Transcript CDC Workshop APORA Kennedy

CDC Strategic Health Engagements in Africa:
Capacity Building for the Future
Mr. Dave Kennedy
Plans and Exercise Branch
Division of Emergency Operations
Office of Public Health Preparedness and Response
April 23, 2015
Division of Global Health Protection
Landscape of CDC Investments in Africa
Programs
 HIV/AIDS
 Influenza
 Malaria and other Parasitic
Diseases
 Emerging and Zoonotic
Infectious Diseases
 Global Disease Detection
 Work Force Development
(FETP)
 Immunization
Platforms
 Integrated Disease Surveillance
and Response (IDSR)
 WHO International Health
Regulations (IHR, 2005)
 Global Health Security Agenda
Activities
 Trainings
 Technical Assistance
 Disease Investigation &
Response
Existing CDC Investments
Ghana
Influenza
FETP
HIV/AIDS
Angola
FETP
Influenza
HIVAIDS
Malaria
GID
Namibia
HIV/AIDS
Botswana
TB
HIV/AIDS
Cote
d’Ivoire
Influenza
HIV/AIDS
Ethiopia
FETP
Influenza
HIV/AIDS
Malaria
Immunization
Nigeria
Influenza
HIV/AIDS
FETP
Malaria
OneHealth
Immunization
DRC
Influenza
HIVAIDS
Malaria
Immunizati
on
Uganda
Malaria
FETP
HIV/AIDS
Influenza
Bacterial/
Viral
pathogens
Zambia
HIV/AIDS
Malaria
Influenza
South Africa
FETP
Global Disease
Detection
Influenza
HIV/AIDS
Madagascar
Influenza
Malaria
Tanzania
Influenza
FETP
HIV/AIDS
Kenya
FETP
Global Disease
Detection
Malaria
Influenza
TB
HIV/AIDS
Immunization
Rwanda
Malaria
FETP
HIV/AIDS
Influenza
Mozambique
FETP
HIV/AIDS
Malaria
Longstanding Partnership with DTRA’s
Cooperative Biological Engagement Program

CDC and CBEP in partnership since 2004

Mitigating risk of emerging infectious disease threats

Foundational support for Global Health Security
concept

Currently partnering in over 20 countries, with
potential to expand in West Africa and South East
Asia in FY16
Early Global Health Security
FY 13’ CDC Demonstrations Projects

Objectives
 Produce visible results in 7 months
 Select from on-going activities in Uganda and Vietnam

Focus
 Lab – Strengthen the nationwide capacity for detection,
specimen referral, and laboratory confirmation of 3 priority
pathogens
 Information Technology – Integrate data sources from disease
surveillance, laboratory and EOC dashboards to guide public
health decisions during a crisis
 Emergency Operations Center – Provide a central point for
epidemic response coordination and information exchange
GHS Demonstration Project
Uganda Successes
Emergency Operations
– Established an EOC of
appropriate size and
scope with four full-time
staff
– EOC has been
successfully activated for
meningitis outbreak,
monitoring of Ugandans
returning from Hajj and
other events of public
health importance.
Laboratory
Information Systems
– Ebola: Suspect
specimens collected and
transported via the
PEPFAR hub network to
CDC/Uganda Virus
Research Institute for
testing
– Cholera: Rapid diagnostic
tests pre-positioned at 17
district health facilities with
specimen referral to
National Health Laboratory
for culture
– TB: Sputum transported to
a GeneXpert site via hubs;
drug-resistant TB
specimens sent to
National TB Lab for culture
– Improve real-time
detection, transport and
confirmation through
new DHIS-2 disease
specific modules
– Lab results interlinked
via EOC through SMS;
online reporting and
tracking via DHIS-2
– Building an integrated
data system using the
EOC as the hub
The Global Health Security Agenda
Accelerating Progress through a new International Partnership
 Launch Event
13 February 2014 - 28 countries with WHO, OIE,
FAO acknowledged need for concerted global
action to enhance Global Health Security
 Commitment Development Meetings (3)
 Washington Ministerial Event
26 September 14 – 44 countries and leading
international organizations met to discuss
commitments made during 2014 and the course
forward
GHSA directly supports the establishment and
maintenance of the “Core Capacities” stated within the
WHO International Health Regulations (IHR, 2005).
Global Health Security Agenda: Objectives
Objectives
Goals
Prevent
avoidable
epidemics
Detect
threats early
Respond
rapidly and
effectively

