAP payments online. And the Administration enhanced and expanded access to the Basic Needs Allowance (BNA), which helps low-income military households better afford basic needs. DOD increased the BNA eligibility threshold from 130 to 150 percent of federal poverty guidelines and excluded federal food assistance programs from Service members’ gross household income calculations, making it easier for them to qualify for and receive a higher BNA.

Galvanizing a Food is Medicine Movement

Food is Medicine (FIM) encompasses a broad range of approaches that promote optimal health and healing and reduce disease burden by providing nutritious food—with human services, education, and policy change—through collaboration at the nexus of health care and community. To accelerate FIM, the Department of Health and Human Services (HHS) established the FIM Initiative to Unify and Advance Collective Action and launched a comprehensive online toolkit to help communities design and implement FIM interventions. Collectively, HHS and other federal agencies continue to lead critical investments that support growth of FIM interventions across the nation.

As part of this work, the Centers for Medicare & Medicaid Services (CMS) created groundbreaking opportunities for states to cover clinically appropriate and evidence-based services and supports that address health-related social needs, such as food insecurity. CMS published updated guidance on state opportunities, which includes a framework of services and supports that CMS considers allowable under specific Medicaid and Children’s Health Insurance Program (CHIP) authorities. This builds on previous guidance and brings together policy from approved section 1115 demonstrations, providing direction and encouragement for state partners to realize these opportunities, such as providing medically-tailored meals and nutrition counseling to beneficiaries with a clinical need. To date, CMS has approved section 1115 demonstrations in 18 states that cover certain evidence-based housing and nutritional services.

CMS finalized the creation of advance investment payments for certain new Medicare Shared Savings Program Accountable Care Organizations (ACOs). ACOs are permitted to use these payments to address the social needs of beneficiaries, including working with local community-based organizations to address food insecurity. CMS also developed an Agency strategy for diabetes prevention and management.

The Indian Health Service (IHS) awarded $2.5 million to help decrease food insecurity in Native communities, integrate an Indigenous perspective to FIM, and advance food sovereignty. Of that funding, five tribes and tribal organizations were awarded $500,000 annually to implement a 5-year Produce Prescription Pilot Program to improve health care outcomes and overall dietary health by increasing the consumption of fruits, vegetables, and traditional foods.

The Department of Veterans Affairs (VA) has taken several steps to support the health and well-being of our nation’s veterans. For example, VA established the Veterans Food Security Office, becoming the first national health care system with an office exclusively dedicated to food security. VA also partnered with the Rockefeller Foundation to pilot the expansion of Food is Medicine programs and launched produce prescription programs at the Salt Lake City and Houston VA Facilities, with additional pilots coming soon. Additionally, veterans’ participation in the VA Healthy Teaching Kitchen Program significantly increased from 31,000 to 43,000 encounters in FY 2024, and all other outpatient nutrition encounters with Dietitians increased from 1.6 to 1.9 million.

To improve access to fruits and vegetables for low-income communities, USDA’s Gus Schumacher Nutrition Incentive Program (GusNIP) from 2021 to 2024 provided nearly $290 million in funding to over 200 projects through nutrition incentive projects and produce prescription projects. USDA also established a network of four Nutrition Hubs under the ASCEND for Better Health Initiative to equitably advance nutrition security and prevent diet-related chronic diseases and cancers in underserved communities.

Understanding the connections between nutrition and health across diverse groups requires substantial investment in science, research, and data as well. In FY 2023 alone, the National Institutes of Health (NIH) provided $2.2 billion to support nutrition research and training.  Significantly, NIH is leading the largest current single investment in human nutrition research through Nutrition for Precision Health (NPH), powered by the All of Us Research Program, which is working across 14 U.S. sites to engage 8,000 participants from diverse backgrounds to learn more about how our bodies respond differently to food. NIH also funded the Advanced Training in Artificial Intelligence for Precision Nutrition Science Research institutional training program. This program’s goal is to build a diverse workforce with competencies in artificial intelligence, machine learning, and data science analytics to tackle complex biomedical challenges in nutrition science and lead to innovative solutions to diet-related chronic disease. NIH also partnered with the FDA to hold a joint workshop to advance collaborative nutrition science that can generate evidence and data to inform food-related policy decision-making across topics such as ultra-processed foods and emerging innovation related to nutrition regulatory science.

Empowering Consumers to Make Healthy Choices

As food can be a vehicle for wellness, FDA is supporting nutritious eating patterns by providing information that helps consumers make informed food choices and by encouraging industry to make foods healthier. FDA updated the criteria for the “healthy” claim for food labels to help consumers quickly find foods that are the foundation of healthy eating patterns. In an additional effort to help consumers quickly and easily identify which foods are part of a healthy diet, FDA conducted consumer research and published a proposed rule on front-of-package nutrition labeling that, if finalized, would require a label on the front of most foods and beverages that indicates if they are high, medium, or low in added sugars, sodium, and saturated fat. Consumers would then have simplified, at-a-glance nutrition information that can help them quickly and easily make more informed food choices.

Research shows that excess sodium consumption is a contributing factor in the development of high blood pressure. High blood pressure is a leading cause of heart disease and stroke, the first and fifth leading causes of death in the country, respectively. FDA has continued its sodium reduction efforts by issuing Phase I and draft Phase II voluntary sodium reduction targets for industry to help reduce sodium across the food supply. Already, 40% of the Phase 1 targets set for foods have been met or nearly met. FDA also issued a proposed rule to allow safe and suitable salt substitutes in standardized foods for which salt is a required or optional ingredient.

The Centers for Disease Control and Prevention (CDC) has meanwhile expanded efforts to improve Americans’ access to nutritious foods and healthy environments. CDC launched the PLACES interactive map so that people can understand what is happening in their community across health outcomes, prevention measures, health risk behaviors, disabilities, and health-related social needs. CDC also added new questions on consumption of fruit, vegetable, and sugar-sweetened beverages in the National Survey of Children’s Health to understand national and state-level trends to inform action. The agency’s investments in key state and local programs to increase healthy eating, active living, and prevent obesity have resulted in 3.8 million children attending childcare where nutrition and physical activity practices are improved, more than 9 million Americans with increased access to healthier food where foods are served or sold, and over 28 million people with increased access to physical activity in communities. CDC also continues to grow obesity prevention and treatment programs, including the Diabetes Prevention Program and Family Healthy Weight Programs.

Federal agencies also leveraged the federal government’s purchasing power to expand healthy food options. For example, the VA reduced sodium in inpatient and residential food operations by 400 milligrams per day compared to 2022, and is expanding procurement of local foods for veterans’ care facilities by drafting a new Veterans Health Administration Directive to recertify local set aside practices for bread, milk, and produce. In addition, HHS directed all HHS Operating Divisions to adopt the Food Service Guidelines for Federal Facilities (FSG) in their facilities. The FSG are a set of best business practices to increase healthy food options for employees and visitors, prevent food loss and waste, and increase local food sourcing.

ENHANCING FOOD SAFETY

The Administration has also taken important steps to protect public health by ensuring safe food products and enhancing consumer protections against foodborne illness.

USDA issued a rule to classify raw poultry products contaminated with specific Salmonella levels and serotypes as adulterated, aiming to reduce over 1 million Salmonella infections annually in the U.S. USDA also finalized a rule declaring Salmonella an adulterant in raw breaded stuffed chicken products exceeding 1 colony-forming unit per gram.

FDA launched the “Closer to Zero” initiative (C2Z), which sets forth a science-based approach to continually reducing exposure to lead, arsenic, cadmium, and mercury to the lowest levels possible in foods eaten by babies and young children. As part of the C2Z initiative, FDA has issued numerous action levels for toxic elements: draft levels for lead in juices; final levels for lead in foods intended for babies and young children; and a final level for arsenic in apple juice. 

In addition, FDA revoked authorizations for the uses of brominated vegetable oil (BVO) in food because of the potential for adverse health effects in humans. FDA also revised its regulations and revoked prior-sanctioned uses of partially hydrogenated oils (PHOs) because studies consistently link consumption of PHOs (industrially produced trans fat) with heart disease. Before the end of the term, FDA also plans to revoke the authorization of Red No. 3, a red dye used in certain medications and various foods and beverages, including candies, cakes, frostings, and frozen desserts, due to studies showing that the dye caused cancer.

SUPPORTING BREAKTHROUGH AGRICULTURE RESEARCH AND INNOVATION

President Biden’s Executive Order on Advancing Biotechnology and Biomanufacturing Innovation catalyzed a series of bold goals and federal actions to ensure that the U.S. can continue to lead the world in science, technology, and innovation, especially to accelerate sustainable agricultural production. For example, the Department of Energy, the Department of Transportation, and USDA collaborated on the Sustainable Aviation Fuel Grand Challenge to harness agriculture to scale up new technologies to produce sustainable aviation fuels on a commercial scale by 2050. And through the Fertilizer Production Expansion Program (FPEP), USDA has awarded $517 million in 76 projects to boost innovative domestic fertilizer production by 9.1 million tons annually and create more than 800 jobs in rural communities.  

Since 2021, USDA has invested over $8.4 billion in extramural funding to advance agricultural research, education, and extension programs to build a stronger, science-informed agricultural future. This includes $1.7 billion in funding for minority-serving higher education institutions (MSIs) to build a more diverse agriculture and food sector through education and scholarships, and nearly $2 billion for activities under the Agriculture and Food Research Initiative (AFRI). USDA and the Department of Education also issued letters to 16 states to close the over $12 billion gap in funding between land-grant Historically Black Colleges and Universities (HBCUs) and their non-HBCU land-grant peers in their states.

To boost innovation, USDA invested $144 million in small businesses through the Small Business Innovation Research (SBIR) program and provided $661 million for new and inventive projects that strengthen the bioeconomy. USDA also partnered with the National Science Foundation (NSF) to invest more than $220 million to establish a nationwide network Artificial Intelligence (AI) Research Institutes to lead AI-driven innovation across agriculture.

SUPPORTING WORKERS ACROSS THE AGRICULTURE AND FOOD SUPPLY CHAIN

The Biden-Harris Administration has taken action to protect farm and food workers across the supply chain and provide them with the resources they need to thrive. For example, USDA’s Farm and Food Workers Relief Grant Program provided $670 million to 14 non-profit organizations and one Tribal entity to distribute $600 relief payments to farm, meatpacking, and grocery workers who incurred expenses due to the COVID-19 pandemic. Through its Farm Labor Stabilization and Protection Pilot Program, USDA awarded $50 million from the American Rescue Plan to agricultural employers, many of which were small and mid-sized farms, so they can hire and retain the workers they need to be competitive while improving labor standards for workers. 

The Administration also increased protections to support the health of farmworkers. EPA stopped the use of the pesticide chlorpyrifos on all food to better protect human health, particularly that of children and farmworkers. EPA issued an emergency order to stop the use of the pesticide dacthal to address the human health risk, and the agency released a final rule restoring pesticide Application Exclusion Zone requirements to protect farmworkers and people who live near farms from being exposed to pesticides as they are being applied. The Department of Labor proposed a rule to establish the nation’s first-ever federal safety standard to address excessive heat in the workplace. If finalized, the rule would protect about 36 million workers and substantially reduce heat injuries, illnesses, and deaths on farms and in other workplaces.

REDUCING FOOD LOSS AND WASTE

In June 2024, the Biden-Harris Administration released the first-ever National Strategy for Reducing Food Loss and Waste and Recycling Organics to accelerate the reduction of food loss and waste.

USDA has invested $57 million of American Rescue Plan funds to get surplus wholesome food to individuals; develop linkages between farmers, providers, and food recovery organizations; and educate school children and youth about food loss and waste and strategies to reduce it. This includes $23.3 million in cooperative agreements to help 119 entities pursue innovative, scalable waste management plans aimed at reducing and diverting food waste from landfills.

In addition, using Bipartisan Infrastructure Law funding, EPA established two grant programs—the Solid Waste Infrastructure for Recycling Program and the Consumer Recycling Education and Outreach Program—to support communities, states, territories and Tribes with materials management. Through these two grant programs, EPA has awarded $198 million with over $83 million going to organics recycling projects, and the remainder supporting composting projects—the majority of which included food waste.

The Administration has also taken other actions to prevent food waste. In 2022, FDA released the most recent version of the Food Code, which clarified for the first time that food donations from retail food establishments are acceptable as long as proper food safety practices are followed. USDA invested $1.5 million to fund a Center that will prioritize food loss and waste prevention and recovery among Land-grant Universities and their partners. FDA and USDA issued a joint Request for Information (RFI) to collect information on food date labeling terms like “Sell By,” “Use By,” and “Best By” to reduce the premature discard of wholesome food and thus help households save money.

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On Friday, January 10, the Biden-Harris Administration convened state leaders, along with representatives from law enforcement groups and the International Association of Directors of Law Enforcement Standards and Training (IADLEST), to continue the work of making our communities safer through good policing.  IADLEST operates the National Decertification Index (NDI), a registry of state and local police misconduct that is currently in place in all 50 states and DC.  State and local police departments can check the NDI to make sure they are hiring officers without disqualifying misconduct in their backgrounds.

The event gathered these leaders to encourage the continued adoption and use of NDI by police departments.  IADLEST presented information on the benefits of using the NDI and on upcoming improvements to the NDI, including an expansion that will cover additional types of misconduct.  State leaders also gave inspiring examples of the successful use of the NDI in their states that prevented officers with serious misconduct from being hired.

Participants in the convening included state leaders from Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Mississippi, Nebraska, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oregon, Tennessee, Vermont, Virginia.

The Biden-Harris Administration has created real incentives for state and local law enforcement agencies to use the National De-Certification Index (NDI).  These incentives include given priority consideration for grant awards to law enforcement agencies that use NDI, creating national accreditation standards that include using NDI, and providing $3 million in funding to expand the NDI.  The Administration also created the first-ever federal police misconduct database, known as the National Law Enforcement Accountability Database (NLEAD), which is being used successfully by each of the 90 federal agencies that employs law enforcement officers.

