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Zhu J, Wu Q, Zhang S, Song B, Wang W. Cracking the code of health security: unveiling the balanced indices through rank-ordered effect analysis. BMC Health Serv Res 2024; 24:27. [PMID: 38178218 PMCID: PMC10768473 DOI: 10.1186/s12913-023-10503-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Health security is a critical issue which involves multiple dimensions. It has received increasing attention in recent years, especially in China. In order to improve the national health level, China has made many efforts, such as the "Healthy China 2030" plan proposed several years ago. However, due to the complexity of its national conditions and the difficulty of index design, the results of these efforts are not significant. Therefore, it is necessary to construct a new measurement index system. METHODS Based on the questionnaire of "Health China 2030", we have collected a total of 3,000 participants from all 31 provinces, autonomous regions, and municipalities in China. We used statistical methods such as multiple correspondence analysis and rank-ordered effect analysis to process the data. The balance index is constructed by a series of actions such as weight division, order calculation and ranking. RESULTS Through multiple correspondence analysis, we can find that there was a close relation in the correspondence space between the satisfaction degrees 1, 2, and 3, while a far distance from satisfaction degrees 4 and 5. There were four positive and four negative indices separately based on the average expected level and four clusters after ordinal rank cluster analysis. Generally speaking, there are no prominent discrepancies across gender and residential areas. CONCLUSIONS We created and examined balanced indicators for health security in China based on the "Health China 2030" questionnaire. The findings of this study give insight into the overall situation of health security in China and indicate opportunities for improvement.
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Affiliation(s)
- Jianping Zhu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Qi Wu
- School of Management, Xiamen University, Xiamen, China
- Data-Mining Research Center, Xiamen University, Xiamen, China
| | - Shiqi Zhang
- School of Management, Xiamen University, Xiamen, China
| | - Boliang Song
- School of Management, Xiamen University, Xiamen, China
| | - Weiwei Wang
- The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
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Karimi F, Vicente-Crespo M, Ndwiga M, Njenga N, Karoki R, Fonn S. Resilience of research capacity strengthening initiatives in Africa during crises: the case of CARTA during COVID. Glob Health Action 2023; 16:2240153. [PMID: 37560811 PMCID: PMC10416737 DOI: 10.1080/16549716.2023.2240153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
Background: Several research capacity strengthening (RCS) initiatives have been established in Africa over the past decade. One such initiative is the Consortium for Advanced Research Training in Africa (CARTA) that has gained traction over the years and has been proven as an effective multidisciplinary approach to strengthen research capacity to address public and population health in Africa. Objectives: In this article, we document the experiences and management-related interventions that cushioned the CARTA programme and enabled it to remain resilient during the COVID pandemic. We further make recommendations on the enablers of resilience and optimal performance of such RCS initiatives during crises and beyond. Methods: We used routine information gathered by the CARTA secretariat from consortium correspondence, meeting minutes, reports and other related documents produced in the year 2020 in order to consolidate the experiences and interventions taken by the programme at programmatic, institutional and fellowship levels. Results: We identified a series of management-related cyclic phases that CARTA went through during the pandemic period, which included immobilisation, reflection, brainstorming, decision-making, intervening and recovery. We further identified strategic management-related interventions that contributed to the resilience of the programme during the pandemic including assessment and monitoring, communication management, policy and resource management, making investments and execution. Moreover, we observed that the strength of the leadership and management of CARTA, coupled with the consortium´s culture of collaboration, mutual trust, respect, openness, transparency, equitability, ownership, commitment and accountability, all contributed to its success during the pandemic period. Conclusion: We conclude that RCS initiatives undergo a series of phases during crises and that they need to promptly adopt and adapt appropriate management-related strategic interventions in order to remain resilient during such periods. This can be significantly realised if RCS initiatives build a culture of trust, commitment and joint ownership, and if they invest in strong management capacity.
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Affiliation(s)
- Florah Karimi
- Division of Research and Related Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Marta Vicente-Crespo
- Division of Research and Related Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercy Ndwiga
- Division of Research and Related Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Naomi Njenga
- Division of Research and Related Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Rita Karoki
- Division of Research and Related Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Sharon Fonn
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Da'ar OB, Kalmey F. The level of countries' preparedness to health risks during Covid-19 and pre-pandemic: the differential response to health systems building blocks and socioeconomic indicators. HEALTH ECONOMICS REVIEW 2023; 13:16. [PMID: 36917372 PMCID: PMC10012285 DOI: 10.1186/s13561-023-00428-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The global health security (GHS) Index assesses countries' level of preparedness to health risks. However, there is no evidence on how and whether the effects of health systems building blocks and socioeconomic indicators on the level of preparedness differ for low and high prepared countries. The aim of this study was to examine the contributions of health systems building blocks and socioeconomic indicators to show differences in the level of preparedness to health risks. The study also aimed to examine trends in the level of preparedness and the World Health Organization (WHO) regional differences before and during the Covid-19 pandemic. We used the 2021 GHS index report data and employed quantile regression, log-linear, double-logarithmic, and time-fixed effects models. As robustness checks, these functional form specifications corroborated with one another, and interval validity tests confirmed. The results show that increases in effective governance, supply chain capacity in terms of medicines and technologies, and health financing had positive effects on countries' level of preparedness to health risks. These effects were considerably larger for countries with higher levels of preparedness to health risks. The positive gradient trends signaled a sense of capacity on the part of countries with higher global health security. However, the health workforce including doctors, and health services including hospital beds, were not statistically significant in explaining variations in countries' level of preparedness. While economic factors had positive effects on the level of preparedness to health risks, their impacts across the distribution of countries' level of preparedness to health risks were mixed. The effects of Social Development Goals (SDGs) were greater for countries with higher levels of preparedness to health risks. The effect of the Human Development Index (HDI) was greatest for countries whose overall GHS index lies at the midpoint of the distribution of countries' level of preparedness. High-income levels were associated with a negative effect on the level of preparedness, especially if countries were in the lower quantiles across the distributions of preparedness. Relative to poor countries, middle- and high-income groups had lower levels of preparedness to health risks, an indication of a sense of complacency. We find the pandemic period (year 2021) was associated with a decrease in the level of preparedness to health risks in comparison to the pre-pandemic period. There were significant WHO regional differences. Apart from the Eastern Mediterranean, the rest of the regions were more prepared to health risks compared to Africa. There was a negative trend in the level of preparedness to health risks from 2019 to 2021 although regional differences in changes over time were not statistically significant. In conclusion, attempts to strengthen countries' level of preparedness to health shocks should be more focused on enhancing essentials such as supply chain capacity in terms of medicines and technologies; health financing, and communication infrastructure. Countries should also strengthen their already existing health workforce and health services. Together, strengthening these health systems essentials will be beneficial to less prepared countries where their impact we find to be weaker. Similarly, boosting SDGs, particularly health-related sub-scales, will be helpful to less prepared countries. Moreover, there is a need to curb complacency in preparedness to health risks during pandemics by high-income countries. The negative trend in the level of preparedness to health risks would suggest that there is a need for better preparedness during pandemics by conflating national health with global health risks. This will ensure the imperative of having a synergistic response to global health risks, which is understood by and communicated to all countries and regions.