Prevent the emergence and spread of antimicrobial drug resistant organisms

Prevent spillover of zoonotic diseases into human populations

Promote national biosafety and biosecurity systems

Ensure that 90% or more of 1 year old population has received measlescontaining vaccine

Launch, strengthen and link global networks for real-time biosurveillance

Strengthen the global norm of rapid, transparent reporting and sample
sharing in the event of health emergencies of international concern

Develop and deploy novel diagnostics and strengthen laboratory systems

Train and deploy an effective biosurveillance workforce

Develop an interconnected global network of Emergency Operations Centers
and multi-sectoral response to biological incidents

In the event of a suspected or confirmed biological attack, have the capacity
to link public health and law enforcement for the purpose of attribution.

Improve global access to medical and non-medical countermeasures during
health emergencies
Prevent | Detect | Respond
Highlights for Uganda, Vietnam, India, and South Africa
South Africa
• Conducted a
biothreat and
vulnerability
assessment at the
biobank/laboratory
in Skukuza to
identify opportunities
for biosafety and
biosecurity upgrades
•
•
India
Provided microbiological
lab training for detection
of selected priority
enteric pathogens in 4
districts of 2 states.
Immediately following
training, interventions to
improve cholera
diagnostics
•
Vietnam
Established a regional
animal zoonotic disease
station in a rural province
north of Hanoi, which will
serve as the hub for all
animal rabies surveillance
activities in the Phu Tho
province.
Uganda
• Surveillance that covers all
reportable diseases in >50%
of districts
• Upgrade public health labs
to meet accreditation
• Improve EOC with staffing
and technology
Ebola Response and GHSA
2014 Ebola Outbreak in
Sierra Leone, Guinea and Liberia
Ebola Response Director’s Update Brief for 20 November 2014
Ebola Preparedness – WHO Checklist
WHO Visit Date (2014)
Country X
Country Y
10/2010/24
10/2710/31
Available
(All Tasks in Component
are available)
Partially Available
(≥ 50% of tasks in
component are
available)
WHO Preparedness Components
Overall Coordination
Rapid Response Team
(RRT)
Public Awareness &
Community Engagement
Infection Prevention and
Control
Case Management
Ebola Treatment Center
Case Management
Safe Burials
Epidemiological
Surveillance
Contact Tracing
Laboratory
Not Available
(< 50% of tasks in
component are
available)
20 November 2014
Capacities at Points of
Entry
Overall Budget for
Outbreak
14
Global Health Security
PREVENT
DETECT
RESPOND
Stopping the Ebola Epidemic
Promote bio-safety
Infection control training and supplies for health
care facilities
Reduce outbreaks
Safe body collections and burials
Reduce spillover of
zoonotic diseases into
human populations
Reduce contact with bats and unsafe handling
of bush meat
Disease surveillance
Improve suspect, probable and laboratoryconfirmed case reporting
Laboratory testing
Specimen transport and diagnostics
Trained workforce
Contact tracing and data management staff to
conduct outbreak detection and response (e.g.,
Field Epidemiology Training Programs; trained,
supervised and paid public health workforce)
Emergency Operations
Center(s)
Emergency Operations Center in each country
and each area within the country experiencing
Ebola outbreak
Receive and deploy
countermeasures
Isolation units with trained staff and an
uninterrupted supply of personal protective
equipment and commodities
Expanding FETP in West Africa

FETPs previously
or currently
supported by
CDC in Africa
The West Africa FETP will
launch in January 2015
and will include the
French speaking nations in
the region:
• Benin
• Burkina Faso (program
HQ)
• Côte d’Ivoire
• Guinea
• Mali
• Niger
• Senegal
• Togo
Way Forward
U.S. Commitment to the
Global Health Security Agenda
By 2020: 30 countries covering
approximately 4 billion people
 Over the next five years the United
States commits to working with at least
30 partner countries to prevent, detect
and respond to infectious disease
threats, whether naturally-occurring or
caused by accidental or intentional
releases of dangerous pathogens.
 Building off experiences from initial GHS
Pilot Projects in Uganda and Vietnam
Expanding Our Global Reach
Global Health Security
Agenda
“…the good news is today, our nations have begun to answer
the call. Together, our countries have made over 100
commitments both to strengthen our own security and to work
with each other to strengthen the security of all countries’
public health systems.”
President Barack Obama, 2014
GHSA Summit Greeting Ebola Survivor Dr. Melvin Korkor from
Liberia