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New actions provide $350 million in federal grants, including incentives to boost supply, preserve affordability, and provide more support for renters

The United States faces a shortfall of millions of affordable homes that has driven up home prices and rents, and has made finding a quality and affordable home out of reach for too many Americans. Over the last four years, President Biden and Vice President Harris have taken action to build more housing, lower housing costs, cut red tape, keep people in their homes, and strengthen communities. After years of under-building, the Administration launched the Housing Supply Action Plan, an all-of-government effort to increase the supply of housing. The Biden-Harris Administration has also stood up for renters, publishing a Blueprint for a Renters Bill of Rights and supporting policies and practices that promote fairness for renters in federal programs. Still, more must be done to build more housing, lower costs, and protect renters.

Today, the Biden-Harris Administration is announcing new actions to:

• Award an additional $100 million in grants to communities that are identifying and removing barriers to affordable housing production and preservation;
• Approve the first residential transit-oriented development (TOD) loan under the Department of Transportation’s (DOT) lending programs to support the development of over 300 units;

Boosting Supply by Providing More Federal Funding and Cutting Red Tape

Through the Housing Supply Action Plan, the Biden-Harris Administration has taken dozens of actions to build more housing by incentivizing local and state governments to reduce regulatory barriers, investing directly in communities, and improving federal financing programs. Today, the Administration is announcing the following actions:

Incentivizing local governments to remove barriers to housing construction.HUD is today announcing $100 million in grant awards through its landmark Pathways to Removing Obstacles to Housing (PRO Housing) program, which provides grants to communities to identify and remove barriers to affordable housing production and preservation. The PRO Housing grants have a catalyzing impact and will help unlock billions of dollars in new construction. The grants come on the heels of an initial $85 million in awarded grants that Vice President Harris announced in June.

Approving DOT’s first-ever residential transit-oriented development (TOD) financing deal.The Build America Bureau at DOT has approved a loan under the Railroad Rehabilitation & Improvement Financing (RRIF) program, its first TOD project with a residential component. The Colony project in Boca Raton, Florida will construct over 300 units at the Tri-Rail Boca Raton commuter rail station and will generate approximately $2 million per year in land lease revenue for the commuter rail system. Over the course of the Biden-Harris Administration, the Build America Bureau has worked with project sponsors to drive interest in its TOD lending programs, which lend at Treasury rates, and streamline program requirements. As a result of these efforts, there are now dozens of projects representing over 13,000 housing units that have expressed interest in the RRIF and Transportation Infrastructure Finance and Innovation (TIFIA) lending programs. The Build America Bureau has also updated its FAQs to reflect the potential for HUD and the Bureau to make coordinated investment decisions, which could address one of the main statutory requirements for TIFIA loans: obtaining an investment-grade credit rating. This update could help unlock more residential lending through TIFIA’s Rural Project Initiative (RPI) in particular, with fixed-rate loans equal to half of the US Treasury rate, which would provide a meaningful advantage to the Bureau’s TIFIA borrowers.

These announcements build on the following actions the Administration has taken in recent weeks to help communities build and preserve more housing that working families can afford:

Streamlining federal historic preservation reviews. The Advisory Council on Historic Preservation (ACHP) adopted a streamlining measure to make it easier and quicker to rehabilitate millions of federally-owned and federally-funded housing units. Its Program Comment on Certain Housing, Building, and Transportation Undertakings provides all federal agencies – including HUD, the Department of Defense, the Department of Veterans Affairs, and the Department of Agriculture, among others – with a clear path to upgrade existing housing and to make it more energy efficient, hazard-free, and accessible to people with disabilities. The measure also accelerates the process for approving the solar energy installations on existing buildings, and for approving the installation of “active transportation” elements, including bike lanes and bus shelters, which help connect people and neighborhoods. This measure represents the first time the ACHP has implemented an all-of-government approach to housing, and comes in the wake of its 2023 Housing and Historic Preservation Policy Statement.

Updating underwriting criteria to build more housing.HUD announced updates to its multifamily housing programs’ underwriting standards and guidelines to make financing of both existing and new housing units feasible for more properties and encourage the production of housing affordable to middle income households. Specifically, HUD has revised its underwriting policies to lower minimum debt service coverage ratios and increase maximum loan-to-value ratios, making more lending capacity available for affordable housing. These revisions will increase supply without exposing the government to undue risk. HUD also created a new category of underwriting to support the dozens of states and cities that have created “middle income” housing programs which invest in housing that is affordable to individuals making between 60% to 120% of area median income.

Making it easier to repurpose surplus federal parcels for housing. Building on the Administration’s work to leverage federal property to build more housing, HUD, the Department of Health and Human Services (HHS), and General Services Administration (GSA) finalized a rule to make it easier for public and nonprofit developers to repurpose federal buildings and land to house the homeless. The Title V program, authorized by the McKinney-Vento Homeless Assistance Act, allows federal agencies to use unutilized, underutilized, excess, or surplus federal properties at no cost to develop housing for people experiencing homelessness. The new rule makes it easier for developers to navigate the process, resulting in additional housing units to address homelessness and affordability challenges. In addition, GSA announced that it will accelerate the disposition of additional federal properties, as part of its ongoing efforts to right-size and modernize the federal buildings portfolio. Many of these properties are suitable for housing. And finally, the United States Postal Service (USPS), through a partnership with the General Services Administration, is in contract discussions with the City of Atlanta and the Atlanta Urban Development Corporation. Assuming the purchase contract is consummated, this city-backed entity will repurpose two USPS-owned sites into hundreds of units of housing, including dedicated affordable units.

Streamlining regulations for HUD’s biggest affordable housing supply block grant.HUD finalized a rule to streamline regulations for the HOME Investment Partnerships Program (HOME), the nation’s largest annual block grant to support affordable housing supply. The final rule makes HOME easier to use for individuals and families looking for a home to rent or buy, as well as for homeowners making upgrades to their homes such as accessibility improvements, new roofs, and replacement of outdated heating and cooling systems with energy efficient ones. The rule streamlines requirements for grantees administering funding, community development organizations building new homes, and property owners renting to HUD-assisted households. The rule also updates requirements regarding property standards, small scale rental housing projects, community land trusts, homebuyer resale, allowable rents for units receiving rental assistance, and tenant protections.

Devoting additional resources to gap financing. The Treasury Department previously announced that it will devote $100 million over three years in payments resulting from Emergency Capital Investment Program investments to a new program at the Community Development Financial Institutions (CDFI) Fund primarily focused on increasing the supply of affordable housing. In the next few days, Treasury will be announcing more details about the new program. The CDFI Fund projects that this new funding could support the financing of thousands of affordable housing units.

Reward communities with pro-housing policies that compete for infrastructure funding.DOT updated the ratings criteria for its Capital Investment Grants (CIG) program, which provides up to $4.6 billion per year to support investments in rail, streetcars, and bus rapid transit. The updated CIG ratings process enables projects that include more affordable housing in close proximity to planned transit investments to score higher. This CIG evaluation process outlined in the rating guidance further rewards pro-growth housing policies by increasing weighting assigned to housing-supportive zoning, making clear that active support of housing helps jurisdictions attract competitive federal transit dollars.

Launching a pilot to make it easier for rural homeowners to repair or rehabilitate their homes. USDA’s Section 504 Direct Single Family Housing Loan and Grant program assists very low-income owner occupants of single-family homes in rural areas to repair or rehabilitate their homes. Loan funds are available for repairs to improve or modernize a home, make homes safer or more sanitary, or remove health and safety hazards. Current regulations around USDA’s payment terms within this program make it difficult to hire contractors, since contractors expect some down payment before work begins. This pilot program will enable payments to be made to contractors prior to the site delivery of materials, which will resemble more typical contractor expectations while still protecting applicants from fraudulent contractors that might take downpayment funds and never complete the job.

Supporting Housing Stability

The White House Blueprint for a Renters Bill of Rights laid out the key principles of a fair rental market and has already catalyzed new federal actions to make those principles a reality. Recent actions include:

Preventing unnecessary and avoidable evictions. HUD published a final rule that requires public housing authorities and private owners participating in certain HUD Multifamily project-based rental assistance programs to provide their tenants with written notification at least 30 days prior to initiating eviction proceedings for nonpayment of rent. The final rule also requires that the 30-day notice include: (1) how tenants can cure lease violations for nonpayment of rent and information on how to recertify their income; (2) how to request a minimum rent hardship exemption if applicable to avoid eviction; and (3) an itemized amount, which is separated by month, of alleged rent owed by the tenant, along with any other arrearages allowed by HUD. This rule will help prevent unnecessary evictions and potential homelessness for tenants in HUD-assisted properties each year.

Supporting local eviction prevention programs. HUD awarded $40 million through the Eviction Protection Grant Program to 21 recipients. This program, started under the Biden-Harris Administration, funds nonprofit organizations and government entities to provide no-cost legal assistance to low-income tenants at risk of or subject to eviction. The new funding adds to $40 million in previously-allocated funds which provided legal assistance to over 44,000 households thus far.

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President Biden came into office facing the worst public health crisis in more than a century. COVID-19 was wreaking havoc on our country – closing our businesses, keeping our kids out of school, and forcing communities into isolation and lockdown. In the first year of the pandemic, nearly 400,000 Americans died of COVID-19.  

Even before taking office, President-elect Biden recognized that the U.S. needed an emergency response that was worthy of the crisis it faced – a response that would leave no stone unturned and that would leverage the full force of the federal government, the innovation of the private sector, and the determination of the American people. Building on decades of research and planning efforts, President Biden, on his first full day in office, released the first comprehensive National Strategy for the COVID-19 Response and Pandemic Preparedness. This strategy focused on building a response to this virus that would give people the tools and transparent communication they needed to protect themselves, reopen our schools, and get our economy moving again.

The following report outlines the numerous actions the Biden-Harris Administration took to combat COVID-19 both nationally and globally, and it serves as a roadmap for how the U.S. can effectively respond to pandemics and public health threats in the future. In addition to this public-facing report, this Administration is leaving behind a three-step playbook that future Administrations can use to continue to protect the nation and effectively respond to any future biological threat.

1 – Taking Immediate Action to Respond to the COVID-19 Pandemic

Standing Up the Largest Vaccination Program in Our Country’s History

In President Biden’s first year of office, the Biden-Harris Administration worked hand-in-hand with doctors, nurses, businesses, unions, community organizations, governors, mayors, and citizens across every state, Tribe, and territory to put vaccines at the center of the United States’ COVID-19 response. These vaccines still remain the best tools available to lower the risk of hospitalization and death.

The Administration stood up the largest free vaccination program in American history: mobilizing 90,000 vaccination locations; standing up mass vaccination sites with the ability to administer more than a combined 125,000 shots a day; deploying over 9,000 federal personnel to support vaccinations nationwide – including over 5,000 active-duty troops, and launching vaccinefinder.org to provide current information on locations for vaccination. Another part of the federal government’s strategy to ensure access to COVID-19 vaccines for the American public was the Federal Retail Pharmacy Program (FRPP) for COVID-19 Vaccination. Pharmacies are readily accessible in the majority of communities in the U.S. – with most Americans living within five miles of a pharmacy. Recognizing this, the federal government made pharmacies a key part of its COVID-19 vaccination strategy, partnering with 21 retail and long-term care pharmacies to vaccinate Americans in more than 41,000 locations nationwide, including long-term care pharmacies.

As a result of these efforts, over 270 million people received at least one shot of a COVID-19 vaccine by May 2023. Additionally, a December 2022 analysis from the Commonwealth Fund suggested that COVID-19 vaccinations saved over 3 million American lives and successfully prevented over 18 million hospitalizations.

Increasing the Country’s Testing Supply

Under the leadership of the Biden-Harris Administration, America’s testing supply increased substantially, allowing Americans to quickly get answers without having to go to a doctor’s office, and to make informed decisions about their day-to-day activities. Less than a month after taking office, the Administration announced a $650 million investment to expand COVID-19 testing for schools and underserved populations, as well as an $815 million investment to increase domestic manufacturing of testing supplies so that we would have a more reliable supply when needed. The Administration, through HHS, also partnered with the private sector to develop and scale manufacturing of tests suitable for home use. Free testing sites were available at 21,500 locations around the country. This was made possible by federal action to expand pharmacy testing sites, a federal surge in free testing sites, delivery of tests to thousands of community health centers and rural health clinics, and $10 billion in American Rescue Plan (ARP) funding to provide tests to K-12 school districts. The Administration also invested nearly $6 billion in ARP funding to cover free testing for uninsured individuals, and to support testing in correctional facilities, shelters for people experiencing homelessness, and mental health facilities. To reach people experiencing homelessness, the U.S. Housing and Urban Development (HUD) collaborated with the Department of Health and Human Services (HHS) to provide tests across major U.S. cities.

The Biden Administration also stood up COVIDtests.gov through which Americans could order tests that were sent by the United States Postal Service directly to their homes — for free. By the end of the Public Health Emergency in May 2023, the Administration had distributed more than 750 million free COVID-19 tests, shipped directly to more than 85 million households. The Administration had also coordinated more than 50 million diagnostic tests in-person at pharmacy and community-based sites.

Collectively, these actions gave Americans the opportunity to keep both themselves and their communities safe, while getting back to school, work, and time with family and friends. Additionally, the Lancet Public Health journal recently published a study showing that making diagnostic tests available quickly during the COVID-19 pandemic mitigated an estimated 7 million hospitalizations and saved approximately 1.4 million lives.