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Affiliation(s)
- Omar B Da'ar
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- Institute for Cost Analysis and Research Evaluation, Minneapolis, MN, USA.
| | - Farah Kalmey
- Institute for Cost Analysis and Research Evaluation, Minneapolis, MN, USA
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Organizational Health and Wellbeing at the Division of Health Research, Lancaster University, Lancaster, UK
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Li X, Jiang H, Liang X. Early Stage Risk Identification and Governance of Major Emerging Infectious Diseases: A Double-Case Study Based on the Chinese Context. Risk Manag Healthc Policy 2023; 16:635-653. [PMID: 37056713 PMCID: PMC10089271 DOI: 10.2147/rmhp.s400546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/25/2023] [Indexed: 04/15/2023] Open
Abstract
Purpose Based on the Chinese context, this study uses severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) outbreaks as examples to identify the risk factors that lead to the major emerging infectious diseases outbreak, and put forward risk governance strategies to improve China's biosecurity risk prevention and control capabilities. Material and Methods This study combines grounded theory and WSR methodology, and utilizes the NVivo 12.0 qualitative analysis software to identify the risk factors that led to the major emerging infectious diseases outbreak. The research data was sourced from 168 publicly available official documents, which are highly authoritative and reliable. Results This study identified 10 categories of Wuli risk factors, 6 categories of logical Shili risk factors, and 8 categories of human Renli risk factors that contributed to the outbreak of major emerging infectious diseases. These risk factors were distributed across the early stages of the outbreak, and have different mechanisms of action at the macro and micro levels. Conclusion This study identified the risk factors that lead to the outbreak of major emerging infectious disease, and discovered the mechanism of the outbreak at the macro and micro levels. At the macro level, Wuli risk factors are the forefront antecedents that lead to the outbreak of the crisis, Renli factors are the intermediate regulatory factors, and Shili risk factors are the back-end posterior factors. At the micro level, there are risk coupling, risk superposition, and risk resonance interactions among various risk factors, leading to the outbreak of the crisis. Based on these interactive relationships, this study proposes risk governance strategies that are helpful for policymakers in dealing with similar crises in the future.
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Affiliation(s)
- Xuefeng Li
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049, People’s Republic of China
- School of Public Policy and Management, University of Chinese Academy of Sciences, Beijing, 100049, People’s Republic of China
| | - Hui Jiang
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049, People’s Republic of China
- Correspondence: Hui Jiang, School of Engineering Science, University of Chinese Academy of Sciences, 19 Yuquan Road, Shijingshan District, Beijing, People’s Republic of China, Email
| | - Xiaoyu Liang
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049, People’s Republic of China
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Anantharam P, Hoffman A, Noonan M, Bugli D, Pechta L, Bornemann J, Victory KR, Greiner AL. Addressing Operational Challenges Faced by COVID-19 Public Health Rapid Response Teams in Non-United States Settings. Disaster Med Public Health Prep 2022; 16:1599-1603. [PMID: 33719992 PMCID: PMC7985625 DOI: 10.1017/dmp.2020.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 11/08/2022]
Abstract
The coronavirus disease 2019 (COVID-19) global response underscores the need for a multidisciplinary approach that integrates and coordinates various public health systems-surveillance, laboratory, and health-care systems/networks, among others-as part of a larger emergency response system. Multidisciplinary public health rapid response teams (RRTs) are one mechanism used within a larger COVID-19 outbreak response strategy. As COVID-19 RRTs are deployed, countries are facing operational challenges in optimizing their RRT's impact, while ensuring the safety of their RRT responders. From March to May 2020, United States Centers for Disease Control and Prevention received requests from 12 countries for technical assistance related to COVID-19 RRTs and emergency operations support. Challenges included: (1) an insufficient number of RRT responders available for COVID-19 deployments; (2) limited capacity to monitor RRT responders' health, safety, and resiliency; (3) difficulty converting critical in-person RRT operational processes to remote information technology platforms; and (4) stigmatization of RRT responders hindering COVID-19 interventions. Although geographically and socioeconomically diverse, these 12 countries experienced similar RRT operational challenges, indicating potential applicability to other countries. As the response has highlighted the critical need for immediate and effective implementation measures, addressing these challenges is essential to ensuring an impactful and sustainable COVID-19 response strategy globally.
