Volume 23, Supplement—December 2017
SUPPLEMENT ISSUE
Global Health Security Supplement
Overview
US Centers for Disease Control and Prevention and Its Partners’ Contributions to Global Health Security
Table 1
Global health protection accomplishments | Number | Timeframe |
---|---|---|
Emergency mitigation of global health threats | ||
Ending the West Africa Ebola outbreak | ||
CDC staff deployments overall, domestic and international | >3,500 | 2014–2016 |
Departing passengers in the 3 affected countries screened for Ebola virus disease | >339,000 | 2014–2016 |
Vaccinations of health workers in Ebola trial | >8,000 | 2015 |
Days of continuous operation of high-throughput laboratory capacity in Sierra Leone; >23,000 specimens tested | 421 | 2014–2015 |
US healthcare workers trained in Anniston, AL, to work in West Africa | >600 | 2015 |
GRRT | ||
CDC-trained GRRT experts prepared to deploy on short notice to a public health emergency | >400 | 2017 (Jun) |
GRRT mobilizations (>14,000 cumulative person-days), supporting responses to global health emergencies including Zika, yellow fever, cholera, measles, polio, and Ebola | >420 | 2015–2017 (Jun) |
Rapid humanitarian responses | ||
Staff deployments in response to public health humanitarian emergencies in >40 countries | >380 | 2011–2016 |
Staff deployments to 6 countries in response to Syria crisis | 85 | 2012–2016 |
Countries with morbidity/mortality surveillance systems implemented in response to Horn of Africa famine | 3 | 2011–2012 |
PHEM program | ||
Fellows from 28 countries trained through CDC PHEM fellowship | 69 | 2013–2017 (Jun) |
Countries that have received CDC emergency management technical assistance and training | 56 | 2013–2016 |
Countries that participated in a real and/or simulated response with CDC technical assistance | 19 | 2013–2016 |
Global Disease Detection Operations Center | ||
Serious public health threats assessed | >1,500 | 2007–2016 |
Countries where serious outbreaks were investigated/contained, where CDC provided technical assistance | >190 | 2007–2016 |
Unique diseases tracked globally | >170 | 2007–2016 |
Outbreaks monitored and reported in >130 countries for ≈40 different diseases | ≈300 | 2016 |
GDD activities | ||
GDD regional centers | 10 | 2006–2016 |
New diagnostic tests established in national or regional laboratories | >380 | 2006–2016 |
New strains/pathogens detected and/or discovered (new to the world, new to country or region, or new modes of transmission likely because of increased ability to detect through newly introduced laboratory tests) in which GDD assisted in detection and identification | 79 | 2006–2016 |
Outbreaks responded to by GDD center that provided epidemiology and/or laboratory assistance | 2,051 | 2006–2016 |
Outbreak investigations in which laboratory support was provided | 1,363 | 2006–2016 |
Participants who received public health trainings conducted at national and/or regional level on topics, including epidemiology, laboratory, all-hazards preparedness, and risk communication |
115,566 |
2006–2016 |
Capacity-building partnerships to contain threats at the source | ||
GHSA implementation | ||
GHSA countries: 17 Phase I countries, 14 Phase II countries, and CARICOM† | >31 | 2015–2017 (Mar) |
Phase I countries with enhanced surveillance systems for zoonotic diseases | 13 | 2015–2017 (Mar) |
Countries that detected dangerous pathogens using new equipment and capabilities | 16 | 2015–2017 (Mar) |
Phase I countries supported in development of Emergency Operations Centers | 16 | 2015–2017 (Mar) |
Joint External Evaluation | ||
GHSA assessments conducted before tool finalization | 6 | 2016 |
Evaluations completed | 52 | 2016–2017 (Jul) |
Public health workforce development | ||
Countries with CDC-supported FETPs | 65 | 1980–2016 |
Graduates of FETPs-Advanced | >3,900 | 1982–2016 |
Outbreaks investigated by FETPs-Advanced trainees | >3,300 | 2005–2016 |
New FETPs-Frontline started | 24 | 2014–2016 |
Participants in FETPs-Frontline | >1,860 | 2015–2016 |
Global vaccine-preventable disease activities | ||
STOP program volunteers trained in surveillance principles to detect and respond to cases of polio and other vaccine-preventable diseases | 2,010 | 1998–2017 (Jul) |
Countries with volunteers deployed for the STOP program | 77 | 1998–2016 |
Countries supported by CDC to build national STOP programs | 4 | 1998–2016 |
NPHIs | ||
Members of International Association of National Public Health Institutes and supported by CDC | >100 | 2016 |
Countries receiving NPHI development support from CDC | >20 | 2016 |
Persons across the globe served by NPHIs | 5 billion | 2016 |
*CARICOM, Caribbean Community; CDC, Centers for Disease Control and Prevention; FETP, field epidemiology training program; GDD, Global Disease Detection; GHSA, Global Health Security Agenda; GRRT, Global Rapid Response Team; NPHI, National Public Health Institute; PHEM, public health emergency management; STOP, Stop Transmission of Polio.