Increasing Treatment Options for Americans

The Biden-Harris Administration also increased investment in the development, manufacturing, and procurement of COVID-19 treatments, which helped to minimize the severity of COVID-19 infections.  By March 2022, about 5 million antiviral treatment courses were available to Americans, and the President announced the Test-to-Treat initiative to help make it easier for people at high risk of severe disease and those with limited financial means to quickly access free oral antiviral treatments. By April 2022, the U.S. government purchased 20 million treatment courses—more than any other country in the world and took action to nearly double the number of locations where Americans could get oral antivirals. The Administration also provided medical providers with more guidance, education and tools to help them understand and prescribe these treatments, and to help them inform the choices that the American people made about receiving safe and effective treatments.

2 – Ensuring an Equitable Pandemic Response and Recovery

On his first day in office, understanding that the pandemic had exacerbated severe and pervasive health and social inequities in America, President Biden issued an Executive Order on Ensuring an Equitable Pandemic Response and Recovery – which included the establishment of the COVID-19 Health Equity Task Force. From the start, the Administration took action to empower communities to improve access for all Americans to tests, therapeutics and vaccines.

In addition, the Administration supported partners through an all-of-society effort that increased response and recovery initiatives in support of communities in every corner of the country. In some communities, local chambers of commerce worked with business leaders to encourage flexibilities such as paid time off for their employees who needed to travel to a vaccination or testing center. In other communities, due to the Administration’s efforts, child care providers offered drop-in services for caregivers to get vaccinated. Some public transit authorities and ride-sharing companies provided free rides to vaccination sites, while churches, civic organizations, barbershops, and beauty salons opened their doors to be trusted spaces for testing or for vaccinations.

Ten months into the Biden-Harris Administration’s term, deaths had declined nearly 90% in Black, brown, and Indigenous communities; the gap in vaccination rates between Black and Latino/Hispanic adults and white adults had closed; and nearly 100% of schools were open for in-person instruction.

Investing in the Hardest-hit and Highest-risk communities:

The Biden-Harris Administration invested over $785 million from President Biden’s American Rescue Plan to support organizations that were building vaccine confidence across communities which historically had lower vaccination levels, including communities of color, rural populations, and low-income populations. The Administration bolstered the efforts of Tribal communities seeking to increase awareness of options to mitigate the spread of the virus, and it expanded public health systems’ ability to respond to the needs of older adults who have been among the highest risk for infection or death from COVID-19.

Additionally, recognizing that the pandemic had tremendous impacts on disabled individuals and resulted in new members of the disability community, the Administration prioritized Long COVID services, supports, and research in the context of disability; established a call line dedicated to ensuring individuals with disabilities can equitably utilize the Administration’s at-home test distribution program; ensured disabled individuals and other high-risk individuals could access at-home testing; and invested American Rescue Plan (ARP) resources to build COVID-19 vaccine confidence and access among people with disabilities.

Putting Community Health Centers at the Forefront of the Response:

Community Health Centers played a vital role in the Administration’s efforts to ensure an equitable response, as they served as the single largest source of comprehensive primary health care for medically underserved urban and rural communities. Because of the Administration’s efforts, these centers tested millions of patients for COVID-19, distributed millions of vaccine doses, increased access to telehealth in order to improve and expand patient care, and offered treatment options such as oral antiviral medications and monoclonal antibody therapy. Additionally, through its COVID-19 Testing Supply and COVID-19 N95 Mask Programs, the Administration enabled health centers to distribute millions of N95 masks, COVID-19 at-home test kits, and COVID-19 point-of-care testing supplies, at no charge to their patients and community members.

Supporting Community-Based Organizations in Vaccine Outreach to High-Risk Communities:

Through community-based organization vaccine outreach, the Administration was able to focus on empowering local trusted messengers and providing educational materials that served the most vulnerable populations. The Administration translated materials into 14 languages, and these were used by community- and faith-based organizations around the country, as well as by doctors’ offices, pharmacies, health centers, employers, and other groups. These education and outreach efforts allowed the Administration to reach the unvaccinated, deploy information about the importance of boosters, support pediatric vaccination efforts, and provide other important COVID-19 updates through trusted community members.

Building the Workforce to Support Underserved Communities:

President Biden’s American Rescue Plan provided a total of over $1.1 billion for community health, outreach, and health education workers—the largest ever one-time investment in the nation’s community health workforce. In the fall of 2022, the Administration invested $225 million in American Rescue Plan funds to train over 13,000 Community Health Workers (CHWs) – responding to the acute need to expand the health care workforce and address pandemic-related burnout. This effort supported apprenticeship programs for workers at over 500 health care and public health sites nationally, including emergency departments, community health centers, state and local public health departments, mobile health clinics, shelters, housing programs, faith-based organizations, and other locations where high-risk populations access care and receive services.  The Administration also rapidly deployed over 14,000 community outreach workers through over 150 national and local organizations to deepen COVID-19 vaccine confidence, increase vaccination rates, and serve as trusted messengers in underserved communities. These actions built upon the efforts of the roughly 50,000 CHWs who were already working in American communities before the pandemic.

3- Getting America Back on its Feet

Countless lives were saved by the Administration’s efforts to ensure all Americans had access to safe tests, treatments and vaccines. In addition, robust support to employers minimized the impact of the COVID-19 pandemic. Thanks to these efforts, families nationwide were able to get back to work and school and the country’s economy recovered faster and more broadly than any of the other leading economies in the world.

Progress By the Numbers

• In May 2023, compared to January 2021, COVID-19 deaths had declined by 95% and hospitalizations were down nearly 91% in the U.S.; those who were not vaccinated were more likely to be hospitalized or to die of COVID-19, compared to people who were vaccinated.

• With the largest domestic vaccination program in history, the U.S. made it possible for over 270 million people to receive at least one shot of a COVID-19 vaccine by May 2023. At its peak, the Biden Administration COVID-19 vaccination program administered over 4 million vaccines in one day, or over 2,700 vaccines a minute, into the arms of the American people. Lifesaving treatments were widely available and used, with more than 15 million courses administered.

• Through COVIDTests.gov, the Administration has delivered more than 921 million free COVID-19 tests – shipped directly to more than 85 million households – as of January 2025.  

• Through the Administration’s efforts, more than 50 million diagnostics tests were administered in-person at pharmacy and community-based sites.

As a result of the Biden-Harris Administration’s efforts, the economic recovery from the pandemic in the U.S. was historic. The American Rescue Plan (ARP) accelerated that economic recovery throughout 2021 and made it more resilient to challenges: one analysis found that the ARP resulted in 4 million more jobs and nearly doubled GDP growth – and that without it, the United States would have come close to a double-digit recession in spring 2021. The results of the ARP have also been historically equitable, with major progress against child poverty, food insecurity, and unemployment for low-income communities and communities of color.

Additionally, the Biden-Harris Administration’s COVID-19 response ensured that schools could reopen and families could get back to work. By the end of March 2020, all public schools in the United States were closed to slow the spread of the novel coronavirus SARS-CoV-2.  In November 2020, 19 percent of districts remained fully remote, with 45 percent using hybrid models and 36 percent fully in person. Shortly after the start of the Biden-Harris Administration, in early May, 2021, just over 3 months after taking office, only 1 percent of districts across the country were fully remote, and over half of schools were fully in person.

These changes are reflected in the public’s perception of the pandemic’s impact on their lives. According to Gallup public opinion polling, in December 2020, 3/5th of Americans believed that COVID-19 in the U.S. was getting worse. By June 2021, that percentage had fallen to three percent of Americans. Additionally, over half of Americans worried about catching COVID in December 2020, and that number fell to less than 20% by June 2021.

Today, although much progress has been made, the Administration continues to ensure that Americans have what they need to stay safe, including by continuing to provide free COVID-19 tests through COVIDtests.gov. In addition, the Administration has extended the authorities which allow pharmacists and pharmacy technicians to continue to administer vaccines, allowing other healthcare workers to focus on other tasks that only they can perform. And, the Administration’s $5 billion investment in Project NextGen continues to accelerate and streamline the rapid development of the next generation of coronavirus vaccines and treatments through public-private collaborations.

In addition to addressing the immediate impact of COVID-19 infections, the Biden-Harris Administration recognized that millions of Americans continue to experience symptoms for months and sometimes years after their acute COVID-19 infection. To help better understand why this occurs and to develop potential treatments, the Biden-Harris Administration has dedicated billions of dollars to research efforts, developed the first-ever National Research Action Plan on Long COVID, and created an Advisory Committee on Long COVID.

4 – Ensuring the World Responded and Recovered from COVID-19

While the Biden-Harris Administration implemented all of these programs to help Americans fight COVID-19 here at home, the Administration also recognized that helping the rest of world quickly and effectively respond to the pandemic was critical to both our domestic and the broader global recovery. The United States committed to bringing the same urgency to international response and recovery efforts that we demonstrated domestically. On day one, President Biden called on his National Security Advisor to advance global health security, international pandemic preparedness, and global health resilience to support the global response to the COVID-19 pandemic. This included re-establishing the National Security Council’s team focused on health security and biodefense.

• Restoring Partnerships with Critical, Life-saving Institutions: As soon as President Biden entered office, he ensured that the U.S. reversed its decision to withdraw from the World Health Organization – which was essential to coordinating a global response during the pandemic. In early 2021, United States committed $4 billion to support COVAX, the multilateral effort that aimed to accelerate the development and manufacturing of COVID-19 vaccines and to support equitable access for every country in the world. In two years, the United States provided over $16 billion to vaccinate the world, save lives, and build stronger health security. The United States also convened world leaders at two Global COVID-19 Summits, accelerating response efforts and mobilizing $3.2 billion in commitments to vaccinate the world, save lives, and build stronger health security.

• Vaccinating the World: The United States donated more COVID-19 vaccines than any other country, and it was the first country to announce a purchase of vaccine doses solely for donation to other countries. The U.S. was also the first country to ensure the African Union could start receiving up to 110 million doses of Moderna at a reduced rate negotiated by the United States – and it was the first country to negotiate a deal to send vaccines directly to humanitarian settings and conflict zones to vaccinate displaced persons. Between May 2021 and February 2024, the Biden-Harris Administration donated – in partnership with COVAX, Caricom, the African Vaccine Acquisition Trust (AVAT), and bilaterally – nearly 700 million doses of COVID-19 vaccines to countries around the world. This included over 44 countries and economies in Sub-Saharan Africa, 31 countries in the Western Hemisphere, and 26 countries in Southern, Central, and Eastern Asia.

The COVID-19 pandemic also led to a dropoff in routine childhood immunization in many countries around the world, as they surged scarce resources to pandemic response. As a result, we began to see the reemergence of vaccine-preventable diseases, from measles to polio. In 2024, the United States Government pledged $1.58 billion to support Gavi, The Vaccine Alliance, over the next five years. This commitment builds on a 24-year partnership that has immunized over a billion children and saved 17 million lives. The new funding aims to vaccinate the next billion children within a decade, saving over eight million lives by reaching unvaccinated children, expanding vaccinations for diseases like malaria and cervical cancer, and enhancing emergency health preparedness. The United States, through Gavi, also supports the launch of the African Vaccine Manufacturing Accelerator, which will help African countries produce vaccines locally, promoting vaccine equity and swift responses to future health crises. In addition, the United States supports the Coalition for Epidemic Preparedness Innovations (CEPI), which is working to accelerate the development of life-saving vaccines against emerging disease threats, and to transform capability for rapid countermeasure development in response to future threats. Notable achievements include: the FDA approval of the world’s first Chikungunya vaccine and technology transfer to regional producers for regional supply to LMICs; the advancement through clinical development of vaccine candidates against Lassa, Nipah, and coronaviruses, among others; and the launch of a new Disease X Vaccine Library with six viral families prioritized as high risk.

• Delivering Life-Saving Resources: In addition, the U.S. government delivered life-saving resources like oxygen, treatments, PPE, and other essential supplies worth more than $1 billion to countries experiencing outbreaks by March 2022. This included countries that were most affected by the pandemic. As an example, as India battled a devastating wave of the Delta variant, the United States delivered supplies worth more than $100 million to provide urgent relief. This included 15 million N95 masks, 1 million rapid diagnostic tests, and vaccine manufacturing supplies to help India make over 20 million doses of COVID-19 vaccines. In addition, the U.S. consistently provided immediate support to allies such as Brazil that were seeing disproportionate cases and deaths due to the pandemic – through providing much-needed ventilators, vaccines, personal protective equipment, and support for struggling businesses and communities.

• Providing Technical Assistance and Supporting Vaccine Manufacturing: U.S. public health experts across multiple federal agencies worked side-by-side with on-the-ground providers – providing technical assistance in vaccine program implementation, care provision, and outbreak investigation. The United States respects countries’ right to protect public health and to promote access to medicines for all. Toward that end, the United States endorsed negotiations of a temporary waiver of WTO intellectual property rules to support access to COVID vaccines.

In addition, the U.S. increased the world’s capacity to manufacture vaccines and fostered an enabling environment for innovation, including by spurring African manufacturing. For example, the U.S. International Development Finance Corporation (DFC) provided a $3.3 million technical assistance grant and a follow-on $15 million loan to Institute Pasteur de Dakar (IPD) in Senegal to expand flexible vaccine manufacturing capacity for both routine and outbreak vaccines. IPD also received support from other U.S. government agencies on regulatory strengthening, workforce development and training, and research and development. 

5) Managing Current Public Health Threats

The tools and strategies that the Biden-Harris Administration developed in response to the COVID-19 pandemic are applicable to a range of biological threats, including avian flu, Marburg, Ebola, mpox, COVID-19 variants, and others.

As an example, the National Wastewater Surveillance System has allowed the U.S. to glean more specific information on where avian flu is found in the environment, often before the first human or animal case has been confirmed. Additionally, Traveler-based Genomic Surveillance, which was among the first to detect multiple Omicron variants up to six weeks before they were reported elsewhere in the United States, continues to screen for other threats including new COVID-19 variants. Hospital data reporting also provides granular information on which hospitals may see strain due to admissions from COVID-19, Flu, and RSV each respiratory season.