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Affiliation(s)
- Puneet Anantharam
- Centers for Disease Control and Prevention, Division of Global Health Protection, Emergency Response and Recovery Branch, Atlanta, Georgia, USA
| | - Adela Hoffman
- Centers for Disease Control and Prevention, Division of Global Health Protection, Emergency Response and Recovery Branch, Atlanta, Georgia, USA
| | - Michelle Noonan
- Centers for Disease Control and Prevention, Office of the Chief Operating Officer, Office of Safety, Security & Asset Management, Atlanta, Georgia, USA
| | - Dante Bugli
- Centers for Disease Control and Prevention, Division of Global Health Protection, Emergency Response and Recovery Branch, Atlanta, Georgia, USA
| | - Laura Pechta
- Centers for Disease Control and Prevention, Division of Global Health Protection, Office of the Director, Atlanta, Georgia, USA
| | - Jennifer Bornemann
- Centers for Disease Control and Prevention, Office of the Chief Operating Officer, Office of Safety, Security & Asset Management, Atlanta, Georgia, USA
| | - Kerton R. Victory
- Centers for Disease Control and Prevention, Division of Global Health Protection, Emergency Response and Recovery Branch, Atlanta, Georgia, USA
| | - Ashley L. Greiner
- Centers for Disease Control and Prevention, Division of Global Health Protection, Emergency Response and Recovery Branch, Atlanta, Georgia, USA
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Qi X, Wang J, Liu J, Amporfro DA, Wang K, Liu H, Shah S, Wu Q, Hao Y. Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China. BMJ Open 2022; 12:e047753. [PMID: 35017231 PMCID: PMC8753098 DOI: 10.1136/bmjopen-2020-047753] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China. DESIGN AND SETTING An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19. OUTCOMES MEASURES PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores. RESULTS A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores. CONCLUSIONS During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.
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Affiliation(s)
- Xinye Qi
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiahui Wang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingjing Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Daniel Adjei Amporfro
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Kexin Wang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huan Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Saleh Shah
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhua Hao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
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Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance. ADVANCES IN PARASITOLOGY 2021; 114:1-26. [PMID: 34696842 PMCID: PMC8503781 DOI: 10.1016/bs.apar.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human parasitic infections—including malaria, and many neglected tropical diseases (NTDs)—have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)’s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance—combining the WHO's normative and technical leadership with greater support in allied policy-making areas—can help sustain future malaria and NTD elimination efforts.
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Macharia D, Jinnai Y, Hirai M, Galgalo T, Lowther SA, Ekechi CO, Widdowson MA, Turcios-Ruiz R, Williams SG, Baggett HKC, Bunnell RE, Oyugi E, Langat D, Makayotto L, Gura Z, Cassell CH. Impact of Kenya's Frontline Epidemiology Training Program on Outbreak Detection and Surveillance Reporting: A Geographical Assessment, 2014-2017. Health Secur 2021; 19:243-253. [PMID: 33970691 DOI: 10.1089/hs.2020.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Rapid detection and response to infectious disease outbreaks requires a robust surveillance system with a sufficient number of trained public health workforce personnel. The Frontline Field Epidemiology Training Program (Frontline) is a focused 3-month program targeting local ministries of health to strengthen local disease surveillance and reporting capacities. Limited literature exists on the impact of Frontline graduates on disease surveillance completeness and timeliness reporting. Using routinely collected Ministry of Health data, we mapped the distribution of graduates between 2014 and 2017 across 47 Kenyan counties. Completeness was defined as the proportion of complete reports received from health facilities in a county compared with the total number of health facilities in that county. Timeliness was defined as the proportion of health facilities submitting surveillance reports on time to the county. Using a panel analysis and controlling for county-fixed effects, we evaluated the relationship between the number of Frontline graduates and priority disease reporting of measles. We found that Frontline training was correlated with improved completeness and timeliness of weekly reporting for priority diseases. The number of Frontline graduates increased by 700%, from 57 graduates in 2014 to 456 graduates in 2017. The annual average rates of reporting completeness increased from 0.8% in 2014 to 55.1% in 2017. The annual average timeliness reporting rates increased from 0.1% in 2014 to 40.5% in 2017. These findings demonstrate how global health security implementation progress in workforce development may influence surveillance and disease reporting.
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Affiliation(s)
- Daniel Macharia
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Yuka Jinnai
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Mitsuaki Hirai
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Tura Galgalo
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Sara A Lowther
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Chinyere O Ekechi
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Marc-Alain Widdowson
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Reina Turcios-Ruiz
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Seymour G Williams
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Henry Kip C Baggett
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Rebecca E Bunnell
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Elvis Oyugi
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Daniel Langat
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Lyndah Makayotto
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Zeinab Gura
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
| | - Cynthia H Cassell
- Daniel Macharia, MSc, is a GIS Analyst/Application Developer; Tura Galgalo, MSc (JKU), MSc (LSTHM), was a Public Health Specialist and Resident Advisor; Chinyere O. Ekechi, JD, is Deputy Director for Programs; and Marc-Alain Widdowson, VetMB, MA, MSc, is Kenya Country Director; all in the Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya. Yuka Jinnai, PhD, MIA, MPH, and Mitsuaki Hirai, DrPH, MPH, are Evaluation Fellows, Applied Research and Evaluation Team; Rebecca E. Bunnell, PhD, MEd, is Deputy Director for Science, Policy, and Communications; and Cynthia H. Cassell, PhD, MA, is Team Lead, Applied Research and Evaluation Team; all in the Office of the Director, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Sara A. Lowther, PhD, MPH, was a Commander, US Public Health Service, and Acting Field Epidemiology Training Program Epidemiology Technical Support Unit Lead; Reina Turcios-Ruiz, MD, FIDSA, is Captain, US Public Health Service, and Evaluation, Policy, Innovation, and Communications Team Lead; Seymour G. Williams, MD, is Captain, US Public Health Service, and Team Lead, Field Epidemiology Training Program; Henry (Kip) C. Baggett, MD, MPH, is a Captain, US Public Health Service, and Branch Chief; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Elvis Oyugi, MBChB, MSc, is Field Coordinator, Field Epidemiology Training Program; Daniel Langat is a Medical Epidemiologist, Division of Disease Surveillance and Response; Lyndah Makayotto, MBChB, MSc, is a Senior Medical Officer and Medical Epidemiologist, Division of Disease Surveillance and Response; Zeinab Gura, MSc, is Head, Division of Human Resources for Health; all in the Ministry of Health, Nairobi, Kenya. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the US CDC, US Department of Health and Human Services, or the Kenya Ministry of Health
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Assefa Y, Hill PS, Gilks CF, Damme WV, van de Pas R, Woldeyohannes S, Reid S. Global health security and universal health coverage: Understanding convergences and divergences for a synergistic response. PLoS One 2020; 15:e0244555. [PMID: 33378383 PMCID: PMC7773202 DOI: 10.1371/journal.pone.0244555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/13/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Global health security (GHS) and universal health coverage (UHC) are key global health agendas which aspire for a healthier and safer world. However, there are tensions between GHS and UHC strategy and implementation. The objective of this study was to assess the relationship between GHS and UHC using two recent quantitative indices. METHODS We conducted a macro-analysis to determine the presence of relationship between GHS index (GHSI) and UHC index (UHCI). We calculated Pearson's correlation coefficient and the coefficient of determination. Analyses were performed using IBM SPSS Statistics Version 25 with a 95% level of confidence. FINDINGS There is a moderate and significant relationship between GHSI and UHCI (r = 0.662, p<0.001) and individual indices of UHCI (maternal and child health and infectious diseases: r = 0.623 (p<0.001) and 0.594 (p<0.001), respectively). However, there is no relationship between GHSI and the non-communicable diseases (NCDs) index (r = 0.063, p>0.05). The risk of GHS threats a significant and negative correlation with the capacity for GHS (r = -0.604, p<0.001) and the capacity for UHC (r = -0.792, p<0.001). CONCLUSION The aspiration for GHS will not be realized without UHC; hence, the tension between these two global health agendas should be transformed into a synergistic solution. We argue that strengthening the health systems, in tandem with the principles of primary health care, and implementing a "One Health" approach will progressively enable countries to achieve both UHC and GHS towards a healthier and safer world that everyone aspires to live in.
