THE 2017 UPDATE TO THE HHS PANDEMIC INFLUENZA PLAN This 2017 Update to the HHS Pandemic Influenza Plan builds upon goals elaborated in the 2005 plan, describes ongoing work toward those goals, and identifies key actions for the next decade. Based on experience drawn over the past decade, it presents the current best thinking about how to address pandemic influenza challenges and builds upon the four domains featured in the 2005 plan: 1. Surveillance, Investigation, and Protective Public Health Measures 2. Vaccines and Antiviral Drugs 3. Health Care and Emergency Response 4. Communications and Outreach In the 2017 Update, seven domains describe how HHS and its partners have added to the evidence base or applied lessons learned, and areas in which capabilities can be optimized: 1. Surveillance, Epidemiology, and Laboratory Activities 2. Community Mitigation Measures 3. Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices 4. Health Care System Preparedness and Response Activities 5. Communications and Public Outreach 6. Scientific Infrastructure and Preparedness 7. Domestic and International Response Policy, Incident Management, and Global Partnerships and Capacity Building Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole. By necessity, these domains have some overlapping content, reflecting the fact that this work is intimately integrated with other aspects of domestic and international pandemic preparedness and response. Within each domain, the Update summarizes the relevance to pandemic influenza, an accompanying goal, and a list of objectives for sustaining momentum that address ongoing work, challenges, and opportunities for the next decade. Evolving science and budget priorities will influence the direction and scope of progress that is critical to mitigating the next influenza pandemic. 13