†CARICOM is an organization of 15 Caribbean nations and dependencies. In 2015, the US government committed to accelerating GHSA implementation with 31 countries and CARICOM (Figure 1). In 17 Phase I, 14 Phase II, and CARICOM nations (Figure 1), CDC provides technical assistance to support country capacity assessments, the development of 5-year GHSA road maps, and annual GHSA implementation plans. In the Phase I countries, CDC also provides financial support for implementation of the GHSA action packages (Table 2) (14–16).
References
- Peiris JS, Yuen KY, Osterhaus AD, Stöhr K. The severe acute respiratory syndrome. N Engl J Med. 2003;349:2431–41. DOIPubMedGoogle Scholar
- Rodier G, Greenspan AL, Hughes JM, Heymann DL. Global public health security. Emerg Infect Dis. 2007;13:1447–52. DOIPubMedGoogle Scholar
- Fineberg HV. Pandemic preparedness and response—lessons from the H1N1 influenza of 2009. N Engl J Med. 2014;370:1335–42. DOIPubMedGoogle Scholar
- Barzilay EJ, Schaad N, Magloire R, Mung KS, Boncy J, Dahourou GA, et al. Cholera surveillance during the Haiti epidemic—the first 2 years. N Engl J Med. 2013;368:599–609. DOIPubMedGoogle Scholar
- Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DA, et al.; KSA MERS-CoV Investigation Team. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med. 2013;369:407–16. DOIPubMedGoogle Scholar
- Bell DM, Damon I, Bedrosian SR, Johnson VR, McQuiston JH, O’Connor J. CDC’s response to the 2014–2016 Ebola epidemic—West Africa and United States. MMWR Suppl. 2016;65:1–106 https://www.cdc.gov/mmwr/volumes/65/su/pdfs/su6503.pdf. DOIGoogle Scholar
- Ikejezie J, Shapiro CN, Kim J, Chiu M, Almiron M, Ugarte C, et al. Zika virus transmission—region of the Americas, May 15, 2015–December 15, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:329–34. DOIPubMedGoogle Scholar
- World Health Organization. Emergency preparedness, response: yellow fever. 2017 [cited 2017 Jul 21]. http://www.who.int/csr/don/archive/disease/yellow_fever/en/
- Gostin LO, Katz R. The International Health Regulations: the governing framework for global health security. Milbank Q. 2016;94:264–313 .
- Schuchat A, Tappero J, Blandford J. Global health and the US Centers for Disease Control and Prevention. Lancet. 2014;384:98–101. DOIPubMedGoogle Scholar
- Schneider D, Evering-Watley M, Walke H, Bloland PB. Training the global public health workforce through applied epidemiology training programs: CDC’s experience, 1951–2011. Public Health Rev. 2011;33:190–203. DOIGoogle Scholar
- Jones D, MacDonald G, Volkov B, Herrera-Guibert D. Multisite evaluation of Field Epidemiology Training Programs: findings and recommendations. Atlanta: Centers for Disease Control and Prevention; 2014 [cited 2017 Jul 21]. https://www.cdc.gov/globalhealth/healthprotection/fetp/pdf/fetp_evaluation_report_may_2014.pdf
- United Nations Development Programme. Human development report. 2015 [cited 2017 Jul 21]. http://hdr.undp.org/sites/default/files/2015_human_development_report.pdf.
