Achievement of comprehensive, effective domestic and international biosurveillance is compromised by jurisdictional complexity and inefficiencies. Federal biosurveillance policy oversight should be established in the Executive Office of the President (EOP) with the National Security Staff (NSS) as the lead entity identified to coordinate investments, interagency collaboration, and program implementation including those activities in support of the President's Global Health Initiative. An outside representative advisory group should be established to facilitate key stakeholders' interface with White House policy and technology coordinating groups.