~~ recommended by emil karpo ~~
The extraordinary success of the quest for the COVID-19 vaccine holds lessons for the rest of the government.
The U.S. government can achieve great things quickly when it has to. In November 2020, the Food and Drug Administration granted emergency-use authorization to the Pfizer-BioNTech vaccine for COVID-19. Seven days later, a competing vaccine from Moderna was approved. The rollout to the public began a few weeks later. The desperate search for a vaccine had been orchestrated by Operation Warp Speed, an initiative announced by the Trump administration that May. Developing, testing, manufacturing, and deploying a new vaccine typically takes a decade or more. OWS, which accomplished the feat in months, belongs in the pantheon of U.S. innovation triumphs, along with the Manhattan Project and the Apollo moon-landing program. It’s a case study in how the U.S. government can solve complex, urgent problems, and it challenges the narrative that public institutions have lost their ability to dream big and move fast.
That narrative, sadly, has ample basis in recent history. Many efforts to upgrade the nation’s transportation systems falter because, as the Biden administration declared in 2021, “America lags its peers … in the on-time and on-budget delivery of infrastructure.” NASA’s latest mega-rocket, the Space Launch System, took its first test flight in 2022, six years behind schedule, despite the investment of an astronomical $23.8 billion since 2011. Agency officials recently admitted to the Government Accountability Office that the SLS program is “unsustainable.”
Despite having pioneered much of the underlying technology, the U.S. has fallen behind other nations in deploying hypersonic missiles. In 2021, China launched a 15,000-mile-per-hour missile designed to evade traditional air defenses. General Mark Milley, who retired in September as the chair of the Joint Chiefs of Staff, warned in 2017 that the U.S. military had become “overly centralized, overly bureaucratic, and overly risk-averse.”
In a 2022 Pew poll, fewer than a quarter of Americans said they were “basically content” with the performance of the federal government. Unfortunately, the deep ideological split over whether the government should be bigger or smaller tends to obscure the question of how to make the government work better.
The federal government employs about 3 million Americans, a number that’s changed little since the late 1960s. One thing that has changed is the number of bureaucrats—people who are not directly providing services to the public but who instead oversee government programs, manage budgets, and ensure compliance with laws and regulations. According to our analysis of data from the U.S. Office of Personnel Management, the number of federal administrators ballooned by nearly 50 percent from 1998 to 2022. New York University’s Paul Light estimated in 2020 that the number of organizational layers in the largest federal agencies has grown nearly fivefold since the 1960s. He counted 1,070 deputy assistant secretaries, 236 assistants to the assistant secretary, 204 deputy deputy assistant secretaries, and 153 deputy assistant assistant secretaries.
This phenomenon, which Light describes as the “thickening” of government, is happening in the private sector too. Over the past 30 years, Bureau of Labor Statistics data suggest, the number of administrative and managerial jobs in the U.S. economy grew more than three times faster than the number of non-bureaucratic jobs. More administrators mean more rules, policies, and management layers.
In theory, all of this extra supervision should yield smarter decisions and less downside risk; bureaucracies exist in part to promote standard practices and to limit the amount of damage that any individual employee can cause. But a thicker organization also produces longer lines of communication, slower response times, more turf battles, and less agility and innovation.
Operation Warp Speed was designed to avoid these problems. It had a ridiculously ambitious charter: Develop and deliver 300 million doses of a safe and effective vaccine by January 2021. Skepticism was warranted, given that only one in 15 potential vaccines that reaches the second phase of clinical trials ends up being licensed. A partnership between the Department of Health and Human Services and the Pentagon, the initiative was led by Moncef Slaoui, a scientist and former pharmaceutical executive, and General Gustave Perna, who was in charge of the U.S. Army Materiel Command. The staff included perhaps 600 HHS employees, plus about 100 from the Department of Defense. To defeat the virus, they would need to coordinate a wide network of partners, including drugmakers, logistics titans such as FedEx and UPS, medical distributors, and a plethora of supermarket and drugstore chains that would help administer the vaccines—all amid severe supply-chain constraints, a domestic shortage of technical talent, and the need for social distancing.
Slaoui and Perna had the benefit of an $18 billion budget that allowed them to fund large-scale trials and purchase millions of vaccine doses in advance. OWS was also able to leverage a preexisting body of research on an emergent vaccine technology, messenger RNA. Yet at the time, almost no one believed that those advantages foreordained success. In interviews to recruit a project leader, Slaoui had reportedly been the only candidate who thought the deadline might be realistic. His willingness to aim high proved to be essential.
