Improving the Nation's Ability to Detect and Respond to 21st Century Urgent Health Threats


Book Description

"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. Methods and metrics used in acquiring biosurveillance data are highly variable. This impedes data sharing and analysis, and recognition and response to health threats. Efficient, comprehensive aggregation and analysis of actionable biosurveillance data should be promoted through support for implementation of IHR 2005; integration of human, animal, food, vector, and environmental surveillance systems into a national biosurveillance strategy; and expansion of biosurveillance to include environmental aspects that are the greatest threat to human health, including water, food, animals, and vectors. The current biosurveillance workforce is inadequate to address existing challenges to biosecurity let alone those that are anticipated to arise with increasing data, globalization, and synthetic biology. The federal government should promote and ensure a sustainable interdisciplinary workforce with investments in expertise, especially in public health informatics; social and behavioral epidemiology; environmental, human and animal health; vector biology; and disaster response. The federal government should continue to invest in a new generation of research to develop and build on innovative technologies in molecular and cellular sciences, engineering, chemistry, physics, information technology, mathematics, and communications that will enhance the efficiency and sensitivity of regional, national and global biosurveillance. Understanding the baseline and variance of human and animal health using these emerging technologies with clear processes to select the best approaches and scale them will allow for the creation of the functional equivalent of a national and international immune system that can protect the public in real time."--Page ii.




Improving the Nation's Ability to Detect and Respond to 21st Century Urgent Health Threats


Book Description

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.




Improving the Nation's Ability to Detect and Respond to 21st Century Urgent Health Threats


Book Description

"The United States has a critical national security interest in preserving the health of its population, livestock, crops, and natural resources. Biosurveillance is the method used to detect, monitor and respond to the array of threats to our national security from natural, accidental, and intentional origins. On October 18, 2007, the White House released Homeland Security Presidential Directive 21 (HSPD-21) which mandates the development of a nationwide, robust, and integrated biosurveillance capability for human health, with connections to international disease surveillance systems, in order to provide early warning and ongoing characterization of disease outbreaks in near real-time. Additionally, HSPD-21 requires the establishment of a federal advisory committee, including representatives from state and local government public health authorities and appropriate private sector health care entities, in order to ensure that the federal government is enhancing state and local government public health surveillance capability. In order to meet this mandate, Centers for Disease Control and Prevention (CDC) was designated the lead to develop the National Biosurveillance Strategy for Human Health and establish the National Biosurveillance Advisory Subcommittee (NBAS). NBAS is comprised of prominent public and private biosurveillance stakeholders and contributors and was created by the Advisory Committee to the Director (ACD), CDC on May 1, 2008. As a subcommittee to the ACD, the National Biosurveillance Advisory Subcommittee provides counsel to the ACD regarding the broad range of issues impacting the development and implementation of a nationwide biosurveillance strategy for human health. The membership of the NBAS ensures diverse perspectives important to the development of the strategy, including those from government, public health, health care delivery, academia and others, are reflected in the strategy's plans. The NBAS provides leadership and guidance to the National Biosurveillance Strategy for Human Health. The NBAS has begun to advance recommendations to improve the nation's biosurveillance capability by developing innovative and practical solutions to challenges in the following areas: Attracting, developing and retaining a cross-trained and multi-talented workforce; Collaborating with global partners to strengthen local capabilities to rapidly identify and contain emerging health threats; Enhancing diagnostics and laboratory electronic information exchange; Improving exchange of information between public health and clinical medicine activities to improve accuracy and timeliness of diagnosis and reporting of health events; Examining the role of biosurveillance in addressing zoonotic and vector-borne diseases and food security; Integrating clinical and health information with environmental monitoring of air, toxin, microbiological disease threats, water quality, and infrastructure and geological disasters; Applying new technological advances in bioinformatics, data mining, aberration detection, digital scanning of open source information, analysis, and visualization methods while being mindful of important privacy concerns; Identifying solutions to cross-sector and intergovernmental collaborations for improving biosurveillance capability "--Page i.




The Future of the Public's Health in the 21st Century


Book Description

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.




Examining Challenges and Possible Strategies to Strengthen U.S. Health Security


Book Description

As the United States continues to adapt to a more digital, mobile, and interconnected world, health care and public health professionals have sought to better prepare for and respond to long-standing and emerging threats to the nation's health security. Health security is the collective effort to prevent, protect against, mitigate, respond to, and recover from the health consequences of natural, man-made, and technological disasters. Although substantial progress has been made in the past 15 years toward improving health care and public health systems and capacities for health security threats, many complex challenges persist, and often the nation's preparedness efforts are not sufficient. On March 8â€"9, 2017, the National Academies of Sciences, Engineering, and Medicine's Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop.