Avian Flu: Protecting Human and Animal Health

Avian flu, or Influenza A(H5N1), was first detected in dairy cattle in the U.S. in late March 2024. While we have seen this virus in birds for decades and the risk to the general public remains low, the Administration immediately knew that the spread to cows and other mammals demanded serious attention and action. Within twenty-four hours of confirmation of the first case, interagency coordination groups began meeting at the senior leader and technical levels to synchronize support to State and local public health and agriculture officials. Since then, the interagency has worked with government, industry and other partners to ensure we keep communities healthy, safe, and informed – by monitoring and stopping transmission, keeping animals healthy, ensuring that our Nation’s food supply remains safe, and safeguarding the livelihood and well-being of American farmers and farmworkers. In total, since USDA began supporting state-led efforts to mitigate the risk of avian flu in poultry in 2022, the Biden-Harris administration has dedicated nearly $2.8 billion to this important work.

Monitoring the Virus and Stopping Transmission: Within a few weeks of the outbreak, USDA took action to stop the spread of the virus, issuing a federal order in April 2024 that mandated avian flu testing of all lactating dairy cattle moving between states. USDA also stood up a voluntary program for states and farmers to test their herds, implement biosecurity and created incentives for them to do so. By the end of 2024, USDA and its partner laboratories had run over 110,000 tests on dairy cattle and made more than 1,000 staff deployments to support response and traceback efforts on the ground, including 221 personnel currently deployed. In October 2024, USDA announced a nationwide milk testing initiative, requiring states to comprehensively monitor and respond to the presence of the virus in America’s dairies. Today, 28 states – representing nearly two-thirds of America’s dairy production – have joined this program. The remaining states are working to stand up the necessary infrastructure.  

CDC has also been closely tracking the virus through a collaborative effort between CDC and many partners, including state, local, and territorial health departments; public health and clinical laboratories; clinics; and emergency departments. These include systems to monitor case reporting, laboratory monitoring at both public health and clinical labs, emergency department visits, hospitalizations, and assessing wastewater. These systems build on developments over the last four years as a result of the COVID-19 pandemic. Altogether, they provide us with early warning signs on where the virus is spreading, as well as visibility on whether there is any severe disease from avian flu. When human cases have been reported, CDC has engaged and supported state and local health officials with technical support, including the deployment of experts to the field to support public health investigations. 

Since the start of the outbreak, USDA and CDC have been monitoring virus specimens using the latest techniques, to inform our response.  When new human cases are reported, CDC’s national laboratory confirms the findings and performs timely genomic sequencing and other analysis to monitor for any concerning changes in the virus, as well as any potential impacts on our treatments and vaccines. This information has been released in technical reports and the sequences are made available on public servers. Similarly on the animal side, genetic sequences from this outbreak are shared by USDA, with over 4,500 raw or curated sequences having been posted to GISAID (the Global Initiative on Sharing Avian Influenza Data) or the National Center for Biotechnology Information (NCBI) Sequence Read Archive. USDA continually monitors these sequences for any potentially concerning changes and immediately shares any such findings with CDC.  

Protecting Workers and the Public: Learning from bottlenecks and shortages in the very early COVID-19 response, the Administration has spent the last several years refilling our Strategic National Stockpile to ensure that we have the PPE, antivirals, tests, vaccines, and more that the country needs to prepare for future health emergencies. As a result, HHS was immediately able to offer support to states. To date, we have delivered nearly 4 million pieces of PPE and thousands of antivirals to protect workers. USDA also set up a program that reimburses farmers when they purchase PPE for their workers, and post-exposure prophylaxis with Tamiflu is also promptly offered to workers with any known exposure. We have also taken steps to build trust with impacted communities along the way – investing $5 million in campaign to educate and test farmworkers. In total, USDA and CDC have deployed over 100 federal workers into the field to support response and support workers.

As we protect workers today, we are also preparing for any possible scenario tomorrow. The CDC and NIH are tracking changes in the virus so we can see whether it’s becoming more adaptable to humans.  We have already prepared nearly 5 million doses of vaccines so they’re ready if we need them.  Further, by the end of the first quarter of 2025, we will have stockpiled 10 million doses of vaccine to inoculate humans against bird flu. And we’ve invested $176 million in Moderna to develop next-generation mRNA vaccines that can rapidly respond to any adaptations in the virus, with phase 3 trials beginning shortly. In addition to vaccines, we have 68 million courses of influenza antivirals on hand in the Strategic National Stockpile to treat those who may become infected with the virus. We have made 3,000 courses available to affected communities. 

Preserving Animal Health: Research suggests the virus travels via surfaces related to normal business operations such as vehicles, milking equipment, and people’s clothing. That’s meant that biosecurity practices—like limiting visitors, disinfecting work apparel, and separating animals of different species— were essential to reduce the spread and keep cows healthy. In early May 2024, USDA launched assistance for producers with H5N1 affected premises to improve on-site biosecurity in order to reduce the spread of the virus. This includes financial support for protecting workers with PPE, funding for disposal of milk, reimbursement for veterinary costs, and payments for shipping laboratory Samples. As of January 2025, over 500 farms have utilized these programs to date. Later that month, USDA expanded support for producers to stop the spread through cattle, by issuing a rule to compensate eligible producers with positive herds who experience a loss of milk production. So far, over 300 producers have applied to the program with tens of millions of dollars in payments distributed.  Additionally, USDA accelerated efforts to develop a first-of-its-kind bovine vaccine for the virus, and candidates have already entered field safety trials. USDA also announced in early January 2025 that work would begin to build a new stockpile of avian flu vaccines for poultry.

Ensuring the Safety of Our Food Supply: We have 100 years of data showing pasteurization works, but it was essential for our Administration to confirm that this was still the case with this new pathogen. USDA and the Food & Drug Administration (FDA) began testing retail dairy samples from across the country to ensure the safety of the commercial pasteurized milk supply and conducted laboratory experiments to reaffirm that pasteurization inactivates the virus. USDA similarly conducted research to confirm that cooking beef to proper temperature inactivates the virus, which it does. USDA also sampled muscle tissue from culled cattle at beef processing facilities as part of our robust ongoing surveillance programs. Today, we are confident that pasteurized milk, as well as properly cooked meat and eggs, are safe for consumers.

Mpox, Marburg, Measles and More: Managing Additional Public Health Threats

The Biden-Harris Administration has also mounted a robust response to other infectious disease threats that have emerged since 2021, including Marburg and Mpox. On Day 1 of the multiple Marburg and Mpox responses, medical countermeasures existed and were ready to be deployed at home and around the world as a result of U.S. preparedness efforts. In the case of Marburg, the United States had invested in experimental vaccines and therapeutics in order to be able to quickly deploy, test, and eventually seek regulatory approval for new countermeasures. 

Mpox Domestic and Global Responses:

• In early 2022, an outbreak of clade II mpox (then known as Monkeypox) rapidly spread globally and domestically. Shortly after the first U.S. case was identified in May 2022, the Administration deployed tens of thousands of doses of an FDA-approved vaccine and hundreds of courses of an investigational therapeutic from the Strategic National Stockpile to support domestic efforts to control spread and treat patients. We also rapidly scaled up testing capacity from 6,000 to 80,000 tests per week and, by October 2022, over one million doses of JYNNEOS had been administered to individuals at heightened risk of exposure to mpox, over 40,000 treatment courses had been distributed across the country, and domestic cases of clade II mpox had decreased by 90%. Today the mpox vaccine, which is effective against both clades of mpox, is also now commercially available with an ample supply at health departments and local pharmacies.

• During the 2022 response, the Biden-Harris Administration also stood up a White House National Monkeypox Response Team and, in collaboration with a diverse group of community-based and civil society partners, promoted equitable access to vaccines, therapeutics and testing and made significant strides in reaching vulnerable populations where they were with trusted community messengers.  Among the many successes of this group were the planning and execution of multiple “pop up” sites at events where at-risk individuals could learn more about mpox and, if they chose to do so, protect themselves by getting vaccinated against mpox.
• When a new clade of mpox began spreading internationally in 2024, the Biden-Harris Administration was poised to act quickly. Within weeks of WHO’s declaration of a public health emergency of international concern, President Biden announced in September 2024 that the United States was prepared to commit at least $500 million and to donate up to one million doses of mpox vaccines to support African countries in preventing and responding to this outbreak. We are delivering on that commitment, with two-thirds of our global mpox funding pledge fulfilled already, and all one million of the pledged mpox vaccine doses available now for countries that are ready to receive them.

• Most biological threats emerge outside the United States, which means that Americans will be safer when countries around the world are prepared to prevent, detect and respond to threats when they emerge. As part of the implementation of the National Biodefense Strategy, the United States Government continues to work with more than 50 countries around the world – including most mpox-affected countries and those at-risk of an mpox outbreak – to build stronger global health security capacities, ensuring countries are better prepared to stop outbreaks at their source while protecting U.S. national and homeland security.

• Domestically, in 2024, the Administration has continued to focus on additional preparedness steps to increase awareness of mpox risks; provided updated recommendations to prevent, detect, and treat both clades; and expanded wastewater surveillance to provide an early warning of mpox activity and community spread. In addition, the United States continued to build on the critical testing landscape created during the 2022 outbreak and can not only detect both clades of mpox, but can also differentiate between clade I and clade II mpox.

Global Marburg Response:

In September 2024, Rwanda’s Ministry of Health announced an outbreak of Marburg Virus Disease (MVD), a rare, viral hemorrhagic fever similar to Ebola. Over the last four years, the Biden-Harris Administration has responded to 11 Ebola or Marburg outbreaks.  Immediately after learning of the outbreak in Rwanda, in partnership with the Government of Rwanda, the United States committed millions of dollars to address urgent health gaps in Rwanda and surrounding countries, through provision of technical assistance with surveillance and contact tracing, infection prevention and control guidance, case management, risk communication and community engagement, safe and dignified burials, donation of laboratory test kits, and point of entry exit screening at Rwanda’s airport and neighboring border crossings. Within 8 days of learning of the outbreak, the United States Government worked with the Government of Rwanda, WHO, CEPI, and other critical partners to share experimental vaccine doses with Rwanda, and into the arms of healthcare workers at high risk of exposure, an unprecedented public health achievement. The United States also contributed tests, treatments and PPE, to support response efforts and protect health workers. This support has been made possible through the United States robust investments in science and research over the last 10 years. On December 20, the outbreak was declared over by the Government of Rwanda, with one of the lowest case fatality ratios (22%) of any Marburg outbreak in history.

Domestic Measles Response:

As the number of children protected from measles infections continues to decline due to declining vaccine coverage and misinformation, multiple jurisdictions have had to rapidly respond to measles outbreaks. The administration has deployed experts to support local responses and has distributed additional vaccine doses to support targeted vaccination campaigns, which are effective in ending outbreaks. The Administration has underscored that while the measles vaccine is highly effective and provides durable protection, 93-95% vaccine coverage is needed to maintain community protection. An unvaccinated individual exposed to the virus has a 90% chance of developing disease – therefore vaccination is critical to this response.

6) Building the Infrastructure for Future Biological Threats

The Biden-Harris Administration has also taken historic actions, building on policies from prior administrations, to protect Americans from biological threats that may emerge in the future.

Replenishing the Strategic National Stockpile:

The Strategic National Stockpile (SNS) was created in 1999 to “provide for the emergency health security of the United States …in the event of a bioterrorist attack or other public health emergency.” Historically, the SNS holds vaccines and therapeutics to protect the country from any number of chemical, biological, radiological, or nuclear events. Many of these medical countermeasures are not commercially available and the SNS is the only source for these critical supplies in the country–and in some instances the world. Under the Biden-Harris Administration, the SNS’s budget increased by 25% – allowing it to secure more of the vaccines, therapeutics and medical supplies needed to protect the country from public health emergencies and disasters.

Since the beginning of the COVID-19 pandemic, the Strategic National Stockpile distributed more than 27,000 tons of medicines, equipment, and supplies to support the country’s public health and health care needs. Early in the pandemic, the Strategic National Stockpile (SNS) deployed 90% of its overall inventory of personal protective equipment (PPE) – nearly 72 million items – as well as 100% of its Federal Medical Stations, which served as alternate care sites across the country. Much of this PPE was purchased ten years before with funds from the H1N1 outbreak—and had not been restocked.
Since President Biden took office, the SNS has dramatically increased its stockpiled quantities of PPE and ventilators—with supplies that were made in America where possible. The SNS now has 70 times the number of N95 respirators, 34 times the number of gloves, 50 times the number of isolation gowns, and 10 times the number of ventilators than it had before the pandemic.  Restocking the SNS to these levels has allowed it to make PPE available to communities impacted by COVID1-9, H5N1 and other infectious disease outbreaks. In 2022, the SNS provided nearly 300 million N95 masks to retail pharmacies and community health centers for free —the largest deployment of personal protective equipment in U.S. history.  Under President Biden, the SNS has also assigned staff to state public health departments and completed a series of tribal consultations and urban Indian confers to ensure all communities understand what tools it has available and how to access them in times of emergency or disaster.

Expanding Surveillance Capabilities:

At the start of the COVID-19 pandemic, because of years of underinvestment in modernizing data systems, some state, local, tribal, and territorial jurisdictions still relied on fax machines to transmit public health data and the U.S. struggles to collect, analyze and share essential data on the presence of SARS-CoV-2 in communities, the rate of transmission, and the impact on hospitals. Throughout our response, the U.S. government has expanded our surveillance capabilities to monitor disease and better inform the public. These steps include: 

• Increasing the number of healthcare facilities which provide automated, near real-time electronic case reporting to local, state, tribal, territorial and federal public health officials from less than 200 in 2020 to over 48,000 in 2024 and supporting public health authorities to adopt the Trusted Exchange Framework and Common Agreement (TEFCA) to further enable the exchange of public health data across the healthcare ecosystem to help rapidly identify emerging outbreaks.

