This week, those of us at ASPR join Americans across the country in commemorating the 25th anniversary of the September 11 attacks.
We remember those we lost. We honor the extraordinary bravery, heroism, and selflessness of the men and women who answered the call that day. And we remember the thousands of responders who, in the face of unimaginable circumstances, simply did what responders do: they went toward the danger when others needed help.
I had the privilege of working side-by-side with some truly extraordinary men and women in the aftermath of September 11. Those days have stayed with me for 25 years.
I will never forget the responders who ran toward danger to save people they had never met. I will never forget the exhaustion, the destruction, or the conditions we worked in. And I will never forget that, day after day and month after month, people continued showing up because the job still needed to be done and people still needed us.
September 11 also exposed serious gaps in our nation’s preparedness and response infrastructure. It set in motion a transformation of federal homeland security, public health, and emergency management.
In the months and years that followed, our nation strengthened its ability to rapidly deliver medicines and medical supplies, prepare communities for public health emergencies, organize medical responders and volunteers, and coordinate the federal response to catastrophic events.
Congress built on those lessons through a series of laws, including the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 and the Project BioShield Act in 2004. Five years after September 11, and following Hurricane Katrina, which exposed additional vulnerabilities, the Pandemic and All-Hazards Preparedness Act (PAHPA) brought many of those reforms together under a more unified federal public health and medical preparedness and response framework and established the Assistant Secretary for Preparedness and Response.
Those reforms were born from hard lessons, and they came at an extraordinary cost.
Twenty-five years later, we owe it to every responder who gave everything they had to protect others that day to do more than remember their sacrifice. We honor them through action. We build on what we learned. And we make sure this country is better prepared for whatever comes next.
Supporting Responders Who Answer the Call
The National Disaster Medical System (NDMS) existed long before PAHPA. On September 11, NDMS responders deployed alongside thousands of other emergency personnel.
Medical teams mobilized to support responders. Disaster Mortuary Operational Response Teams helped identify and honor those who died, helping provide families and communities much-needed closure in the days and weeks that followed. Veterinary responders cared for the search-and-rescue and law enforcement animals working amid the rubble.
Their service, commitment, and dedication were extraordinary.
But September 11 also exposed gaps in how federal medical resources were coordinated during a large-scale, complex emergency.
In those initial hours, some NDMS teams did not have clear direction about where they were needed. Teams were sent to staging areas that did not always match the immediate operational need. Responders were ready to work, but in some cases, they waited while the larger response system determined where and how to use them.
The problem was never a lack of commitment. The responders were capable, trained, and ready to serve.
The system around them needed to be better.
We needed stronger coordination, clearer roles, and better mechanisms to make sure federal medical capabilities could get where they were needed and be used effectively when communities needed them most.
PAHPA helped strengthen that system by bringing federal public health and medical response under clearer leadership. It placed NDMS under the newly established Assistant Secretary for Preparedness and Response. Subsequent reauthorizations built on those authorities as real-world emergencies continued to reveal operational needs and opportunities to improve how NDMS recruits, trains, equips, and deploys its workforce.
Today, NDMS provides our nation with a standing capability to rapidly augment state and local healthcare systems when their resources are overwhelmed. Its trained and credentialed medical, veterinary, and mortuary responders can deploy with specialized equipment and supplies and integrate with partners already operating on the ground. Its Definitive Care Program helps the healthcare system absorb surges of patients during mass-casualty events.
The lesson remains just as relevant 25 years later: the willingness to answer the call is essential, but willingness alone is not enough.
The people who step forward must be trained. They must be organized. They must be equipped. And they must be integrated into a response system that allows them to make the greatest possible difference when lives are on the line. Going forward, we encourage Congress to consider how NDMS is resourced to strengthen training opportunities. We also appreciate consideration of direct-hire authorities for NDMS, which would expedite the processes used to staff this critical system.
Delivering Lifesaving Medicines and Supplies
September 11 also marked a turning point for another federal preparedness capability.
In 2001, what we know today as the Strategic National Stockpile was called the National Pharmaceutical Stockpile. It was created to make sure lifesaving medicines and medical supplies could rapidly reach communities during a public health emergency.
On September 11, the stockpile was mobilized for the first time in an actual emergency.
HHS deployed one of its 12-hour Push Packages to New York City, along with additional medical supplies and technical assistance personnel. Pharmaceuticals and supplies reached New York within seven hours.
That demonstrated something very important: when disaster strikes, you cannot start building your capability then. Resources, systems, relationships, and logistics have to exist beforehand.
September 11 also changed how our nation thought about the stockpile itself.
Originally developed largely around the threat of biological and chemical terrorism, the program began expanding after the attacks toward a broader, all-hazards mission. That evolution accelerated only weeks later when anthrax was deliberately sent through the U.S. mail, requiring the stockpile to move antibiotics and other medical countermeasures to affected communities across the country.
