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Health Security Effort to Boost Global Disease Response

By Cheryl Pellerin
American Forces Press Service

WASHINGTON, Feb. 13, 2014 – Top administration officials today are joining representatives from federal agencies and 26 nations to launch an international effort that will help to boost the global capacity to prevent, detect and respond to disease outbreaks.

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Navy Lt. Kimberly Edgel, left, and Christian Baldeviano examine a positive malaria blood smear at Naval Medical Research Unit 6 in Callao, Peru, Jan. 17, 2012. Researchers at NAMRU-6 studied malaria infection, diagnosis and treatment. U.S. Navy photo
  

(Click photo for screen-resolution image);high-resolution image available.

At the Department of Health and Human Services headquarters this morning, HHS Secretary Kathleen Sebelius and Lisa Monaco, assistant to the president for homeland security and counterterrorism, are speaking about the Global Health Security Agenda.

Joining them are officials from Finland, Germany, Canada, the United Kingdom, the Netherlands, Norway, Japan, South Korea China, India, Indonesia and other participating countries.

Representatives from three international organizations in Washington and Geneva, including the World Health Organization, will be there, along with officials from the departments of State, Defense and Agriculture, and from the Centers for Disease Control and Prevention.

In advance of the international meeting, officials from the National Security Council, the Defense Department and CDC held a conference call with reporters to detail the U.S. plan to work even more closely with partners to strengthen the global disease response.

On the call were Laura Holgate, senior director for weapons of mass destruction, terrorism and threat reduction at the National Security Council; Andrew C. Weber, assistant secretary of defense for nuclear, chemical and biological defense programs; and CDC Director Dr. Tom Frieden.

“With the Global Health Security agreement, we’re talking about making the world safer and more secure by strengthening our ability as an international community to prevent, detect and respond to infectious disease outbreaks,” Holgate said.

Such diseases include Ebola and other hemorrhagic illnesses; flu; dengue fever; Middle East respiratory syndrome, or MERS; severe acute respiratory syndrome, or SARS; and other infectious diseases that arise in nature or that are accidentally or intentionally released, she added.

In 2007, most countries agreed to abide by updated International Health Regulations, or IHR, adopted two years earlier at the 58th World Health Assembly. The legally binding rules accepted country by country had been revised specifically to help in containing diseases that potentially could spread quickly worldwide.

The WHO set a five-year deadline for countries to ensure their national capacities to identify, investigate, assess and respond to such public health events.

“In 2012, we were struck by the reality that 80 percent of the [IHR] countries did not meet the WHO deadline to be prepared for these threats,” Holgate said. “We looked around the world and said, ‘This is not something the United States can do alone.’”

The United States has been a leader in global health security for many years, she said, investing hundreds of millions of dollars a year to support with partner countries cross-sector activities in security, health, agriculture and animal health.

“We want to step up our global game and make a difference that is meaningful in our global ability to manage infectious disease challenges,” Holgate said.

The United States has four deliverables for the meeting, Holgate said:

-- It will announce a commitment to partner with at least 30 countries to meet specific milestones over five years related to the Global Health Security Agenda.

-- In 2014, the focus for this commitment for CDC and the Defense Department will be to partner with up to 10 countries to implement and accelerate efforts in field epidemiology, diagnostic tests and other capabilities.

-- The United States will preview a component of the president’s budget for fiscal year 2015 that adds $45 million to the CDC budget explicitly for global health security.

-- This fall, the United States will convene from the White House a forum to bring partner nations back together and highlight progress, discuss commitments achieved, and set a path for future work.

In his remarks, Weber said the global threat requires the Defense Department to innovate, especially to confront biological terrorism, by working closely with domestic and international health, emergency response and agricultural organizations in unprecedented partnerships.

“The Department of Defense’s global presence with our service members and their families posted around the world make us particularly concerned about natural and deliberate infectious disease outbreaks,” he said.

Weber said DOD is bringing resources to the Global Health Security Agenda “through our effective programs, through collaborative investments with the CDC and international partners, and by leveraging the department’s long history of medical and health innovation.”

For example, he added, the DOD Cooperative Threat Reduction Program has partnered with the Georgian Ministry of Health to create in Tblisi the Lugar Center for Public Health Research, a state-of-the-art laboratory for Georgia’s public and animal infectious disease surveillance system.

CDC’s Frieden said the bottom line is that the United States has the ability to make the nation and the world safer from infectious threats.

“We face a real storm of vulnerability,” the director said. “There are new risks from new infections like H7N9 [avian flu virus] … and we’re now seeing some microbes that are resistant to all our treatments. And unfortunately, there is the possibility of the spread of intentionally created organisms either through a terrorist attack or through inadvertent release of organisms. In our globalized world, a threat anywhere is a threat everywhere.”

Frieden said the Global Health Security Agenda offers opportunities for progress, the first being evidence of strong interest and commitment by dozens of countries. “The fact that the SARS epidemic a decade ago caused $30 billion of economic damage is something that leaders all around the world have seen,” he explained.

More than 194 countries have committed to the WHO IHR, but less than 20 percent have met their commitments, the director said. “This means we really do have the opportunity to make rapid progress,” he added.

New infectious-disease-related technologies, another opportunity, are available and being tested, he said.

“We’re testing one now in the field in Uganda that can diagnose plague in 20 minutes at a patient’s bedside, and it’s already been used to save lives and stop outbreaks,” Frieden said.

Three priorities of the Global Health Security Agenda are prevention, detection and response, the director explained, “and for each we have measurable, concrete, ambitious targets that countries will be able to meet.”

Toward prevention, he said, if countries are growing dangerous organisms in laboratories, those involved in the initiative will make sure the organisms are securely stored.

“We’ll work to strengthen immunization programs that prevent deaths today, but we’ll also help establish the infrastructure if it’s needed,” Frieden said.

As part of the initiative, he added, ultimately countries will be able to detect at least five of the most deadly organisms in at least 80 percent of their country, and they will have emergency operations centers that can marshal a rapid response team within 120 minutes to quickly control an outbreak.

“The future here is pretty clear,” the director said. “In 2013, we did two pilot projects -- one in Uganda and one in Vietnam -- and showed that very rapid progress is possible. In 2014, working … with the Department of Defense, we’ll commit $40 million to 10 additional countries to make initial rapid progress toward global health security.”

Frieden added, “In 2015 a proposal in the president’s budget will [seek to] add $45 million to the CDC budget to expand the initiative toward the five-year goal of making sure that at least 30 countries with at least 4 million people not currently protected will [become] well protected.”

The purpose of today’s meeting, he said, “is really to call on the world and our partners to step to the plate and make sure we can protect all people in all countries.”

(Follow Cheryl Pellerin on Twitter @PellerinAFPS)

Contact Author

Biographies:
Andrew C. Weber

Related Sites:
Special Report: Biosurveillance

Related Articles:
Global Force’s Needs Shape DOD Biosurveillance
Medical Intelligence Center Monitors Health Threats


Click photo for screen-resolution imageThis transmission electron micrograph captured some details of the new H7N9 influenza virus, a bird flu virus subtype that had not been found in people until April 1, 2013, when the World Health Organization reported three human infections with H7N9 in China. Other cases since have been reported, most with severe respiratory illness. Some cases have been fatal. The first case outside China was in Malaysia, reported Feb. 12, 2014, and detected in a traveler from an H7N9-affected area of China. The new H7N9 virus has not been detected in people or birds in the United States. Centers for Disease Control and Prevention photo by Cynthia S. Goldsmith and Thomas Rowe  
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