In this guest post, Beth P. Bell—director of the National Center for Emerging and Zoonotic Infectious Diseases—and Tom Kenyon—director of the Center for Disease Control and Prevention’s (CDC) Center for Global Heath—write about a new initiative from the US government to address global health security.
The US government’s recent commitment to global health security recognizes that health security is an essential part of every nation’s national security. As both Department of Health and Human Services Secretary Kathleen Sebelius and CDC Director Tom Frieden have said, “A health threat anywhere is a health threat everywhere.”
These threats may come from naturally occurring disease outbreaks, the emergence of drug-resistance, or by the intentional or accidental release of dangerous pathogens. They may occur anywhere on the planet at any time. Mitigation of such threats is greatly enhanced when the nations in which they may arise are able to detect them early, respond rapidly, and prevent them from happening again—or better still, from happening in the first place.
In February, the United States joined with 28 other countries, the World Health Organization (WHO), and 3 other international organizations to launch the Global Health Security Agenda. At the launch, the United States made a commitment to working with 30 countries over the next 5 years to establish and strengthen their abilities to prevent, detect, and respond to infectious disease threats. In fiscal year (FY) 2014, a group of 12 nations will accelerate engagement in these global health security strengthening partnerships with US agencies. Pending additional resources, more countries will be added in FY 2015 and beyond.
Global health security is embodied in a comprehensive set of specific targets to prevent, detect, and respond to infectious disease threats. These objectives are based in part on the WHO’s revised International Health Regulations (IHR (2005)) which established core requirements for monitoring public health threats globally and responding rapidly and effectively to contain them. Although adopted by nearly every nation on earth, fewer than 20 percent of Member States who signed on to the IHR (2005) are in full compliance. One of the major objectives of the US government’s global health security effort is to greatly increase IHR compliance.
Partner countries will develop systems, policies, and procedures to prevent or mitigate outbreaks. Prevention priorities include:
- Monitoring and slowing antimicrobial resistance (AR), the ability of bacterial and viral pathogens to acquire resistance to antimicrobial drugs. Nations should have at least one reference laboratory able to identify—and to report—at least three of the seven WHO priority AR pathogens using standardized detection assays.
- Practices and policies to prevent animal diseases from spilling over into human populations.
- Immunization of at least 90 percent of each nation’s 1-year-olds with at least one dose of measles vaccine (or a combination vaccine including measles). Having this capacity means a nation is able to adequately carry out other immunization and health-care efforts.
The United States will also work with countries to create and strengthen real-time networks of information systems to detect outbreaks, and up-to-date rapid diagnostic tests to enable their laboratories to conduct at least five of 10 core tests for high-risk and high-priority diseases. Six of these core tests are for diseases that are among the WHO Top 10 Causes of Death in low-income countries: influenza virus, poliovirus, HIV, tuberculosis, malaria, and typhoid fever. The remaining four tests will be selected by the partner country based on national public health concerns.
Other priorities will strengthen countries’ abilities to detect global disease threats including:
- Surveillance for potential public health emergencies.
- Interconnected electronic reporting systems.
- Training for doctors, veterinarians, biostaticians, lab scientists, and field epidemiologists.
The United States will also assist partner countries to develop skills and build systems to mount effective responses to health threats. These include establishing emergency operation centers (EOCs) with rapid-response teams and linkage to a network of labs that monitor for disease outbreaks. The goal is for an EOC to be able to activate a coordinated response within two hours of detecting a public health emergency.
Nobody knows where the next health threat will arise. In a world linked by international travel and commerce, no nation is more than a plane flight away from any other. Global health security is a key element of every country’s national health security.
For more information, please visit CDC’s global health security website at http://www.cdc.gov/globalhealth/security/.