On Public Health Security February 2014

A Health Threat Anywhere is a Health Threat Everywhere

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On Public Health Security
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February 2014 
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Dr. Ali S. Khan

Dear Partners,

Global pandemics define generations. The 1918 Spanish influenza killed as many as 50 million people worldwide. In the late 1940s and early 1950s, in the United States alone, polio crippled about 35,000 people each year. In more recent history, HIV/AIDS swept across the globe killing an estimated 30 million people over the last 30 years. Within the past decade, SARS and H1N1 had significant human and economic impacts, and they reminded us of the potential for the global spread of disease. New threats emerge, such as H7N9 influenza in China and Middle East Respiratory Syndrome coronavirus (MERS-CoV), and old threats reemerge. The next pandemic is a matter of when, not if.

quote We are taking yesterday's approach of going door to door into the future of digital disease detection - Doctor Larry Brilliant

We know that no single country or organization can achieve global health security alone. Global health security is a shared responsibility, and this effort requires partnerships across all sectors. I was reminded of this late last month when I had the pleasure to serve on a panel with CDC’s Dr. Anne Schuchat, CDC Foundation Board Chairman Gary Cohen, and Dr. Larry Brilliant, from the Skoll Global Threats Fund. Dr. Brilliant is a veteran of many historic global health campaigns, such as smallpox eradication, and he has worked for governments, the World Health Organization (WHO), and Google. He pointed to successful partnerships as integral to the success of the smallpox eradication effort. He also gave us a glimpse of the future as government and the private sector work together to bring disease detection into the digital age. We are moving from the age of knocking on doors to carry out health campaigns to using new technologies that allow us to find organisms faster than ever.

Photo of panel discussionDrawing on our own experiences on the front lines of combatting global health threats—whether H1N1 for Dr. Schuchat, SARS for me, or smallpox for Dr. Brilliant—we all agreed that a health threat anywhere is a health threat everywhere.


Global Health Security Agenda

Rather than waiting for the next pandemic to find us, the United States—led by the Department of Health and Human Services, the State Department, and the Department of Defense—along with partner nations and the WHO—launched a Global Health Security Agenda (GHSA) last week to accelerate progress toward our vision of a world safe and secure from infectious disease threats.

The Global Health Security Agenda is based on three fundamental principles:

  • Prevent avoidable catastrophes and epidemics.
  • Detect threats early.
  • Respond to outbreaks as rapidly and effectively as possible.

Over the past several years, CDC has been ramping up its own work in global health security to keep the U.S. and the world safe from naturally occurring outbreaks and intentional or accidental releases of dangerous pathogens.  For example, CDC recently completed two pilot projects in Uganda and Vietnam, in close cooperation with each country’s Ministry of Health that serve as a model for increasing global health security in the rest of the world.

My office, in support of CDC’s Center for Global Health (CGH), sent CDC staff to each country to train counterparts in emergency management principles, strengthen laboratory detection of specific pathogens of concern—like flu strains in Vietnam and Ebola in Uganda—and  improve real-time information systems.  We helped physically develop Uganda’s Emergency Operations Center (EOC), and staff from Vietnam and Uganda came to Atlanta to learn how we run our own EOC.  Finally, we helped each country run emergency drills to demonstrate their progress.  The larger U.S. government Global Health Security Agenda builds on these promising pilot projects and expands this work to other countries over the coming years. We also hope to support the biosafety/biosecurity aspects of the GHSA, but on the world-renowned expertise of our Select Agent Program.


Partnerships to Strengthen Global Health Security

As the GHSA moves forward, we are working with a range of internal and external partners. For example, CGH leads the agency’s global health security engagement with other U.S. government agencies, multilateral institutions, ministries of health, and other international organizations to promote mutual strategies, research and policies.

PHPR will work closely with CGH on strengthening the emergency management programs of our partner nations. Last year, we developed an International Public Health Emergency Management Fellowship to build emergency management capacity of public health preparedness and response staff from other countries. We hosted our first fellows from China and Kenya for six months, and this year our second cohort will include fellows from China, India, and Vietnam. Each of these fellows takes home valuable lessons learned and best practices from their experience working in CDC’s accredited emergency management program. A stronger public health workforce abroad makes us all safer.

Even with an increased focus on global health security, preparedness and response at the state and local level continues to be the backbone of detecting and responding to health threats at home. We cannot stop all threats from spreading, and when they do, we need to be ready. We have made much progress in stopping disease threats at their source before they spread, but there are still gaps that we need to address together, both at home and overseas.

For more information on the conference, go to the following links:


Thank you,

Ali S. Khan, MD MPH
Assistant Surgeon General (retired) & Director
Office of Public Health Preparedness & Response
DHHS/Centers for Disease Control and Prevention

Upcoming Events


Regional Disaster Response Coordination to Support Health Outcomes Workshop

The National Academy of Sciences’ Institute of Medicine (IOM) will host a Regional Disaster Response Coordination to Support Health Outcomes Workshop on March 26 in Irvine, Ca. As part of a series of three regional workshops in 2014, the focus is on coordination at a regional level across the whole of community: organizations, partners, and stakeholders - to plan and prepare for health incidents in order to provide robust health outcomes.


Snapshot of Public Health Preparedness

The 2013-2014 National Snapshot of Public Health Preparedness is CDC’s fifth preparedness report, demonstrating how federal investments enhance the nation’s ability to respond to public health threats and emergencies. We present activities that occurred during 2012 and 2013 in the framework of CDC’s three strategic directions: improving health security at home and around the world; better preventing the leading causes of illness, injury, disability and death; and strengthening public health through collaboration with healthcare.


Solicitation: OPHPR’s Innovative Applied Research on Resilience for Public Health

This Broad Agency Announcement (BAA) is a research solicitation for “Innovative Applied Research on Resilience for Public Health” . The overall objective is innovative research that will yield knowledge, practices, processes, and/or tools that can be applied to support state and local public health efforts to increase community resilience. The purpose of this BAA is to solicit White Papers and proposals that address community health resilience, especially as directly applicable to state and local public health and its coordination with the healthcare system. White papers may be submitted to the Government beginning on February 11, 2014 and must be submitted no later than 12pm on February 25, 2014.