Interim Implementation Guide for the National Health Security Strategy of the United States of America


Book Description

The Pandemic and All-Hazards Preparedness Act (PAHPA) was enacted in 2006 to improve the nation's ability to detect, prepare for, and respond to a variety of public health emergencies. Among other things, PAHPA directs the Secretary of the Department of Health and Human Services (HHS) to develop a National Health Security Strategy (NHSS), to be initially presented to Congress in 2009 and subsequently revised every four years afterward. National Health Security Strategy Identifies Goals and Strategic Objectives for the Nation As noted in the National Health Security Strategy document, national health security is achieved when the Nation and its people are prepared for, protected from, ready to respond to, and able to recover from incidents with potentially catastrophic health consequences. The NHSS is designed to achieve two goals: 1. Build community resilience; 2. Strengthen and sustain health and emergency response systems. These goals are supported by ten strategic objectives, which address areas that require urgent and focused attention and improvement. The strategic objectives describe what must be accomplished to address current gaps in national health security over the next four years and to maintain improvements in health security over the longer term. The ten strategic objectives are: 1. Foster informed, empowered individuals and communities 2. Develop and maintain the workforce needed for national health security 3. Ensure situational awareness 4. Foster integrated, scalable health care delivery systems 5. Ensure timely and effective communications 6. Promote an effective countermeasures enterprise 7. Ensure prevention or mitigation of environmental and other emerging threats to health 8. Incorporate post-incident health recovery into planning and response 9. Work with cross-border and global partners to enhance national, continental, and global health security 10. Ensure that all systems that support national health security are based upon the best available science, evaluation, and quality improvement methods.




Research Priorities in Emergency Preparedness and Response for Public Health Systems


Book Description

Schools of public health act as a resource by providing expertise to strengthen our nation's emergency response systems. In response to the Pandemic and All Hazards Preparedness Act (PAHPA), there is an immediate and critical need to define research priorities for the Centers for Public Health Preparedness (CPHP) at schools of public health. It is because of this crucial need, that the Institute of Medicine (IOM) convened an ad hoc committee, conducted a fast-track study, and issued the book entitled Research Priorities in Emergency Preparedness and Response for Public Health Systems. The book defines a set of near-term research priorities for emergency preparedness and response in public health systems. These priorities will be used by the Coordinating Office for Terrorism Preparedness and Emergency Response (COPTER) to help develop a research agenda that will in turn be used to inform research funding opportunity announcements. After considering the information presented during the public meeting and workshop and based on its expert judgment, the committee identified four priority areas for research that represent specific important aspects of systems of public health preparedness. The four areas are: enhancing the usefulness of training; improving timely emergency communications; creating and maintaining sustainable response systems; and generating effectiveness criteria and metrics.




Are We Ready?


Book Description

A contemporary history of a critical period, Are We Ready? analyzes the impact of 9/11, the anthrax attacks that followed, and preparations for a possible smallpox attack on the nation's public health infrastructure. David Rosner and Gerald Markowitz interviewed local, state, and federal officials to determine the immediate reactions of key participants in these events. The authors explore the extent to which these emergencies permanently altered the political, cultural, and organizational life of the country and consider whether the nation is now better prepared to withstand another potentially devastating attack. This well-reasoned and well-researched book presents compelling evidence that few with hands-on experience with disease and emergency preparedness believe that an adequate response to terrorism—whether biological, chemical, or radiological—is possible without a strong and vibrant infrastructure to provide everyday services as well as emergency responses. Are We Ready? begins with an examination of the experiences of local New York officials who were the first responders to 9/11 and follows them as events unfolded and as state and national authorities arrived. It goes on to analyze how various states dealt with changing federal funding for a variety of public health services. Using oral histories of CDC and other federal officials, the book then focuses on the federal reaction to 9/11 and anthrax. What emerges is a picture of dedicated public servants who were overcome by the emotions of the moment yet who were able to react in ways that significantly reduced the public anxiety and public health threat. Despite the extraordinary opportunity to revitalize and reinvigorate the nation’s public health infrastructure, the growing federal and state budget deficits, the refocusing of national attention on the war in Iraq, and the passage of time all combined to undermine many of the needed reforms to the nation’s public health defenses. Copub: Milbank Memorial Fund




Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public's Health and National Security


Book Description

Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.




Public Health Preparedness


Book Description

CDC has now published four preparedness reports to demonstrate how federal investments are improving the nation's ability to respond to public health threats and emergencies. This report is an update to CDC's 2010 state-by-state report; it presents available data that demonstrate trends and document progress in two important preparedness activities, laboratory capabilities and response readiness planning. These data do not represent all preparedness activities occurring in states and localities. As other data become available, they will be included in future reports. Fact sheets in this report present data on activities occurring from 2007 to 2010 in the 50 states and 4 localities (Chicago, Los Angeles County, the District of Columbia, and New York City) directly funded by CDC's PHEP cooperative agreement.