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Affiliation(s)
- Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Peter S. Hill
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Charles F. Gilks
- School of Public Health, the University of Queensland, Brisbane, Australia
| | | | | | | | - Simon Reid
- School of Public Health, the University of Queensland, Brisbane, Australia
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10
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Greiner AL, Stehling-Ariza T, Bugli D, Hoffman A, Giese C, Moorhouse L, Neatherlin JC, Shahpar C. Challenges in Public Health Rapid Response Team Management. Health Secur 2020; 18:S8-S13. [PMID: 32004121 DOI: 10.1089/hs.2019.0060] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The International Health Regulations (2005) dictate the need for states parties to establish capacity to respond promptly and effectively to public health risks. Public health rapid response teams (RRTs) can fulfill this need as a component of a larger public health emergency response infrastructure. However, lack of a standardized approach to establishing and managing RRTs can lead to substantial delays in effective response measures. As part of the Global Health Security Agenda, national governments have sought to develop and more formally institute their RRTs. RRT challenges were identified from 21 countries spanning 4 continents from 2016 to 2018 through direct observation of RRTs deployed during public health emergencies, discussions with RRT managers involved in outbreak response, and during formal RRT management training workshops. One major challenge identified is the development and maintenance of an RRT roster to ensure deployable surge staff identification, selection, and availability. Another challenge is ensuring that RRT members are trained and have the relevant competencies to be effective in the field. Finally, the lack of defined RRT standard operating procedures covering both nonemergency maintenance measures and the multistage emergency response processes required for RRT function can delay the RRT's response time and effectiveness. These findings highlight the importance of planning to preemptively address these challenges to ensure rapid and effective response measures, ultimately strengthening global health security.
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Affiliation(s)
- Ashley L Greiner
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Tasha Stehling-Ariza
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Dante Bugli
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Adela Hoffman
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Coralie Giese
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Lisa Moorhouse
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - John C Neatherlin
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Cyrus Shahpar
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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11
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Stoeva P. Dimensions of Health Security-A Conceptual Analysis. GLOBAL CHALLENGES (HOBOKEN, NJ) 2020; 4:1700003. [PMID: 33033624 PMCID: PMC7533848 DOI: 10.1002/gch2.201700003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Discussions of the politics and practicalities of confronting health security challenges-from infectious disease outbreaks to antimicrobial resistance and the silent epidemic of noncommunicable diseases-hinge on the conceptualization of health security. There is no consensus among analysts about the specific parameters of health security. This inhibits comparative evaluation and critique, and affects the consistency of advice for policymakers. This article aims to contribute to debates about the meaning and scope of health security by applying Baldwin's (1997) framework for conceptualizing security with a view to propose an alternative framing. Asking Baldwin's concept-defining questions of the health security literature highlights how implicit and explicit assumptions currently place health security squarely within a narrow traditionalist analytical framework. Such framing of health security is inaccurate and constraining, as demonstrated by practice and empirical observations. Alternative approaches to security propose that security politics can also be multiactor, cooperative, and ethical, while being conscious of postcolonial and feminist critique in search of sustainable solutions to existential threats to individuals and communities. A broader conceptualization of health security can transform the politics of health security, improving health outcomes beyond acute crises and contribute to broader security studies' debates.
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Affiliation(s)
- Preslava Stoeva
- Department of Global Health & DevelopmentLondon School of Hygiene and Tropical Medicine15‐17 Tavistock PlaceLondonWC1H 9SHUK
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12
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Sabin NS, Calliope AS, Simpson SV, Arima H, Ito H, Nishimura T, Yamamoto T. Implications of human activities for (re)emerging infectious diseases, including COVID-19. J Physiol Anthropol 2020; 39:29. [PMID: 32977862 PMCID: PMC7517057 DOI: 10.1186/s40101-020-00239-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Since 1980, the world has been threatened by different waves of emerging disease epidemics. In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries. It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment. However, it is possible to face a new disease or to reduce the risk of its spread by implementing better early warning systems and effective disease control and prevention, e.g., effective global surveillance, development of technology for better diagnostics, effective treatments, and vaccines, the global political will to respond to any threats and multidisciplinary collaboration involving all sectors in charge of good health maintenance. In this review, we generally describe some factors related to human activities and show how they can play a role in the transmission and spread of infectious diseases by using some diseases as examples. Additionally, we describe and discuss major factors that are facilitating the spread of the new pandemic known as COVID-19 worldwide.