• Standing up a National Wastewater Surveillance System, which routinely reports early warning information from over 1,500 sites covering over 150 million people in the United States.

• Scaling up genomic sequencing, which is important to detect new pathogens including variants.  At the start of the COVID-19 pandemic, only 23 public health labs demonstrated advanced molecular detection surveillance capabilities. By the end of 2022, this number expanded to 68 public health laboratories, and CDC launched 5 Pathogen Centers of Excellence. The average turnaround time for public health laboratories to publish genome sequences has dramatically improved – decreasing from 96 to 40 days. Some laboratories able to sequence in less than two days.

• Developing a COVID-19 Variant Playbook, which served to assess the disease severity and transmissibility of a new variant immediately, and to expedite the rapid laboratory evaluation of the effectiveness of vaccines, tests, and treatments against any variant.

• As a result of close collaboration between the CDC, the Centers for Medicare and Medicaid Services and industry stakeholders, over 80% of all hospitals from across America are now sharing critical data on emergency department visits and hospital admissions.

Advancing Capabilities in RNA Vaccine Technologies: 

With investments totaling over $400 million, the Administration has also been advancing capabilities in RNA vaccine technologies to guard against future pandemics. To further these efforts, multiple companies are currently partnering with HHS to develop RNA vaccines that may allow for a faster, more sustainable response capability against multiple threats, lower the requirement for needles, simplify storage requirements, or investigate new methods of administration.

Strengthening Domestic PPE Supply Chain:

Given gaps in domestic capacity for critical PPE, this Administration, in an effort to minimize foreign reliance, the President signed the “Make PPE in America Act” in 2021. The statute requires that the Departments of Homeland Security (DHS), Health and Human Services (HHS) and Veterans Affairs (VA) (collectively referred to as “covered agencies”) issue long-term contracts for PPE containing only materials and components that are grown, reprocessed, reused or produced in the U.S. This requirement is critical to strengthening our domestic manufacturing capabilities and promoting the production of essential PPE in the United States. The statute recognizes the power of leveraging the federal government’s buying power as a catalyst to increase market participants, support competition and the health of the domestic PPE industry.

A sustained federal commitment to procure PPE from domestic sources supports the health of the domestic PPE industry. Since the enactment of the Make PPE in America Act, covered agencies took actions to support a long-term domestic federal procurement strategy, model demand, and more closely align their acquisition strategies to send a government-wide demand signal to the PPE industry, while working collaboratively with the Defense Logistics Agency (DLA) and the Office of Management and Budget (OMB) to implement the Make PPE in America Act.

Stopping Outbreaks at their Source and Transforming our Biopreparedness Capabilities:

In 2022, President Biden signed National Security Memorandum 15 on Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security. This NSM launched a new National Biodefense Strategy and Implementation Plan, which envisions “a world free from catastrophic biological incidents” and directs a coordinated, whole-of-government effort to prepare for biothreats. It includes an ambitious five-to-ten-year vision for developing moonshot biodefense capabilities, including the ability to develop new vaccines within 100 days and repurpose therapeutics within 90 days.

The most effective way to limit the impact of biological threats is to stop them at their source. The United States is working with countries and partners around the world to ensure they have the capacity to identify and stop emerging threats before they grow into regional or global threats. To advance that goal, the administration published an updated Global Health Security Strategy, laying out our commitment to working with foreign partners in order to continue building our capacity to prevent, detect, and respond to biological threats wherever they emerge. The Administration took several concrete actions to support these transformative efforts.  The U.S. Government reached the ambitious goal of directly supporting 50 countries in building their health security capacity, which is one of the most powerful prevention tools we have in this space. The United States has also leveraged financial resources and diplomatic channels to mobilize support for 50 additional countries to strengthen their health security capacities, for a total of more than 100 countries receiving support.

Limitations in the existing global systems to finance pandemic prevention, preparedness, and response left countries and financial institutions ill prepared to effectively contain COVID-19. On day one, President Biden called on his Administration to transform the existing financing institutions and to cultivate new financing sources for global health security that are more effective and sustainable, and that are less dependent on U.S. government assistance. The United States was instrumental in the creation of the Pandemic Fund in 2022, the only multilateral financing facility dedicated exclusively to pandemic preparedness financing for low- and middle- income countries. The Pandemic Fund made significant progress in its first two years, awarding grants totaling $885 million, which mobilized an additional $6 billion in investments, to support 75 countries and economies across six geographic regions. The United States is also working to evolve Multilateral Development Banks to be better equipped to respond to the increasing frequency, scope, and complexity of global challenges, including pandemics. The Biden-Harris Administration strongly supported the establishment of the International Monetary Fund Resilience and Sustainability Trust and its goal of supporting low-income and vulnerable middle-income countries to access long-term, affordable financing to address longer-term challenges, such as health emergencies. During the COVID-19 pandemic, many countries and institutions lacked the liquidity to procure the medical countermeasures (MCM) needed to mount effective and timely responses. The U.S. Development Finance Corporation helped develop and lead a G7 Surge Financing Initiative, through which G7 development finance institutions (DFIs), the European Investment Bank, the International Finance Corporation, and global and regional health stakeholders are developing and deploying innovative financing tools to accelerate access to MCMs in health emergencies. 

While there will always be new or evolving biological threats, developing effective countermeasures for known threats is a critical piece of preparedness. For example, the U.S. government invested billions of dollars in mRNA technology in advance of the COVID-19 pandemic. These public investments translated into millions of lives saved in the United States and around the world, and were crucial to developing the mRNA vaccine technology that can be leveraged in a future pandemic, as well as potentially treating other diseases. For example, the Department of Defense and the National Laboratories are leveraging Artificial Intelligence for rapid development of medical countermeasures. The Administration is executing a whole-of-government implementation plan for strengthening capabilities in early warning, vaccines, therapeutics, diagnostics, clinical trials, and PPE.

Strengthening Research Capacity and Oversight:

The lives saved and hospitalizations avoided as a result of the COVID-19 therapeutics and vaccines were the result of decades of foundational research investments. Because viruses and bacteria are constantly changing and the frequency of naturally occurring biological outbreaks is increasing, the Biden-Harris Administration published the American Pandemic Preparedness Plan in the fall of 2021. In addition, the administration has continued to invest more than $7 billion annually in research by Federal, academic and industry researchers in new ways of protecting Americans from tuberculosis, HIV and other infectious diseases that remain leading causes of illness in our nation. These investments are crucial to ensure our nation is prepared for future threats and to deter those who are seeking asymmetric advantages over the US.

In 2024, the Administration also released an updated policy to enhance oversight of research. This update to standards that were originally released in 2012 will reduce the likelihood of accidental outbreaks and deliberate misuse of life science research, while ensuring that lifesaving research proceeds.

Supporting Global Biosafety and Biosecurity:

Expanding biosurveillance capacity and the rapid evolution of technology are critical for health security, but can also elevate the risk of accidental and deliberate incidents. The Biden-Harris Administration has taken significant steps to minimize the chances of laboratory accidents; reduce the likelihood of deliberate use or accidental misuse; ensure effective biosafety and biosecurity practices and oversight; and promote responsible research and innovation. The Biden-Harris Administration knows that in order to protect the domestic population, investing in global biosafety and biosecurity practices and oversight is essential. These efforts – which minimize the chances of laboratory accidents, reduce the likelihood of deliberate use or accidental misuse, and more – have been critical as we expand biosurveillance capacity. For example, the United States secured inclusion of biosafety and biosecurity as a critical component of the Pandemic Fund grants to support laboratory systems. One of the projects, the Caribbean Public Health Agency Train-the-Trainer Workshop on the Safe Transportation of Infectious Substances, resulted in certified trainers well-positioned to serve as national trainers and advisors in biosafety and safe transport protocols, ensuring safer practices across the region. The U.S. global health security bilateral partnerships also build capacity in biosafety and biosecurity: the final global health security report of the Administration showed that global health security partner countries with at least two years of U.S. Government support demonstrated a net improvement in biosafety and biosecurity capacity from 2018 to 2023. The Administration also supported the 2024 World Health Assembly resolution on Strengthening Laboratory Biological Risk Management, which calls for improvements to biosafety and biosecurity practices globally.

Standing up the Office of Pandemic Preparedness and Response Policy:

Recognizing the growing threat of pandemics, the Administration stood up the Office of Pandemic Preparedness and Response Policy (OPPR) in August of 2023. This is a permanent office in the Executive Office of the President charged with leading and coordinating actions related to preparedness for, and response to, known and unknown biological threats or pathogens that could lead to a pandemic and/or to national security. OPPR assumed the duties of the COVID-19 Response Team and Mpox team at the White House and has continued to coordinate and develop policies and priorities related to pandemic preparedness and response.

Because every successful response to a biological event has required a synchronized, integrated team, OPPR has worked with federal, state and local health partners, and has engaged with a broad array of private sector, academic and other stakeholders to ensure lessons from the response to COVID-19 and other recent outbreaks inform future plans and response efforts.  Recent accomplishments include:

• Partnering with multiple industry stakeholders to resolve supply chain issues affecting the availability of a new immunization, reducing infant hospitalizations by more than 80%.
• Partnering with leaders from the European Union, the Republic of Korea, Japan, India and multiple industries to develop a process to quickly recognize and address supply chain issues affecting availability of medications in the US and partner countries.
• Partnering with leaders from the Long-Term Care industry to improve vaccination rates for residents of long-term care facilities.
• Partnering with leaders from across the domestic healthcare enterprise to identify and mitigate constraints to our national preparedness for future biological events and to create a collaborative committed to continuing to mitigate future challenges.
• Partnering with community support organizations to identify best practices from the COVID-19 pandemic and to develop strategies to sustain outreach to historically medically underserved communities to ensure all Americans can access their healthcare options.

Conclusion

As of result of the Biden-Harris Administration’s efforts, the COVID-19 pandemic no longer disrupts our daily lives, our children are back in schools, our economy is stronger than ever and families have been able to resume their pre-pandemic routines. As new viruses and other biological threats have continued to emerge, we have remained vigilant in monitoring and responding to each threat. From investments into research for new tests and treatments for diseases, to launching the largest vaccination program in our country’s history, to expanding the nation’s surveillance capabilities, to replenishing the Strategic National Stockpile, the Biden-Harris Administration has transformed our nation’s pandemic preparedness and response.

In order to ensure that future Administrations are prepared for any threat that emerges, the Biden-Harris Administration will also leave behind a three-step internal playbook with nearly 300 pages of guidance on how to rapidly and effectively respond to biological threats from all sources – naturally occurring, accidental and deliberate.

• Step 1: Within 24 hours of notification of a serious biological threat, NSC convenes Departments and Agencies for a biological incident notification and assessment (BINA).
• Step 2: If the threat poses a significant risk to the United States, within 24-48 hours Departments and Agencies establish an Incident Response Coordination Structure (IRCS), with agency leadership and support roles pre-determined in a playbook.
• Step 3: Departments and Agencies operationalize a rapid and effective response, with coordination by the IRCS and leadership from the White House. The playbook includes detailed operational annexes to address many scenarios that commonly arise during biological incident responses. 

Under the Biden-Harris Administration, we have exercised this three-step playbook numerous times, including in recent weeks. All Departments and Agencies have received final versions of the Playbook, and the Biden-Harris Administration will give copies to the incoming Administration to ensure they are prepared to act on day one of a crisis to protect the American people. 

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President Biden came into office facing the worst public health crisis in more than a century. COVID-19 was wreaking havoc on our country – closing our businesses, keeping our kids out of school, and forcing communities into isolation and lockdown. In the first year of the pandemic, nearly 400,000 Americans died of COVID-19.  

Even before taking office, President-elect Biden recognized that the U.S. needed an emergency response that was worthy of the crisis it faced – a response that would leave no stone unturned and that would leverage the full force of the federal government, the innovation of the private sector, and the determination of the American people. Building on decades of research and planning efforts, President Biden, on his first full day in office, released the first comprehensive National Strategy for the COVID-19 Response and Pandemic Preparedness. This strategy focused on building a response to this virus that would give people the tools and transparent communication they needed to protect themselves, reopen our schools, and get our economy moving again.

The following report outlines the numerous actions the Biden-Harris Administration took to combat COVID-19 both nationally and globally, and it serves as a roadmap for how the U.S. can effectively respond to pandemics and public health threats in the future. In addition to this public-facing report, this Administration is leaving behind a three-step playbook that future Administrations can use to continue to protect the nation and effectively respond to any future biological threat.

1 – Taking Immediate Action to Respond to the COVID-19 Pandemic

Standing Up the Largest Vaccination Program in Our Country’s History

In President Biden’s first year of office, the Biden-Harris Administration worked hand-in-hand with doctors, nurses, businesses, unions, community organizations, governors, mayors, and citizens across every state, Tribe, and territory to put vaccines at the center of the United States’ COVID-19 response. These vaccines still remain the best tools available to lower the risk of hospitalization and death.

The Administration stood up the largest free vaccination program in American history: mobilizing 90,000 vaccination locations; standing up mass vaccination sites with the ability to administer more than a combined 125,000 shots a day; deploying over 9,000 federal personnel to support vaccinations nationwide – including over 5,000 active-duty troops, and launching vaccinefinder.org to provide current information on locations for vaccination. Another part of the federal government’s strategy to ensure access to COVID-19 vaccines for the American public was the Federal Retail Pharmacy Program (FRPP) for COVID-19 Vaccination. Pharmacies are readily accessible in the majority of communities in the U.S. – with most Americans living within five miles of a pharmacy. Recognizing this, the federal government made pharmacies a key part of its COVID-19 vaccination strategy, partnering with 21 retail and long-term care pharmacies to vaccinate Americans in more than 41,000 locations nationwide, including long-term care pharmacies.