- Heymann DL, Chen L, Takemi K, Fidler DP, Tappero JW, Thomas MJ, et al. Global health security: the wider lessons from the West African Ebola virus disease epidemic. Lancet. 2015;385:1884–901. DOIPubMedGoogle Scholar
- Frieden TR, Tappero JW, Dowell SF, Hien NT, Guillaume FD, Aceng JR. Safer countries through global health security. Lancet. 2014;383:764–6. DOIPubMedGoogle Scholar
- Global Health Security Agenda [cited 2017 Jul 21]. https://www.GHSAgenda.org/
- Centers for Disease Control and Prevention. CDC’s ongoing work to contain Ebola in West Africa: flare-ups of Ebola since the control of the initial outbreak. 2016 [cited 2017 Jul 21]. https://www.cdc.gov/vhf/ebola/pdf/cdcs-ongoing-work.pdf
- Kupferschmidt K. Fears of Ebola resurgence quickly dispelled in Liberia. Science. 2017;356:575. DOIPubMedGoogle Scholar
- Toole MJ, Waldman RJ. Refugees and displaced persons. War, hunger, and public health. JAMA. 1993;270:600–5. DOIPubMedGoogle Scholar
- Brennan RJ, Nandy R. Complex humanitarian emergencies: a major global health challenge. Emerg Med (Fremantle). 2001;13:147–56. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Famine-affected, refugee, and displaced populations: recommendations for public health issues. MMWR Recomm Rep. 1992;41(RR-13):1–76.PubMedGoogle Scholar
- Toole MJ, Waldman RJ. The public health aspects of complex emergencies and refugee situations. Annu Rev Public Health. 1997;18:283–312. DOIPubMedGoogle Scholar
- Salama P, Spiegel P, Talley L, Waldman R. Lessons learned from complex emergencies over past decade. Lancet. 2004;364:1801–13. DOIPubMedGoogle Scholar
- Spiegel PB, Checchi F, Colombo S, Paik E. Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010;375:341–5. DOIPubMedGoogle Scholar
- United Nations Office for the Coordination of Humanitarian Affairs. Plan and budget. 2016 [cited 2017 Jul 21]. https://docs.unocha.org/sites/dms/Documents/OCHAin2016.pdf.
- Leidel L, Groseclose S, Burney B, Navin P, Wooster M; Centers for Disease Control and Prevention. CDC’s emergency management program activities—worldwide, 2003–2012. MMWR Morb Mortal Wkly Rep. 2013;62:709–13.PubMedGoogle Scholar
- Centers for Disease Control and Prevention. Emergency Management Accreditation Program (EMAP) frequently asked questions (FAQ) [cited 2017 Jul 21]. https://esp.cdc.gov/sites/ophpr/DEOv2/Documents/One%20Pager_Emergency%20Management%20Accreditation%20Program_20131112.pdf
- Christian KA, Iuliano AD, Uyeki TM, Mintz ED, Nichol ST, Rollin P, et al. What we are watching—five top global infectious disease threats, 2013–2016: an update from CDC’s Global Disease Detection Operations Center. Health Secur. 2017;15:453–62. DOIGoogle Scholar
- Dowell SF, Blazes D, Desmond-Hellmann S. Four steps to precision public health. Nature. 2016;540:189–91. DOIGoogle Scholar
- Maïnassara HB, Paireau J, Idi I, Pelat JP, Oukem-Boyer OO, Fontanet A, et al. Response strategies against meningitis epidemics after elimination of serogroup A meningococci, Niger. Emerg Infect Dis. 2015;21:1322–9. DOIPubMedGoogle Scholar
- World Health Organization. Joint external evaluation tool: International Health Regulations (2005). [cited 2017 July 21]. http://www.who.int/iris/handle/10665/204368
- Iuliano AD, Jang Y, Jones J, Davis CT, Wentworth DE, Uyeki TM, et al. Increase in human infections with avian influenza A(H7N9) virus during the fifth epidemic—China, October 2016– February 2017. MMWR Morb Mortal Wkly Rep. 2017;66:254–5. DOIPubMedGoogle Scholar
- Novak RT, Kambou JL, Diomandé FVK, Tarbangdo TF, Ouédraogo-Traoré R, Sangaré L, et al. Serogroup A meningococcal conjugate vaccination in Burkina Faso: analysis of national surveillance data. Lancet Infect Dis. 2012;12:757–64. DOIPubMedGoogle Scholar