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Affiliation(s)
- Nundu Sabiti Sabin
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akintije Simba Calliope
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shirley Victoria Simpson
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiromu Ito
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Takayuki Nishimura
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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13
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Goodson JL. Recent setbacks in measles elimination: the importance of investing in innovations for immunizations. Pan Afr Med J 2020; 35:15. [PMID: 32373266 PMCID: PMC7196335 DOI: 10.11604/pamj.supp.2020.35.1.21740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 11/18/2022] Open
Abstract
The recent setbacks in efforts to achieve measles elimination goals are alarming. To reverse the current trends, it is imperative that the global health community urgently intensify efforts and make resource commitments to implement evidence-based elimination strategies fully, including supporting research and innovations. The Immunization Agenda 2030: A Global Strategy to Leave No One Behind (IA2030) is the new global guidance document that builds on lessons learned and progress made toward the GVAP goals, includes research and innovation as a core strategic priority, and identifies measles as a “tracer” for improving immunisation services and strengthening primary health care systems. To achieve vaccination coverage and equity targets that leave no one behind, and accelerate progress toward disease eradication and elimination goals, sustained and predictable investments are needed for the identified research and innovations priorities for the new decade.
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Affiliation(s)
- James L Goodson
- Accelerated Disease Control and Surveillance Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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14
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Ibrahim LM, Stephen M, Okudo I, Kitgakka SM, Mamadu IN, Njai IF, Oladele S, Garba S, Ojo O, Ihekweazu C, Lasuba CLP, Yahaya AA, Nsubuga P, Alemu W. A rapid assessment of the implementation of integrated disease surveillance and response system in Northeast Nigeria, 2017. BMC Public Health 2020; 20:600. [PMID: 32357933 PMCID: PMC7195793 DOI: 10.1186/s12889-020-08707-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background Integrated disease surveillance and response (IDSR) is the strategy adopted for public health surveillance in Nigeria. IDSR has been operational in Nigeria since 2001 but the functionality varies from state to state. The outbreaks of cerebrospinal meningitis and cholera in 2017 indicated weakness in the functionality of the system. A rapid assessment of the IDSR was conducted in three northeastern states to identify and address gaps to strengthen the system. Method The survey was conducted at the state and local government areas using standard IDSR assessment tools which were adapted to the Nigerian context. Checklists were used to extract data from reports and records on resources and tools for implementation of IDSR. Questionnaires were used to interview respondents on their capacities to implement IDSR. Quantitative data were entered into an MS Excel spreadsheet, analysed and presented in proportions. Qualitative data were summarised and reported by thematic area. Results A total of 34 respondents participated in the rapid survey from six health facilities and six local government areas (LGAs). Of the 2598 health facilities in the three states, only 606 (23%) were involved in reporting IDSR. The standard case definitions were available in all state and LGA offices and health facilities visited. Only 41 (63%) and 31 (47.7%) of the LGAs in the three states had rapid response teams and epidemic preparedness and response committees respectively. The Disease Surveillance and Notification Officers (DSNOs) and clinicians’ knowledge were limited to only timeliness and completeness among over 10 core indicators for IDSR. Review of the facility registers revealed many missing variables; the commonly missed variables were patients’ age, sex, diagnosis and laboratory results. Conclusions The major gaps were poor documentation of patients’ data in the facility registers, inadequate reporting tools, limited participation of health facilities in IDSR and limited capacities of personnel to identify, report IDSR priority diseases, analyze and interpret IDSR data for decision making. Training of surveillance focal persons, provision of IDSR reporting tools and effective supportive supervisions will strengthen the system in the country.
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Affiliation(s)
- Luka Mangveep Ibrahim
- World health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria.
| | | | - Ifeanyi Okudo
- World health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | | | - Ibrahim Njida Mamadu
- World health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | - Isha Fatma Njai
- World health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | - Saliu Oladele
- World health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | - Sadiq Garba
- Nigerian Center for Disease Control, Jabi, Abuja, Nigeria
| | - Olubunmi Ojo
- Nigerian Center for Disease Control, Jabi, Abuja, Nigeria
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15
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Affiliation(s)
- Bill Gates
- From the Bill and Melinda Gates Foundation, Seattle
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16
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Liu CX. Pay attention to situation of SARS-CoV-2 and TCM advantages in treatment of novel coronavirus infection. CHINESE HERBAL MEDICINES 2020; 12:97-103. [PMID: 32518555 PMCID: PMC7270776 DOI: 10.1016/j.chmed.2020.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 12/13/2022] Open
Abstract
Since the outbreak of the new coronavirus epidemic, novel coronavirus has infected nearly 100,000 people in more than 110 countries. How to face this new coronavirus epidemic outbreak is an important issue. Basic reproduction number (R0) is an important parameter in epidemiology; The basic reproduction number of an infection can be thought of as the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection. Epidemiology dynamics is a mathematical model based on a susceptibility-infection-recovery epidemic model. Researchers analyzed the epidemiological benefits of different transmission rates for the establishment of effective strategy in prevention and control strategies for epidemic infectious diseases. In this review, the early use of TCM for light and ordinary patients, can rapidly improve symptoms, shorten hospitalization days and reduce severe cases transformed from light and normal. Many TCM formulas and products have wide application in treating infectious and non-infectious diseases. The TCM theoretical system of treating epidemic diseases with TCM and the treatment scheme of integrated Chinese and Western medicine have proved their effectiveness in clinical practice. TCM can cure COVID-19 pneumonia, and also shows that the role of TCM in blocking the progress of COVID-19 pneumonia.
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Affiliation(s)
- Chang-Xiao Liu
- Innovation Research Station, Research Center of Modern Chinese Materia Medica, Tianjin Institute of Pharmaceutical Research, Tianjin 300462, China.,State Key Laboratory of Drug Delivery Technology and Pharmacokinetics, Tianjin Institute of Pharmaceutical Research, Tianjin 300462, China.,Tianjin Binhai Research Center for Food and Drug Regulatory Science, Tianjin 300462, China
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17
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Commentary: Challenges to Achieve Conceptual Clarity in the Definition of Pandemics. Camb Q Healthc Ethics 2020; 29:218-222. [DOI: 10.1017/s0963180119001014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
From a scientific standpoint, the world is more prepared than ever to respond to infectious disease outbreaks; paradoxically, globalization and air travel, antimicrobial resistance, the threat of bioterrorism, and newly emerging pathogens driven by ecological, socioeconomic, and environmental factors, have increased the risk of global epidemics.1,2,3Following the 2002–2003 severe acute respiratory syndrome (SARS), global efforts to build global emergency response capabilities to contain infectious disease outbreaks were put in place.4,5,6But the recent H1N1, Ebola, and Zika global epidemics have shown unnecessary delays and insufficient coordination in response efforts.7,8,9,10In a thoughtful and compelling essay,11Thana C. de Campos argues that greater clarity in the definition of pandemics would probably result in more timely effective emergency responses, and pandemic preparedness. In her view, a central problem is that the definition of pandemics is based solely on disease transmission across several countries, and not on spread and severity together, which conflates two very different situations: emergency and nonemergency disease outbreaks. A greater emphasis on severity, such that pandemics are defined as severe and rapidly spreading infectious disease outbreaks, would make them “true global health emergencies,” allowing for priority resource allocation and effective collective actions in emergency response efforts. Sympathetic to the position taken by de Campos, here I highlight some of the challenges in the definition of severity during an infectious disease outbreak.