As a result of these efforts, over 270 million people received at least one shot of a COVID-19 vaccine by May 2023. Additionally, a December 2022 analysis from the Commonwealth Fund suggested that COVID-19 vaccinations saved over 3 million American lives and successfully prevented over 18 million hospitalizations.

Increasing the Country’s Testing Supply

Under the leadership of the Biden-Harris Administration, America’s testing supply increased substantially, allowing Americans to quickly get answers without having to go to a doctor’s office, and to make informed decisions about their day-to-day activities. Less than a month after taking office, the Administration announced a $650 million investment to expand COVID-19 testing for schools and underserved populations, as well as an $815 million investment to increase domestic manufacturing of testing supplies so that we would have a more reliable supply when needed. The Administration, through HHS, also partnered with the private sector to develop and scale manufacturing of tests suitable for home use. Free testing sites were available at 21,500 locations around the country. This was made possible by federal action to expand pharmacy testing sites, a federal surge in free testing sites, delivery of tests to thousands of community health centers and rural health clinics, and $10 billion in American Rescue Plan (ARP) funding to provide tests to K-12 school districts. The Administration also invested nearly $6 billion in ARP funding to cover free testing for uninsured individuals, and to support testing in correctional facilities, shelters for people experiencing homelessness, and mental health facilities. To reach people experiencing homelessness, the U.S. Housing and Urban Development (HUD) collaborated with the Department of Health and Human Services (HHS) to provide tests across major U.S. cities.

The Biden Administration also stood up COVIDtests.gov through which Americans could order tests that were sent by the United States Postal Service directly to their homes — for free. By the end of the Public Health Emergency in May 2023, the Administration had distributed more than 750 million free COVID-19 tests, shipped directly to more than 85 million households. The Administration had also coordinated more than 50 million diagnostic tests in-person at pharmacy and community-based sites.

Collectively, these actions gave Americans the opportunity to keep both themselves and their communities safe, while getting back to school, work, and time with family and friends. Additionally, the Lancet Public Health journal recently published a study showing that making diagnostic tests available quickly during the COVID-19 pandemic mitigated an estimated 7 million hospitalizations and saved approximately 1.4 million lives.

Increasing Treatment Options for Americans

The Biden-Harris Administration also increased investment in the development, manufacturing, and procurement of COVID-19 treatments, which helped to minimize the severity of COVID-19 infections.  By March 2022, about 5 million antiviral treatment courses were available to Americans, and the President announced the Test-to-Treat initiative to help make it easier for people at high risk of severe disease and those with limited financial means to quickly access free oral antiviral treatments. By April 2022, the U.S. government purchased 20 million treatment courses—more than any other country in the world and took action to nearly double the number of locations where Americans could get oral antivirals. The Administration also provided medical providers with more guidance, education and tools to help them understand and prescribe these treatments, and to help them inform the choices that the American people made about receiving safe and effective treatments.

2 – Ensuring an Equitable Pandemic Response and Recovery

On his first day in office, understanding that the pandemic had exacerbated severe and pervasive health and social inequities in America, President Biden issued an Executive Order on Ensuring an Equitable Pandemic Response and Recovery – which included the establishment of the COVID-19 Health Equity Task Force. From the start, the Administration took action to empower communities to improve access for all Americans to tests, therapeutics and vaccines.

In addition, the Administration supported partners through an all-of-society effort that increased response and recovery initiatives in support of communities in every corner of the country. In some communities, local chambers of commerce worked with business leaders to encourage flexibilities such as paid time off for their employees who needed to travel to a vaccination or testing center. In other communities, due to the Administration’s efforts, child care providers offered drop-in services for caregivers to get vaccinated. Some public transit authorities and ride-sharing companies provided free rides to vaccination sites, while churches, civic organizations, barbershops, and beauty salons opened their doors to be trusted spaces for testing or for vaccinations.

Ten months into the Biden-Harris Administration’s term, deaths had declined nearly 90% in Black, brown, and Indigenous communities; the gap in vaccination rates between Black and Latino/Hispanic adults and white adults had closed; and nearly 100% of schools were open for in-person instruction.

Investing in the Hardest-hit and Highest-risk communities:

The Biden-Harris Administration invested over $785 million from President Biden’s American Rescue Plan to support organizations that were building vaccine confidence across communities which historically had lower vaccination levels, including communities of color, rural populations, and low-income populations. The Administration bolstered the efforts of Tribal communities seeking to increase awareness of options to mitigate the spread of the virus, and it expanded public health systems’ ability to respond to the needs of older adults who have been among the highest risk for infection or death from COVID-19.

Additionally, recognizing that the pandemic had tremendous impacts on disabled individuals and resulted in new members of the disability community, the Administration prioritized Long COVID services, supports, and research in the context of disability; established a call line dedicated to ensuring individuals with disabilities can equitably utilize the Administration’s at-home test distribution program; ensured disabled individuals and other high-risk individuals could access at-home testing; and invested American Rescue Plan (ARP) resources to build COVID-19 vaccine confidence and access among people with disabilities.

Putting Community Health Centers at the Forefront of the Response:

Community Health Centers played a vital role in the Administration’s efforts to ensure an equitable response, as they served as the single largest source of comprehensive primary health care for medically underserved urban and rural communities. Because of the Administration’s efforts, these centers tested millions of patients for COVID-19, distributed millions of vaccine doses, increased access to telehealth in order to improve and expand patient care, and offered treatment options such as oral antiviral medications and monoclonal antibody therapy. Additionally, through its COVID-19 Testing Supply and COVID-19 N95 Mask Programs, the Administration enabled health centers to distribute millions of N95 masks, COVID-19 at-home test kits, and COVID-19 point-of-care testing supplies, at no charge to their patients and community members.

Supporting Community-Based Organizations in Vaccine Outreach to High-Risk Communities:

Through community-based organization vaccine outreach, the Administration was able to focus on empowering local trusted messengers and providing educational materials that served the most vulnerable populations. The Administration translated materials into 14 languages, and these were used by community- and faith-based organizations around the country, as well as by doctors’ offices, pharmacies, health centers, employers, and other groups. These education and outreach efforts allowed the Administration to reach the unvaccinated, deploy information about the importance of boosters, support pediatric vaccination efforts, and provide other important COVID-19 updates through trusted community members.

Building the Workforce to Support Underserved Communities:

President Biden’s American Rescue Plan provided a total of over $1.1 billion for community health, outreach, and health education workers—the largest ever one-time investment in the nation’s community health workforce. In the fall of 2022, the Administration invested $225 million in American Rescue Plan funds to train over 13,000 Community Health Workers (CHWs) – responding to the acute need to expand the health care workforce and address pandemic-related burnout. This effort supported apprenticeship programs for workers at over 500 health care and public health sites nationally, including emergency departments, community health centers, state and local public health departments, mobile health clinics, shelters, housing programs, faith-based organizations, and other locations where high-risk populations access care and receive services.  The Administration also rapidly deployed over 14,000 community outreach workers through over 150 national and local organizations to deepen COVID-19 vaccine confidence, increase vaccination rates, and serve as trusted messengers in underserved communities. These actions built upon the efforts of the roughly 50,000 CHWs who were already working in American communities before the pandemic.

3- Getting America Back on its Feet

Countless lives were saved by the Administration’s efforts to ensure all Americans had access to safe tests, treatments and vaccines. In addition, robust support to employers minimized the impact of the COVID-19 pandemic. Thanks to these efforts, families nationwide were able to get back to work and school and the country’s economy recovered faster and more broadly than any of the other leading economies in the world.

Progress By the Numbers

• In May 2023, compared to January 2021, COVID-19 deaths had declined by 95% and hospitalizations were down nearly 91% in the U.S.; those who were not vaccinated were more likely to be hospitalized or to die of COVID-19, compared to people who were vaccinated.

• With the largest domestic vaccination program in history, the U.S. made it possible for over 270 million people to receive at least one shot of a COVID-19 vaccine by May 2023. At its peak, the Biden Administration COVID-19 vaccination program administered over 4 million vaccines in one day, or over 2,700 vaccines a minute, into the arms of the American people. Lifesaving treatments were widely available and used, with more than 15 million courses administered.

• Through COVIDTests.gov, the Administration has delivered more than 921 million free COVID-19 tests – shipped directly to more than 85 million households – as of January 2025.  

• Through the Administration’s efforts, more than 50 million diagnostics tests were administered in-person at pharmacy and community-based sites.

As a result of the Biden-Harris Administration’s efforts, the economic recovery from the pandemic in the U.S. was historic. The American Rescue Plan (ARP) accelerated that economic recovery throughout 2021 and made it more resilient to challenges: one analysis found that the ARP resulted in 4 million more jobs and nearly doubled GDP growth – and that without it, the United States would have come close to a double-digit recession in spring 2021. The results of the ARP have also been historically equitable, with major progress against child poverty, food insecurity, and unemployment for low-income communities and communities of color.

Additionally, the Biden-Harris Administration’s COVID-19 response ensured that schools could reopen and families could get back to work. By the end of March 2020, all public schools in the United States were closed to slow the spread of the novel coronavirus SARS-CoV-2.  In November 2020, 19 percent of districts remained fully remote, with 45 percent using hybrid models and 36 percent fully in person. Shortly after the start of the Biden-Harris Administration, in early May, 2021, just over 3 months after taking office, only 1 percent of districts across the country were fully remote, and over half of schools were fully in person.

These changes are reflected in the public’s perception of the pandemic’s impact on their lives. According to Gallup public opinion polling, in December 2020, 3/5th of Americans believed that COVID-19 in the U.S. was getting worse. By June 2021, that percentage had fallen to three percent of Americans. Additionally, over half of Americans worried about catching COVID in December 2020, and that number fell to less than 20% by June 2021.

Today, although much progress has been made, the Administration continues to ensure that Americans have what they need to stay safe, including by continuing to provide free COVID-19 tests through COVIDtests.gov. In addition, the Administration has extended the authorities which allow pharmacists and pharmacy technicians to continue to administer vaccines, allowing other healthcare workers to focus on other tasks that only they can perform. And, the Administration’s $5 billion investment in Project NextGen continues to accelerate and streamline the rapid development of the next generation of coronavirus vaccines and treatments through public-private collaborations.

In addition to addressing the immediate impact of COVID-19 infections, the Biden-Harris Administration recognized that millions of Americans continue to experience symptoms for months and sometimes years after their acute COVID-19 infection. To help better understand why this occurs and to develop potential treatments, the Biden-Harris Administration has dedicated billions of dollars to research efforts, developed the first-ever National Research Action Plan on Long COVID, and created an Advisory Committee on Long COVID.

4 – Ensuring the World Responded and Recovered from COVID-19

While the Biden-Harris Administration implemented all of these programs to help Americans fight COVID-19 here at home, the Administration also recognized that helping the rest of world quickly and effectively respond to the pandemic was critical to both our domestic and the broader global recovery. The United States committed to bringing the same urgency to international response and recovery efforts that we demonstrated domestically. On day one, President Biden called on his National Security Advisor to advance global health security, international pandemic preparedness, and global health resilience to support the global response to the COVID-19 pandemic. This included re-establishing the National Security Council’s team focused on health security and biodefense.

• Restoring Partnerships with Critical, Life-saving Institutions: As soon as President Biden entered office, he ensured that the U.S. reversed its decision to withdraw from the World Health Organization – which was essential to coordinating a global response during the pandemic. In early 2021, United States committed $4 billion to support COVAX, the multilateral effort that aimed to accelerate the development and manufacturing of COVID-19 vaccines and to support equitable access for every country in the world. In two years, the United States provided over $16 billion to vaccinate the world, save lives, and build stronger health security. The United States also convened world leaders at two Global COVID-19 Summits, accelerating response efforts and mobilizing $3.2 billion in commitments to vaccinate the world, save lives, and build stronger health security.

• Vaccinating the World: The United States donated more COVID-19 vaccines than any other country, and it was the first country to announce a purchase of vaccine doses solely for donation to other countries. The U.S. was also the first country to ensure the African Union could start receiving up to 110 million doses of Moderna at a reduced rate negotiated by the United States – and it was the first country to negotiate a deal to send vaccines directly to humanitarian settings and conflict zones to vaccinate displaced persons. Between May 2021 and February 2024, the Biden-Harris Administration donated – in partnership with COVAX, Caricom, the African Vaccine Acquisition Trust (AVAT), and bilaterally – nearly 700 million doses of COVID-19 vaccines to countries around the world. This included over 44 countries and economies in Sub-Saharan Africa, 31 countries in the Western Hemisphere, and 26 countries in Southern, Central, and Eastern Asia.

The COVID-19 pandemic also led to a dropoff in routine childhood immunization in many countries around the world, as they surged scarce resources to pandemic response. As a result, we began to see the reemergence of vaccine-preventable diseases, from measles to polio. In 2024, the United States Government pledged $1.58 billion to support Gavi, The Vaccine Alliance, over the next five years. This commitment builds on a 24-year partnership that has immunized over a billion children and saved 17 million lives. The new funding aims to vaccinate the next billion children within a decade, saving over eight million lives by reaching unvaccinated children, expanding vaccinations for diseases like malaria and cervical cancer, and enhancing emergency health preparedness. The United States, through Gavi, also supports the launch of the African Vaccine Manufacturing Accelerator, which will help African countries produce vaccines locally, promoting vaccine equity and swift responses to future health crises. In addition, the United States supports the Coalition for Epidemic Preparedness Innovations (CEPI), which is working to accelerate the development of life-saving vaccines against emerging disease threats, and to transform capability for rapid countermeasure development in response to future threats. Notable achievements include: the FDA approval of the world’s first Chikungunya vaccine and technology transfer to regional producers for regional supply to LMICs; the advancement through clinical development of vaccine candidates against Lassa, Nipah, and coronaviruses, among others; and the launch of a new Disease X Vaccine Library with six viral families prioritized as high risk.