Those experiences helped drive a series of changes in the years that followed. The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 established the stockpile in law and broadened its mission to protect the nation in the event of a bioterrorist attack or other public health emergency. The Project BioShield Act of 2004 strengthened the federal government’s ability to develop and acquire medical countermeasures. PAHPA then built on that foundation as part of a broader effort to strengthen and better coordinate federal public health and medical preparedness and response.
Today, the Strategic National Stockpile remains a critical component of our nation’s health security infrastructure, maintaining medicines, medical supplies, and other countermeasures that can be rapidly deployed when an emergency overwhelms state and local resources.
And the lesson from September 11 remains the same: preparedness is about much more than having supplies sitting on a shelf.
It means anticipating what may be needed. Positioning resources before an emergency occurs. Building logistics. Building the partnerships. And making sure the system can get the right resources to the right place when every hour matters.
ASPR looks forward to continuing to work with Congress to ensure the resources and authorities remain available to support this critical national security asset.
Harnessing the Spirit of Service
In the days following September 11, 2001, Americans across emergency response, public health, law enforcement, healthcare, and countless other fields were moved to serve.
People wanted to help.
That instinct — to step forward when your neighbors need you — remains one of this country’s greatest strengths.
Medical professionals and other volunteers arrived at disaster sites offering their skills, their time, and whatever help they could provide. But in 2001, communities did not have a national system designed to organize that tremendous willingness to serve.
The Medical Reserve Corps grew out of that experience.
HHS launched the program in 2002, and PAHPA later formally established the MRC in law. Today, approximately 268,000 volunteers serve through more than 700 locally organized MRC units. They train before emergencies happen and work alongside public health departments, emergency managers, healthcare organizations, and other community partners.
The principle behind it is straightforward: do not wait until the worst day to figure out who can help.
By recruiting, organizing, and training volunteers beforehand, communities have people they know and trust who are ready to step forward when additional capacity is needed.
MRC continues to support local preparedness and resilience and ensures communities have a local resource to mitigate local and community disasters and events.
Preparing Healthcare Before Disaster Strikes
Another lesson came from that dark day: even the most dedicated responders cannot succeed without resilient healthcare systems behind them.
That truth was reinforced in the aftermath of Hurricane Katrina in 2005 and helped shape the reforms that followed.
Patients had to be evacuated. Communications and transportation were disrupted. Healthcare workers faced extraordinary conditions while trying to continue caring for their communities.
The Hospital Preparedness Program (HPP) helps strengthen preparedness and coordination across healthcare systems before emergencies occur.
Through HPP, healthcare coalitions bring hospitals, emergency medical services, emergency management, public health, and other healthcare partners together, so they are not meeting each other for the first time when disaster strikes.
They plan. They train. They exercise.
They prepare to manage a sudden influx of patients, coordinate available beds and specialty care, share critical information, and determine how personnel, supplies, and other resources can be used across a region when individual facilities are strained.
HPP also supports training, technical assistance, and investments that strengthen healthcare readiness before those capabilities are tested in a real emergency.
That is what preparedness is about: identifying vulnerabilities before the crisis and building the relationships and capabilities needed to overcome them.
Carrying the Lessons Forward
I am proud to have served in the response to the September 11 attacks.
And today, I am equally proud to work alongside men and women at ASPR who have deployed when this nation needed them and who continue serving the American people today.
September 11 changed this country. It changed me, and it changed everyone who was part of that response.
Responders climbed countless flights of stairs. They entered burning buildings. They treated the injured. They searched through wreckage. They carried strangers to safety.
Some never came home.
Others came home carrying injuries, illnesses, and memories that have remained with them for the past 25 years.
We owe it to those we lost, and to those still living with the health effects and trauma of their service, to make sure the lessons they paid such a high price to teach us are never forgotten.
For me, “Never Forget” cannot simply be a call to remember. It must be a call to act.
Over the past 20 years, PAHPA and its reauthorizations have helped strengthen the systems surrounding the people who answer the call.
As Congress considers the next reauthorization of PAHPA, we should make the most of that opportunity: apply the lessons we have learned, strengthen the systems responders depend on, and make sure communities have the capabilities they need on their worst days.
This week, we will tell more stories reflecting on September 11 and the people who served, many of whom continue to serve here at ASPR.
We will remember those who ran toward danger.
We will remember those who worked through the days, nights, weeks, and months that followed.
And we will remember those whose service ultimately cost them their lives.
But honoring their sacrifice requires more than remembering.
Twenty-five years later, it is our responsibility to continue making our nation’s health security stronger. We owe it to the people who served that day. We owe it to the responders who will answer the next call.
And most importantly, we owe it to the American people to make sure this nation is prepared when the next worst day comes.