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18
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Gialloreti LE, Moramarco S, Palombi L. Investing in epidemiological surveillance for recovering health systems in war-torn countries. Perspect Public Health 2020; 140:25-26. [DOI: 10.1177/1757913919872514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Stefania Moramarco
- Fellow Researcher, PhD, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Leonardo Palombi
- Full Professor, PhD, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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19
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McPhee E, Gronvall GK, Sell TK. Analysis of sectoral participation in the development of Joint External Evaluations. BMC Public Health 2019; 19:631. [PMID: 31122234 PMCID: PMC6533773 DOI: 10.1186/s12889-019-6978-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Joint External Evaluation Process (JEE), developed in response to the 2014 Global Health Security Agenda (GHSA), is a voluntary, independent process conducted by a team of external evaluators to assess a country's public health preparedness capabilities under the 2005 International Health Regulations (IHR) revision. Feedback from the JEE process is intended to aid in the development of national action plans by elucidating weaknesses in current preparedness and response capabilities. METHODS To identify gaps in sector participation and the development of national action plans in response to public health emergencies, all English-language JEE reports available on March 31, 2018 (N = 47) were systematically reviewed to determine sectoral backgrounds of key host country participants. RESULTS Overall, strong representation was seen in the health, agriculture, domestic security, and environment sectors, whereas the energy/nuclear and defense sectors were largely under-represented. CONCLUSIONS While strong participation by more traditional sectors such as health and agriculture is common in the JEE development process, involvement by the defense and energy/nuclear sectors in the JEE process could be increased, potentially improving preparedness and response to widespread public health emergencies.
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Affiliation(s)
- Emily McPhee
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Gigi K Gronvall
- Johns Hopkins Center for Health Security, 621 East Pratt Street, Suite 210, Baltimore, MD, 21202, USA
| | - Tara Kirk Sell
- Johns Hopkins Center for Health Security, 621 East Pratt Street, Suite 210, Baltimore, MD, 21202, USA.
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20
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Bell E, Tappero JW, Ijaz K, Bartee M, Fernandez J, Burris H, Sliter K, Nikkari S, Chungong S, Rodier G, Jafari H. Joint External Evaluation-Development and Scale-Up of Global Multisectoral Health Capacity Evaluation Process. Emerg Infect Dis 2018; 23. [PMID: 29155678 PMCID: PMC5711324 DOI: 10.3201/eid2313.170949] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Joint External Evaluation (JEE), a consolidation of the World Health Organization (WHO) International Health Regulations 2005 (IHR 2005) Monitoring and Evaluation Framework and the Global Health Security Agenda country assessment tool, is an objective, voluntary, independent peer-to-peer multisectoral assessment of a country's health security preparedness and response capacity across 19 IHR technical areas. WHO approved the standardized JEE tool in February 2016. The JEE process is wholly transparent; countries request a JEE and are encouraged to make its findings public. Donors (e.g., member states, public and private partners, and other public health institutions) can support countries in addressing identified JEE gaps, and implementing country-led national action plans for health security. Through July 2017, 52 JEEs were completed, and 25 more countries were scheduled across WHO's 6 regions. JEEs facilitate progress toward IHR 2005 implementation, thereby building trust and mutual accountability among countries to detect and respond to public health threats.
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21
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Tappero JW, Cassell CH, Bunnell RE, Angulo FJ, Craig A, Pesik N, Dahl BA, Ijaz K, Jafari H, Martin R. US Centers for Disease Control and Prevention and Its Partners' Contributions to Global Health Security. Emerg Infect Dis 2018; 23. [PMID: 29155656 PMCID: PMC5711315 DOI: 10.3201/eid2313.170946] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.
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22
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Hagan JE, Greiner A, Luvsansharav UO, Lake J, Lee C, Pastore R, Takashima Y, Sarankhuu A, Demberelsuren S, Smith R, Park B, Goodson JL. Use of a Diagonal Approach to Health System Strengthening and Measles Elimination after a Large Nationwide Outbreak in Mongolia. Emerg Infect Dis 2018; 23. [PMID: 29155667 PMCID: PMC5711310 DOI: 10.3201/eid2313.170594] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Measles is a highly transmissible infectious disease that causes serious illness and death worldwide. Efforts to eliminate measles through achieving high immunization coverage, well-performing surveillance systems, and rapid and effective outbreak response mechanisms while strategically engaging and strengthening health systems have been termed a diagonal approach. In March 2015, a large nationwide measles epidemic occurred in Mongolia, 1 year after verification of measles elimination in this country. A multidisciplinary team conducted an outbreak investigation that included a broad health system assessment, organized around the Global Health Security Agenda framework of Prevent-Detect-Respond, to provide recommendations for evidence-based interventions to interrupt the epidemic and strengthen the overall health system to prevent future outbreaks of measles and other epidemic-prone infectious threats. This investigation demonstrated the value of evaluating elements of the broader health system in investigating measles outbreaks and the need for using a diagonal approach to achieving sustainable measles elimination.