So did a lean management structure. Slaoui and Perna, according to multiple accounts, had the authority to work across agencies, and they were seldom second-guessed by their political masters. They reported to a board, co-chaired by the secretaries of HHS and Defense, that not only provided oversight but also helped clear away obstacles. Working briskly, the board focused on approving major decisions, such as awarding multibillion-dollar contracts to drugmakers and eliminating supply bottlenecks via the Defense Production Act (which compels private companies to put government contracts at the head of the queue).
Slaoui, Perna, and their board also gave others authority to make important decisions in real time. Tasked with recruiting at least 30,000 participants to test each candidate vaccine—for some of the largest clinical trials in history—the OWS team members John Mascola and Matthew Hepburn had to identify people who were at risk of exposure to the virus even as pandemic hot spots waxed and waned unpredictably around the country. Fortunately, they were free to revise the trial plan on the fly. “People understood they had a lot of latitude and were accountable,” a former HHS deputy chief of staff named Paul Mango told us this summer. “The absence of micromanagement was highly energizing.”
OWS had to synchronize the work of hundreds of public and private entities. Information circulated peer-to-peer rather than having to go up the chain of command. For each vaccine candidate, a product-coordination team met daily to set priorities and address problems that needed quick resolution. These teams worked with U.S. Customs and Border Protection to expedite equipment imports, with the State Department to secure visas for essential talent, and with the U.S. Army Corps of Engineers to build factories.
Rather than test one vaccine candidate at a time, OWS simultaneously placed bets on mRNA and two other technologies, tapping two developers for each type. Factories were retrofitted for mass production of vaccines while clinical trials were still in progress. Distribution teams were simultaneously developing packaging and securing local vaccination sites. The redundancies and overlapping timelines shaved years off the development process—and provided insurance amid great uncertainty about which vaccines would work.
Above all, Operation Warp Speed shunned complexity in favor of simplicity. Many private-sector executives are wary of doing business with government agencies, which typically impose elaborate, albeit well-intended, requirements on virtually every interaction and are slow to respond to the concerns of contractors and suppliers. In this case, private-sector vaccine suppliers were subjected to fewer rules than what the 2,000-page Federal Acquisitions Regulations manual spells out, and granted enhanced intellectual-property rights.
At every point, OWS staffers were encouraged to prioritize progress over process. Mango credited former HHS General Counsel Robert Charrow for setting the right tone. “He and his team,” Mango told us, “were pretty scrappy in finding ways to get things done and saying yes instead of no.”
Years after the darkest days of the pandemic, many people overlook the enduring importance of Operation Warp Speed. When then-President Donald Trump announced it, skeptics mocked its Star Trek–inspired name and worried that officials would cut corners on safety to produce a vaccine before the 2020 election. Since then, others have faulted it as overly generous to drug companies. OWS fell short of its manufacturing targets, and the vaccine shortages of early 2021 prompted more criticism of the initiative. Democrats have been loath to give any credit to Donald Trump and his underlings, while Republicans—many of whom were skeptical of the vaccine push—struggle to admit that the federal government can do anything right.
In fact, OWS offers powerful evidence that upending bureaucratic norms can, quite literally, save lives. If complex, hidebound institutions such as HHS and the Pentagon can exceed expectations, other agencies should also be capable of warp-speed performance. The most immediate applications might lie in inventing vaccines for other diseases and in advancing transformative technologies such as desalination, solid-state batteries, and carbon capture. But the basic approach of Operation Warp Speed—defining a specific problem, committing to an ambitious goal, and then giving people the freedom and the wherewithal to produce breakthrough solutions—could be used more expansively.
The Department of Defense might focus laserlike on reducing the development time for new major weapons programs by 50 percent. The Department of Transportation might set itself the goal of cutting the timeline and cost of major transit projects in half by streamlining and coordinating regulatory approval, funding, and procurement. The Department of Housing and Urban Development might devote itself to eliminating America’s 4-million-unit housing shortage, including by pushing local governments to reform land use and supporting the construction sector with financing, incentives for innovation, and lower taxes on inputs. Those executive-branch agencies, to be fair, are subject to budget restrictions and other congressional limits, but an OWS-like focus on results might persuade lawmakers to grant them more freedom.
Americans got speedy access to vaccines because the harms of the pandemic—to the economy as well as to human health—were acute enough to warrant radical thinking. Many of the other seemingly intractable challenges that the U.S. faces, although less deadly than the coronavirus, warrant the same rule-busting audacity that made Operation Warp Speed a success.
No comments:
Post a Comment