• Delivering Life-Saving Resources: In addition, the U.S. government delivered life-saving resources like oxygen, treatments, PPE, and other essential supplies worth more than $1 billion to countries experiencing outbreaks by March 2022. This included countries that were most affected by the pandemic. As an example, as India battled a devastating wave of the Delta variant, the United States delivered supplies worth more than $100 million to provide urgent relief. This included 15 million N95 masks, 1 million rapid diagnostic tests, and vaccine manufacturing supplies to help India make over 20 million doses of COVID-19 vaccines. In addition, the U.S. consistently provided immediate support to allies such as Brazil that were seeing disproportionate cases and deaths due to the pandemic – through providing much-needed ventilators, vaccines, personal protective equipment, and support for struggling businesses and communities.

• Providing Technical Assistance and Supporting Vaccine Manufacturing: U.S. public health experts across multiple federal agencies worked side-by-side with on-the-ground providers – providing technical assistance in vaccine program implementation, care provision, and outbreak investigation. The United States respects countries’ right to protect public health and to promote access to medicines for all. Toward that end, the United States endorsed negotiations of a temporary waiver of WTO intellectual property rules to support access to COVID vaccines.

In addition, the U.S. increased the world’s capacity to manufacture vaccines and fostered an enabling environment for innovation, including by spurring African manufacturing. For example, the U.S. International Development Finance Corporation (DFC) provided a $3.3 million technical assistance grant and a follow-on $15 million loan to Institute Pasteur de Dakar (IPD) in Senegal to expand flexible vaccine manufacturing capacity for both routine and outbreak vaccines. IPD also received support from other U.S. government agencies on regulatory strengthening, workforce development and training, and research and development. 

5) Managing Current Public Health Threats

The tools and strategies that the Biden-Harris Administration developed in response to the COVID-19 pandemic are applicable to a range of biological threats, including avian flu, Marburg, Ebola, mpox, COVID-19 variants, and others.

As an example, the National Wastewater Surveillance System has allowed the U.S. to glean more specific information on where avian flu is found in the environment, often before the first human or animal case has been confirmed. Additionally, Traveler-based Genomic Surveillance, which was among the first to detect multiple Omicron variants up to six weeks before they were reported elsewhere in the United States, continues to screen for other threats including new COVID-19 variants. Hospital data reporting also provides granular information on which hospitals may see strain due to admissions from COVID-19, Flu, and RSV each respiratory season.

Avian Flu: Protecting Human and Animal Health

Avian flu, or Influenza A(H5N1), was first detected in dairy cattle in the U.S. in late March 2024. While we have seen this virus in birds for decades and the risk to the general public remains low, the Administration immediately knew that the spread to cows and other mammals demanded serious attention and action. Within twenty-four hours of confirmation of the first case, interagency coordination groups began meeting at the senior leader and technical levels to synchronize support to State and local public health and agriculture officials. Since then, the interagency has worked with government, industry and other partners to ensure we keep communities healthy, safe, and informed – by monitoring and stopping transmission, keeping animals healthy, ensuring that our Nation’s food supply remains safe, and safeguarding the livelihood and well-being of American farmers and farmworkers. In total, since USDA began supporting state-led efforts to mitigate the risk of avian flu in poultry in 2022, the Biden-Harris administration has dedicated nearly $2.8 billion to this important work.

Monitoring the Virus and Stopping Transmission: Within a few weeks of the outbreak, USDA took action to stop the spread of the virus, issuing a federal order in April 2024 that mandated avian flu testing of all lactating dairy cattle moving between states. USDA also stood up a voluntary program for states and farmers to test their herds, implement biosecurity and created incentives for them to do so. By the end of 2024, USDA and its partner laboratories had run over 110,000 tests on dairy cattle and made more than 1,000 staff deployments to support response and traceback efforts on the ground, including 221 personnel currently deployed. In October 2024, USDA announced a nationwide milk testing initiative, requiring states to comprehensively monitor and respond to the presence of the virus in America’s dairies. Today, 28 states – representing nearly two-thirds of America’s dairy production – have joined this program. The remaining states are working to stand up the necessary infrastructure.  

CDC has also been closely tracking the virus through a collaborative effort between CDC and many partners, including state, local, and territorial health departments; public health and clinical laboratories; clinics; and emergency departments. These include systems to monitor case reporting, laboratory monitoring at both public health and clinical labs, emergency department visits, hospitalizations, and assessing wastewater. These systems build on developments over the last four years as a result of the COVID-19 pandemic. Altogether, they provide us with early warning signs on where the virus is spreading, as well as visibility on whether there is any severe disease from avian flu. When human cases have been reported, CDC has engaged and supported state and local health officials with technical support, including the deployment of experts to the field to support public health investigations. 

Since the start of the outbreak, USDA and CDC have been monitoring virus specimens using the latest techniques, to inform our response.  When new human cases are reported, CDC’s national laboratory confirms the findings and performs timely genomic sequencing and other analysis to monitor for any concerning changes in the virus, as well as any potential impacts on our treatments and vaccines. This information has been released in technical reports and the sequences are made available on public servers. Similarly on the animal side, genetic sequences from this outbreak are shared by USDA, with over 4,500 raw or curated sequences having been posted to GISAID (the Global Initiative on Sharing Avian Influenza Data) or the National Center for Biotechnology Information (NCBI) Sequence Read Archive. USDA continually monitors these sequences for any potentially concerning changes and immediately shares any such findings with CDC.  

Protecting Workers and the Public: Learning from bottlenecks and shortages in the very early COVID-19 response, the Administration has spent the last several years refilling our Strategic National Stockpile to ensure that we have the PPE, antivirals, tests, vaccines, and more that the country needs to prepare for future health emergencies. As a result, HHS was immediately able to offer support to states. To date, we have delivered nearly 4 million pieces of PPE and thousands of antivirals to protect workers. USDA also set up a program that reimburses farmers when they purchase PPE for their workers, and post-exposure prophylaxis with Tamiflu is also promptly offered to workers with any known exposure. We have also taken steps to build trust with impacted communities along the way – investing $5 million in campaign to educate and test farmworkers. In total, USDA and CDC have deployed over 100 federal workers into the field to support response and support workers.

As we protect workers today, we are also preparing for any possible scenario tomorrow. The CDC and NIH are tracking changes in the virus so we can see whether it’s becoming more adaptable to humans.  We have already prepared nearly 5 million doses of vaccines so they’re ready if we need them.  Further, by the end of the first quarter of 2025, we will have stockpiled 10 million doses of vaccine to inoculate humans against bird flu. And we’ve invested $176 million in Moderna to develop next-generation mRNA vaccines that can rapidly respond to any adaptations in the virus, with phase 3 trials beginning shortly. In addition to vaccines, we have 68 million courses of influenza antivirals on hand in the Strategic National Stockpile to treat those who may become infected with the virus. We have made 3,000 courses available to affected communities. 

Preserving Animal Health: Research suggests the virus travels via surfaces related to normal business operations such as vehicles, milking equipment, and people’s clothing. That’s meant that biosecurity practices—like limiting visitors, disinfecting work apparel, and separating animals of different species— were essential to reduce the spread and keep cows healthy. In early May 2024, USDA launched assistance for producers with H5N1 affected premises to improve on-site biosecurity in order to reduce the spread of the virus. This includes financial support for protecting workers with PPE, funding for disposal of milk, reimbursement for veterinary costs, and payments for shipping laboratory Samples. As of January 2025, over 500 farms have utilized these programs to date. Later that month, USDA expanded support for producers to stop the spread through cattle, by issuing a rule to compensate eligible producers with positive herds who experience a loss of milk production. So far, over 300 producers have applied to the program with tens of millions of dollars in payments distributed.  Additionally, USDA accelerated efforts to develop a first-of-its-kind bovine vaccine for the virus, and candidates have already entered field safety trials. USDA also announced in early January 2025 that work would begin to build a new stockpile of avian flu vaccines for poultry.

Ensuring the Safety of Our Food Supply: We have 100 years of data showing pasteurization works, but it was essential for our Administration to confirm that this was still the case with this new pathogen. USDA and the Food & Drug Administration (FDA) began testing retail dairy samples from across the country to ensure the safety of the commercial pasteurized milk supply and conducted laboratory experiments to reaffirm that pasteurization inactivates the virus. USDA similarly conducted research to confirm that cooking beef to proper temperature inactivates the virus, which it does. USDA also sampled muscle tissue from culled cattle at beef processing facilities as part of our robust ongoing surveillance programs. Today, we are confident that pasteurized milk, as well as properly cooked meat and eggs, are safe for consumers.

Mpox, Marburg, Measles and More: Managing Additional Public Health Threats

The Biden-Harris Administration has also mounted a robust response to other infectious disease threats that have emerged since 2021, including Marburg and Mpox. On Day 1 of the multiple Marburg and Mpox responses, medical countermeasures existed and were ready to be deployed at home and around the world as a result of U.S. preparedness efforts. In the case of Marburg, the United States had invested in experimental vaccines and therapeutics in order to be able to quickly deploy, test, and eventually seek regulatory approval for new countermeasures. 

Mpox Domestic and Global Responses:

• In early 2022, an outbreak of clade II mpox (then known as Monkeypox) rapidly spread globally and domestically. Shortly after the first U.S. case was identified in May 2022, the Administration deployed tens of thousands of doses of an FDA-approved vaccine and hundreds of courses of an investigational therapeutic from the Strategic National Stockpile to support domestic efforts to control spread and treat patients. We also rapidly scaled up testing capacity from 6,000 to 80,000 tests per week and, by October 2022, over one million doses of JYNNEOS had been administered to individuals at heightened risk of exposure to mpox, over 40,000 treatment courses had been distributed across the country, and domestic cases of clade II mpox had decreased by 90%. Today the mpox vaccine, which is effective against both clades of mpox, is also now commercially available with an ample supply at health departments and local pharmacies.

• During the 2022 response, the Biden-Harris Administration also stood up a White House National Monkeypox Response Team and, in collaboration with a diverse group of community-based and civil society partners, promoted equitable access to vaccines, therapeutics and testing and made significant strides in reaching vulnerable populations where they were with trusted community messengers.  Among the many successes of this group were the planning and execution of multiple “pop up” sites at events where at-risk individuals could learn more about mpox and, if they chose to do so, protect themselves by getting vaccinated against mpox.
• When a new clade of mpox began spreading internationally in 2024, the Biden-Harris Administration was poised to act quickly. Within weeks of WHO’s declaration of a public health emergency of international concern, President Biden announced in September 2024 that the United States was prepared to commit at least $500 million and to donate up to one million doses of mpox vaccines to support African countries in preventing and responding to this outbreak. We are delivering on that commitment, with two-thirds of our global mpox funding pledge fulfilled already, and all one million of the pledged mpox vaccine doses available now for countries that are ready to receive them.

• Most biological threats emerge outside the United States, which means that Americans will be safer when countries around the world are prepared to prevent, detect and respond to threats when they emerge. As part of the implementation of the National Biodefense Strategy, the United States Government continues to work with more than 50 countries around the world – including most mpox-affected countries and those at-risk of an mpox outbreak – to build stronger global health security capacities, ensuring countries are better prepared to stop outbreaks at their source while protecting U.S. national and homeland security.

• Domestically, in 2024, the Administration has continued to focus on additional preparedness steps to increase awareness of mpox risks; provided updated recommendations to prevent, detect, and treat both clades; and expanded wastewater surveillance to provide an early warning of mpox activity and community spread. In addition, the United States continued to build on the critical testing landscape created during the 2022 outbreak and can not only detect both clades of mpox, but can also differentiate between clade I and clade II mpox.

Global Marburg Response:

In September 2024, Rwanda’s Ministry of Health announced an outbreak of Marburg Virus Disease (MVD), a rare, viral hemorrhagic fever similar to Ebola. Over the last four years, the Biden-Harris Administration has responded to 11 Ebola or Marburg outbreaks.  Immediately after learning of the outbreak in Rwanda, in partnership with the Government of Rwanda, the United States committed millions of dollars to address urgent health gaps in Rwanda and surrounding countries, through provision of technical assistance with surveillance and contact tracing, infection prevention and control guidance, case management, risk communication and community engagement, safe and dignified burials, donation of laboratory test kits, and point of entry exit screening at Rwanda’s airport and neighboring border crossings. Within 8 days of learning of the outbreak, the United States Government worked with the Government of Rwanda, WHO, CEPI, and other critical partners to share experimental vaccine doses with Rwanda, and into the arms of healthcare workers at high risk of exposure, an unprecedented public health achievement. The United States also contributed tests, treatments and PPE, to support response efforts and protect health workers. This support has been made possible through the United States robust investments in science and research over the last 10 years. On December 20, the outbreak was declared over by the Government of Rwanda, with one of the lowest case fatality ratios (22%) of any Marburg outbreak in history.

Domestic Measles Response:

As the number of children protected from measles infections continues to decline due to declining vaccine coverage and misinformation, multiple jurisdictions have had to rapidly respond to measles outbreaks. The administration has deployed experts to support local responses and has distributed additional vaccine doses to support targeted vaccination campaigns, which are effective in ending outbreaks. The Administration has underscored that while the measles vaccine is highly effective and provides durable protection, 93-95% vaccine coverage is needed to maintain community protection. An unvaccinated individual exposed to the virus has a 90% chance of developing disease – therefore vaccination is critical to this response.

6) Building the Infrastructure for Future Biological Threats

The Biden-Harris Administration has also taken historic actions, building on policies from prior administrations, to protect Americans from biological threats that may emerge in the future.