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23
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Cassell CH, Bambery Z, Roy K, Meltzer MI, Ahmed Z, Payne RL, Bunnell RE. Relevance of Global Health Security to the US Export Economy. Health Secur 2017; 15:563-568. [PMID: 29199867 PMCID: PMC5734155 DOI: 10.1089/hs.2017.0051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
To reduce the health security risk and impact of outbreaks around the world, the US Centers for Disease Control and Prevention and its partners are building capabilities to prevent, detect, and contain outbreaks in 49 global health security priority countries. We examine the extent of economic vulnerability to the US export economy posed by trade disruptions in these 49 countries. Using 2015 US Department of Commerce data, we assessed the value of US exports and the number of US jobs supported by those exports. US exports to the 49 countries exceeded $308 billion and supported more than 1.6 million jobs across all US states in agriculture, manufacturing, mining, oil and gas, services, and other sectors. These exports represented 13.7% of all US export revenue worldwide and 14.3% of all US jobs supported by all US exports. The economic linkages between the United States and these global health security priority countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics. The authors examine the extent of economic vulnerability to the US export economy posed by trade disruptions in the 49 global health security priority countries. Using 2015 US Department of Commerce data, they assess the value of US exports and the number of US jobs supported by those exports.
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Stehling-Ariza T, Lefevre A, Calles D, Djawe K, Garfield R, Gerber M, Ghiselli M, Giese C, Greiner AL, Hoffman A, Miller LA, Moorhouse L, Navarro-Colorado C, Walsh J, Bugli D, Shahpar C. CDC Global Rapid Response Team. Emerg Infect Dis 2017. [DOI: 10.3201/eids1.170711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Stehling-Ariza T, Lefevre A, Calles D, Djawe K, Garfield R, Gerber M, Ghiselli M, Giese C, Greiner AL, Hoffman A, Miller LA, Moorhouse L, Navarro-Colorado C, Walsh J, Bugli D, Shahpar C. Establishment of CDC Global Rapid Response Team to Ensure Global Health Security. Emerg Infect Dis 2017; 23. [PMID: 29155672 PMCID: PMC5711298 DOI: 10.3201/eid2313.170711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security.
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Goodson JL, Alexander JP, Linkins RW, Orenstein WA. Measles and rubella elimination: learning from polio eradication and moving forward with a diagonal approach. Expert Rev Vaccines 2017; 16:1203-1216. [PMID: 29037086 PMCID: PMC6477920 DOI: 10.1080/14760584.2017.1393337] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In 1988, an estimated 350,000 children were paralyzed by polio and 125 countries reported polio cases, the World Health Assembly passed a resolution to achieve polio eradication by 2000, and the Global Polio Eradication Initiative (GPEI) was established as a partnership focused on eradication. Today, following eradication efforts, polio cases have decreased >99% and eradication of all three types of wild polioviruses is approaching. However, since polio resources substantially support disease surveillance and other health programs, losing polio assets could reverse progress toward achieving Global Vaccine Action Plan goals. Areas covered: As the end of polio approaches and GPEI funds and capacity decrease, we document knowledge, experience, and lessons learned from 30 years of polio eradication. Expert commentary: Transitioning polio assets to measles and rubella (MR) elimination efforts would accelerate progress toward global vaccination coverage and equity. MR elimination feasibility and benefits have long been established. Focusing efforts on MR elimination after achieving polio eradication would make a permanent impact on reducing child mortality but should be done through a 'diagonal approach' of using measles disease transmission to identify areas possibly susceptible to other vaccine-preventable diseases and to strengthen the overall immunization and health systems to achieve disease-specific goals.
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Affiliation(s)
- James L. Goodson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James P. Alexander
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert W. Linkins
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Walter A. Orenstein
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Undurraga EA, Carias C, Meltzer MI, Kahn EB. Potential for broad-scale transmission of Ebola virus disease during the West Africa crisis: lessons for the Global Health security agenda. Infect Dis Poverty 2017; 6:159. [PMID: 29191243 PMCID: PMC5710062 DOI: 10.1186/s40249-017-0373-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/27/2017] [Indexed: 01/19/2023] Open
Abstract
Background The 2014–2016 Ebola crisis in West Africa had approximately eight times as many reported deaths as the sum of all previous Ebola outbreaks. The outbreak magnitude and occurrence of multiple Ebola cases in at least seven countries beyond Liberia, Sierra Leone, and Guinea, hinted at the possibility of broad-scale transmission of Ebola. Main text Using a modeling tool developed by the US Centers for Disease Control and Prevention during the Ebola outbreak, we estimated the number of Ebola cases that might have occurred had the disease spread beyond the three countries in West Africa to cities in other countries at high risk for disease transmission (based on late 2014 air travel patterns). We estimated Ebola cases in three scenarios: a delayed response, a Liberia-like response, and a fast response scenario. Based on our estimates of the number of Ebola cases that could have occurred had Ebola spread to other countries beyond the West African foci, we emphasize the need for improved levels of preparedness and response to public health threats, which is the goal of the Global Health Security Agenda. Our estimates suggest that Ebola could have potentially spread widely beyond the West Africa foci, had local and international health workers and organizations not committed to a major response effort. Our results underscore the importance of rapid detection and initiation of an effective, organized response, and the challenges faced by countries with limited public health systems. Actionable lessons for strengthening local public health systems in countries at high risk of disease transmission include increasing health personnel, bolstering primary and critical healthcare facilities, developing public health infrastructure (e.g. laboratory capacity), and improving disease surveillance. With stronger local public health systems infectious disease outbreaks would still occur, but their rapid escalation would be considerably less likely, minimizing the impact of public health threats such as Ebola. Conclusions The Ebola outbreak could have potentially spread to other countries, where limited public health surveillance and response capabilities may have resulted in additional foci. Health security requires robust local health systems that can rapidly detect and effectively respond to an infectious disease outbreak. Electronic supplementary material The online version of this article (10.1186/s40249-017-0373-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eduardo A Undurraga
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. .,Present address: School of Government, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile.