- Woolhouse ME, Gowtage-Sequeria S. Host range and emerging and reemerging pathogens. Emerg Infect Dis. 2005;11:1842–7. DOIPubMedGoogle Scholar
- Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, et al. Global trends in emerging infectious diseases. Nature. 2008;451:990–3. DOIPubMedGoogle Scholar
- Gebreyes WA, Dupouy-Camet J, Newport MJ, Oliveira CJ, Schlesinger LS, Saif YM, et al. The global One Health paradigm: challenges and opportunities for tackling infectious diseases at the human, animal, and environment interface in low-resource settings. PLoS Negl Trop Dis. 2014;8:e3257. DOIPubMedGoogle Scholar
- Rist CL, Arriola CS, Rubin C. Prioritizing zoonosis: a proposed One Health tool for collaborative decision-making. PLoS One. 2014;9:e109986. https://doi.org/10.1371/journal.pone.0109986
- Pathmanathan I, O’Connor KA, Adams ML, Rao CY, Kilmarx PH, Park BJ, et al.; Centers for Disease Control and Prevention (CDC). Rapid assessment of Ebola infection prevention and control needs—six districts, Sierra Leone, October 2014. MMWR Morb Mortal Wkly Rep. 2014;63:1172–4.PubMedGoogle Scholar
- Centers for Disease Control and Prevention. Global health-global immunization: history of the STOP Program. 2016. [cited 2017 Apr 7]. https://www.cdc.gov/globalhealth/immunization/stop/about.htm
- Waziri NE, Ohuabunwo CJ, Nguku PM, Ogbuanu IU, Gidado S, Biya O, et al. Polio eradication in Nigeria and the role of the National Stop Transmission of Polio program, 2012–2013. J Infect Dis. 2014;210(Suppl 1):S111–7. DOIPubMedGoogle Scholar
- Kisakye A, Tenywa E. The National Stop Transmission of Polio (STOP) programme in Uganda 2012–2014. African Health Monitor. 2014;19:53–4.
- Centers for Disease Control and Prevention. CDC in Pakistan. 2013 [cited 2016 Sep 9]. https://www.cdc.gov/globalhealth/countries/pakistan/pdf/pakistan_factsheet.pdf
- Frieden TR, Damon IK. Ebola in West Africa—CDC’s role in epidemic detection, control, and prevention. Emerg Infect Dis. 2015;21:1897–905. DOIPubMedGoogle Scholar
- Frieden TR, Koplan JP. Stronger national public health institutes for global health. Lancet. 2010;376:1721–2. DOIPubMedGoogle Scholar
- International Association of National Public Health Institutes. National Public Health Institutes Core Functions and Attributes. 2009 [cited 2017 July 21]. www.ianphi.org/documents/pdfs/Core%20Functions%20IANPHI%20Brief.pdf
- Lee JW, McKibbin WJ. Estimating the global economic costs of SARS. In: Knobler S, Mahmoud A, Lemon S, Mac A, Sivitz L, Oberholtzer K, editors. Learning from SARS: preparing for the next disease outbreak. Washington: National Academies Press; 2008. p. 92–109.
- Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay DK, Cheng PY, et al. Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis. 2012;12:687–95. DOIPubMedGoogle Scholar
- Burns A, van der Mensbrugghe D, Timmer H. Evaluating the economic consequences of avian influenza. World Bank. 2008 [cited 2017 July 21]. http://documents.worldbank.org/curated/en/977141468158986545/pdf/474170WP0Evalu101PUBLIC10Box334133B.pdf.
- The World Bank. Summary on the Ebola recovery plan: Sierra Leone. 2015 [cited 2017 July 21]. http://www.worldbank.org/en/topic/ebola/brief/summary-on-the-ebola-recovery-plan-sierra-leone.
- Bambery Z, Cassell CH, Bunnell RE, Roy K, Ahmed Z, Payne RL, et al. Impact of hypothetical infectious disease outbreak on U.S. exports and export-based jobs. Health Secur. In press 2017.
1Group members are listed at the end of this article.