Replenishing the Strategic National Stockpile:

The Strategic National Stockpile (SNS) was created in 1999 to “provide for the emergency health security of the United States …in the event of a bioterrorist attack or other public health emergency.” Historically, the SNS holds vaccines and therapeutics to protect the country from any number of chemical, biological, radiological, or nuclear events. Many of these medical countermeasures are not commercially available and the SNS is the only source for these critical supplies in the country–and in some instances the world. Under the Biden-Harris Administration, the SNS’s budget increased by 25% – allowing it to secure more of the vaccines, therapeutics and medical supplies needed to protect the country from public health emergencies and disasters.

Since the beginning of the COVID-19 pandemic, the Strategic National Stockpile distributed more than 27,000 tons of medicines, equipment, and supplies to support the country’s public health and health care needs. Early in the pandemic, the Strategic National Stockpile (SNS) deployed 90% of its overall inventory of personal protective equipment (PPE) – nearly 72 million items – as well as 100% of its Federal Medical Stations, which served as alternate care sites across the country. Much of this PPE was purchased ten years before with funds from the H1N1 outbreak—and had not been restocked.
Since President Biden took office, the SNS has dramatically increased its stockpiled quantities of PPE and ventilators—with supplies that were made in America where possible. The SNS now has 70 times the number of N95 respirators, 34 times the number of gloves, 50 times the number of isolation gowns, and 10 times the number of ventilators than it had before the pandemic.  Restocking the SNS to these levels has allowed it to make PPE available to communities impacted by COVID1-9, H5N1 and other infectious disease outbreaks. In 2022, the SNS provided nearly 300 million N95 masks to retail pharmacies and community health centers for free —the largest deployment of personal protective equipment in U.S. history.  Under President Biden, the SNS has also assigned staff to state public health departments and completed a series of tribal consultations and urban Indian confers to ensure all communities understand what tools it has available and how to access them in times of emergency or disaster.

Expanding Surveillance Capabilities:

At the start of the COVID-19 pandemic, because of years of underinvestment in modernizing data systems, some state, local, tribal, and territorial jurisdictions still relied on fax machines to transmit public health data and the U.S. struggles to collect, analyze and share essential data on the presence of SARS-CoV-2 in communities, the rate of transmission, and the impact on hospitals. Throughout our response, the U.S. government has expanded our surveillance capabilities to monitor disease and better inform the public. These steps include: 

• Increasing the number of healthcare facilities which provide automated, near real-time electronic case reporting to local, state, tribal, territorial and federal public health officials from less than 200 in 2020 to over 48,000 in 2024 and supporting public health authorities to adopt the Trusted Exchange Framework and Common Agreement (TEFCA) to further enable the exchange of public health data across the healthcare ecosystem to help rapidly identify emerging outbreaks.

• Standing up a National Wastewater Surveillance System, which routinely reports early warning information from over 1,500 sites covering over 150 million people in the United States.

• Scaling up genomic sequencing, which is important to detect new pathogens including variants.  At the start of the COVID-19 pandemic, only 23 public health labs demonstrated advanced molecular detection surveillance capabilities. By the end of 2022, this number expanded to 68 public health laboratories, and CDC launched 5 Pathogen Centers of Excellence. The average turnaround time for public health laboratories to publish genome sequences has dramatically improved – decreasing from 96 to 40 days. Some laboratories able to sequence in less than two days.

• Developing a COVID-19 Variant Playbook, which served to assess the disease severity and transmissibility of a new variant immediately, and to expedite the rapid laboratory evaluation of the effectiveness of vaccines, tests, and treatments against any variant.

• As a result of close collaboration between the CDC, the Centers for Medicare and Medicaid Services and industry stakeholders, over 80% of all hospitals from across America are now sharing critical data on emergency department visits and hospital admissions.

Advancing Capabilities in RNA Vaccine Technologies: 

With investments totaling over $400 million, the Administration has also been advancing capabilities in RNA vaccine technologies to guard against future pandemics. To further these efforts, multiple companies are currently partnering with HHS to develop RNA vaccines that may allow for a faster, more sustainable response capability against multiple threats, lower the requirement for needles, simplify storage requirements, or investigate new methods of administration.

Strengthening Domestic PPE Supply Chain:

Given gaps in domestic capacity for critical PPE, this Administration, in an effort to minimize foreign reliance, the President signed the “Make PPE in America Act” in 2021. The statute requires that the Departments of Homeland Security (DHS), Health and Human Services (HHS) and Veterans Affairs (VA) (collectively referred to as “covered agencies”) issue long-term contracts for PPE containing only materials and components that are grown, reprocessed, reused or produced in the U.S. This requirement is critical to strengthening our domestic manufacturing capabilities and promoting the production of essential PPE in the United States. The statute recognizes the power of leveraging the federal government’s buying power as a catalyst to increase market participants, support competition and the health of the domestic PPE industry.

A sustained federal commitment to procure PPE from domestic sources supports the health of the domestic PPE industry. Since the enactment of the Make PPE in America Act, covered agencies took actions to support a long-term domestic federal procurement strategy, model demand, and more closely align their acquisition strategies to send a government-wide demand signal to the PPE industry, while working collaboratively with the Defense Logistics Agency (DLA) and the Office of Management and Budget (OMB) to implement the Make PPE in America Act.

Stopping Outbreaks at their Source and Transforming our Biopreparedness Capabilities:

In 2022, President Biden signed National Security Memorandum 15 on Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security. This NSM launched a new National Biodefense Strategy and Implementation Plan, which envisions “a world free from catastrophic biological incidents” and directs a coordinated, whole-of-government effort to prepare for biothreats. It includes an ambitious five-to-ten-year vision for developing moonshot biodefense capabilities, including the ability to develop new vaccines within 100 days and repurpose therapeutics within 90 days.

The most effective way to limit the impact of biological threats is to stop them at their source. The United States is working with countries and partners around the world to ensure they have the capacity to identify and stop emerging threats before they grow into regional or global threats. To advance that goal, the administration published an updated Global Health Security Strategy, laying out our commitment to working with foreign partners in order to continue building our capacity to prevent, detect, and respond to biological threats wherever they emerge. The Administration took several concrete actions to support these transformative efforts.  The U.S. Government reached the ambitious goal of directly supporting 50 countries in building their health security capacity, which is one of the most powerful prevention tools we have in this space. The United States has also leveraged financial resources and diplomatic channels to mobilize support for 50 additional countries to strengthen their health security capacities, for a total of more than 100 countries receiving support.

Limitations in the existing global systems to finance pandemic prevention, preparedness, and response left countries and financial institutions ill prepared to effectively contain COVID-19. On day one, President Biden called on his Administration to transform the existing financing institutions and to cultivate new financing sources for global health security that are more effective and sustainable, and that are less dependent on U.S. government assistance. The United States was instrumental in the creation of the Pandemic Fund in 2022, the only multilateral financing facility dedicated exclusively to pandemic preparedness financing for low- and middle- income countries. The Pandemic Fund made significant progress in its first two years, awarding grants totaling $885 million, which mobilized an additional $6 billion in investments, to support 75 countries and economies across six geographic regions. The United States is also working to evolve Multilateral Development Banks to be better equipped to respond to the increasing frequency, scope, and complexity of global challenges, including pandemics. The Biden-Harris Administration strongly supported the establishment of the International Monetary Fund Resilience and Sustainability Trust and its goal of supporting low-income and vulnerable middle-income countries to access long-term, affordable financing to address longer-term challenges, such as health emergencies. During the COVID-19 pandemic, many countries and institutions lacked the liquidity to procure the medical countermeasures (MCM) needed to mount effective and timely responses. The U.S. Development Finance Corporation helped develop and lead a G7 Surge Financing Initiative, through which G7 development finance institutions (DFIs), the European Investment Bank, the International Finance Corporation, and global and regional health stakeholders are developing and deploying innovative financing tools to accelerate access to MCMs in health emergencies. 

While there will always be new or evolving biological threats, developing effective countermeasures for known threats is a critical piece of preparedness. For example, the U.S. government invested billions of dollars in mRNA technology in advance of the COVID-19 pandemic. These public investments translated into millions of lives saved in the United States and around the world, and were crucial to developing the mRNA vaccine technology that can be leveraged in a future pandemic, as well as potentially treating other diseases. For example, the Department of Defense and the National Laboratories are leveraging Artificial Intelligence for rapid development of medical countermeasures. The Administration is executing a whole-of-government implementation plan for strengthening capabilities in early warning, vaccines, therapeutics, diagnostics, clinical trials, and PPE.

Strengthening Research Capacity and Oversight:

The lives saved and hospitalizations avoided as a result of the COVID-19 therapeutics and vaccines were the result of decades of foundational research investments. Because viruses and bacteria are constantly changing and the frequency of naturally occurring biological outbreaks is increasing, the Biden-Harris Administration published the American Pandemic Preparedness Plan in the fall of 2021. In addition, the administration has continued to invest more than $7 billion annually in research by Federal, academic and industry researchers in new ways of protecting Americans from tuberculosis, HIV and other infectious diseases that remain leading causes of illness in our nation. These investments are crucial to ensure our nation is prepared for future threats and to deter those who are seeking asymmetric advantages over the US.

In 2024, the Administration also released an updated policy to enhance oversight of research. This update to standards that were originally released in 2012 will reduce the likelihood of accidental outbreaks and deliberate misuse of life science research, while ensuring that lifesaving research proceeds.

Supporting Global Biosafety and Biosecurity:

Expanding biosurveillance capacity and the rapid evolution of technology are critical for health security, but can also elevate the risk of accidental and deliberate incidents. The Biden-Harris Administration has taken significant steps to minimize the chances of laboratory accidents; reduce the likelihood of deliberate use or accidental misuse; ensure effective biosafety and biosecurity practices and oversight; and promote responsible research and innovation. The Biden-Harris Administration knows that in order to protect the domestic population, investing in global biosafety and biosecurity practices and oversight is essential. These efforts – which minimize the chances of laboratory accidents, reduce the likelihood of deliberate use or accidental misuse, and more – have been critical as we expand biosurveillance capacity. For example, the United States secured inclusion of biosafety and biosecurity as a critical component of the Pandemic Fund grants to support laboratory systems. One of the projects, the Caribbean Public Health Agency Train-the-Trainer Workshop on the Safe Transportation of Infectious Substances, resulted in certified trainers well-positioned to serve as national trainers and advisors in biosafety and safe transport protocols, ensuring safer practices across the region. The U.S. global health security bilateral partnerships also build capacity in biosafety and biosecurity: the final global health security report of the Administration showed that global health security partner countries with at least two years of U.S. Government support demonstrated a net improvement in biosafety and biosecurity capacity from 2018 to 2023. The Administration also supported the 2024 World Health Assembly resolution on Strengthening Laboratory Biological Risk Management, which calls for improvements to biosafety and biosecurity practices globally.

Standing up the Office of Pandemic Preparedness and Response Policy:

Recognizing the growing threat of pandemics, the Administration stood up the Office of Pandemic Preparedness and Response Policy (OPPR) in August of 2023. This is a permanent office in the Executive Office of the President charged with leading and coordinating actions related to preparedness for, and response to, known and unknown biological threats or pathogens that could lead to a pandemic and/or to national security. OPPR assumed the duties of the COVID-19 Response Team and Mpox team at the White House and has continued to coordinate and develop policies and priorities related to pandemic preparedness and response.

Because every successful response to a biological event has required a synchronized, integrated team, OPPR has worked with federal, state and local health partners, and has engaged with a broad array of private sector, academic and other stakeholders to ensure lessons from the response to COVID-19 and other recent outbreaks inform future plans and response efforts.  Recent accomplishments include:

• Partnering with multiple industry stakeholders to resolve supply chain issues affecting the availability of a new immunization, reducing infant hospitalizations by more than 80%.
• Partnering with leaders from the European Union, the Republic of Korea, Japan, India and multiple industries to develop a process to quickly recognize and address supply chain issues affecting availability of medications in the US and partner countries.
• Partnering with leaders from the Long-Term Care industry to improve vaccination rates for residents of long-term care facilities.
• Partnering with leaders from across the domestic healthcare enterprise to identify and mitigate constraints to our national preparedness for future biological events and to create a collaborative committed to continuing to mitigate future challenges.
• Partnering with community support organizations to identify best practices from the COVID-19 pandemic and to develop strategies to sustain outreach to historically medically underserved communities to ensure all Americans can access their healthcare options.

Conclusion

As of result of the Biden-Harris Administration’s efforts, the COVID-19 pandemic no longer disrupts our daily lives, our children are back in schools, our economy is stronger than ever and families have been able to resume their pre-pandemic routines. As new viruses and other biological threats have continued to emerge, we have remained vigilant in monitoring and responding to each threat. From investments into research for new tests and treatments for diseases, to launching the largest vaccination program in our country’s history, to expanding the nation’s surveillance capabilities, to replenishing the Strategic National Stockpile, the Biden-Harris Administration has transformed our nation’s pandemic preparedness and response.

In order to ensure that future Administrations are prepared for any threat that emerges, the Biden-Harris Administration will also leave behind a three-step internal playbook with nearly 300 pages of guidance on how to rapidly and effectively respond to biological threats from all sources – naturally occurring, accidental and deliberate.

• Step 1: Within 24 hours of notification of a serious biological threat, NSC convenes Departments and Agencies for a biological incident notification and assessment (BINA).
• Step 2: If the threat poses a significant risk to the United States, within 24-48 hours Departments and Agencies establish an Incident Response Coordination Structure (IRCS), with agency leadership and support roles pre-determined in a playbook.
• Step 3: Departments and Agencies operationalize a rapid and effective response, with coordination by the IRCS and leadership from the White House. The playbook includes detailed operational annexes to address many scenarios that commonly arise during biological incident responses. 

Under the Biden-Harris Administration, we have exercised this three-step playbook numerous times, including in recent weeks. All Departments and Agencies have received final versions of the Playbook, and the Biden-Harris Administration will give copies to the incoming Administration to ensure they are prepared to act on day one of a crisis to protect the American people. 

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