| | - Cristina Carias
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Martin I Meltzer
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily B Kahn
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Scott J, Wilson N, Baker MG. Improving New Zealand's preparations for the next pandemic. Aust N Z J Public Health 2017; 42:3-6. [PMID: 29168306 PMCID: PMC7159781 DOI: 10.1111/1753-6405.12736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Julia Scott
- Department of Public Health, University of Otago, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, New Zealand
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Tappero JW, Cassell CH, Bunnell RE, Angulo FJ, Craig A, Pesik N, Dahl BA, Ijaz K, Jafari H, Martin R. US Centers for Disease Control and Prevention and Its Partners’ Contributions to Global Health Security. Emerg Infect Dis 2017. [DOI: 10.3201/eid23s1.170946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Bajpai VK, Chandra V, Kim NH, Rai R, Kumar P, Kim K, Aeron A, Kang SC, Maheshwari DK, Na M, Rather IA, Park YH. Ghost probiotics with a combined regimen: a novel therapeutic approach against the Zika virus, an emerging world threat. Crit Rev Biotechnol 2017; 38:438-454. [PMID: 28877637 DOI: 10.1080/07388551.2017.1368445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The Zika virus (ZIKV) used to be an obscure flavivirus closely related to dengue virus (DENV). Transmission of this epidemic pathogen occurs mainly via mosquitoes, but it is also capable of placental and sexual transmission. Although the characteristics of these viruses are well defined, infections are unpredictable in terms of disease severity, unusual clinical manifestations, unexpected methods of transmission, long-term persistence, and the development of new strains. Recently, ZIKV has gained huge medical attention following the large-scale epidemics around the world, and reported cases of congenital abnormalities associated with Zika virus infections which have created a public health emergency of international concern. Despite continuous research on ZIKV, no specific treatment or vaccine has been developed, excepting a preventive strategy for congenital ZIKV infection. Probiotics, known as GRAS, are bacteria that confer various health beneficial effects, and have been shown to be effective at curing a number of viral diseases by modulating the immune system. Furthermore, probiotic preparations consisting of dead cells and cellular metabolites, so-called "Ghost probiotics", can also act as biological response modifiers. Here, we review available information on the epidemiology, transmission, and clinical features of ZIKV, and on treatment and prevention strategies. In addition, we emphasize the use of probiotics and plant-based natural remedies and describe their action mechanisms, and the green technologies for microbial conversion, which could contribute to the development of novel therapies that may reduce the pathogenicity of ZIKV. Accordingly, we draw attention to new findings, unanswered questions, unresolved issues, and controversies regarding ZIKV.
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Affiliation(s)
- Vivek K Bajpai
- a Department of Applied Microbiology and Biotechnology, School of Biotechnology , Yeungnam University , Gyeongsan , Gyeongbuk , Korea
| | - Vishal Chandra
- b Department of Biosciences , Integral University , Lucknow , India.,c Stephenson Cancer Center (SCC) , University of Oklahoma Health Sciences Center (OUHSC) , Oklahoma City , OK , USA
| | - Na-Hyung Kim
- d Department of Oriental Pharmacy , Wonkwang University , Iksan-city , Jeonbuk , Korea
| | - Rajni Rai
- e School of Biotechnology , Yeungnam University , Gyeongsan , Gyeongbuk , Korea
| | - Pradeep Kumar
- e School of Biotechnology , Yeungnam University , Gyeongsan , Gyeongbuk , Korea
| | - Kangmin Kim
- f Division of Biotechnology, College of Environmental and Bioresource Sciences , Chonbuk National University , Iksan-si , Jeonbuk , Korea
| | - Abhinav Aeron
- f Division of Biotechnology, College of Environmental and Bioresource Sciences , Chonbuk National University , Iksan-si , Jeonbuk , Korea
| | - Sun Chul Kang
- g Department of Biotechnology, College of Engineering , Daegu University , Gyeongsan , Gyeongbuk , Korea
| | - D K Maheshwari
- h Department of Botany and Microbiology , Gurukul Kangri University , Haridwar , India
| | - MinKyun Na
- i College of Pharmacy , Chungnam National University , Daejeon , Korea
| | - Irfan A Rather
- a Department of Applied Microbiology and Biotechnology, School of Biotechnology , Yeungnam University , Gyeongsan , Gyeongbuk , Korea
| | - Yong-Ha Park
- a Department of Applied Microbiology and Biotechnology, School of Biotechnology , Yeungnam University , Gyeongsan , Gyeongbuk , Korea
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Wolicki SB, Nuzzo JB, Blazes DL, Pitts DL, Iskander JK, Tappero JW. Public Health Surveillance: At the Core of the Global Health Security Agenda. Health Secur 2017; 14:185-8. [PMID: 27314658 DOI: 10.1089/hs.2016.0002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Global health security involves developing the infrastructure and capacity to protect the health of people and societies worldwide. The acceleration of global travel and trade poses greater opportunities for infectious diseases to emerge and spread. The International Health Regulations (IHR) were adopted in 2005 with the intent of proactively developing public health systems that could react to the spread of infectious disease and provide better containment. Various challenges delayed adherence to the IHR. The Global Health Security Agenda came about as an international collaborative effort, working multilaterally among governments and across sectors, seeking to implement the IHR and develop the capacities to prevent, detect, and respond to public health emergencies of international concern. When examining the recent West African Ebola epidemic as a case study for global health security, both strengths and weaknesses in the public health response are evident. The central role of public health surveillance is a lesson reiterated by Ebola. Through further implementation of the Global Health Security Agenda, identified gaps in surveillance can be filled and global health security strengthened.
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Higgs ES, Dubey SA, Coller BAG, Simon JK, Bollinger L, Sorenson RA, Wilson B, Nason MC, Hensley LE. Accelerating Vaccine Development During the 2013-2016 West African Ebola Virus Disease Outbreak. Curr Top Microbiol Immunol 2017; 411:229-261. [PMID: 28918539 DOI: 10.1007/82_2017_53] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Ebola virus disease outbreak that began in Western Africa in December 2013 was unprecedented in both scope and spread, and the global response was slower and less coherent than was optimal given the scale and pace of the epidemic. Past experience with limited localized outbreaks, lack of licensed medical countermeasures, reluctance by first responders to direct scarce resources to clinical research, community resistance to outside interventions, and lack of local infrastructure were among the factors delaying clinical research during the outbreak. Despite these hurdles, the global health community succeeded in accelerating Ebola virus vaccine development, in a 5-month interval initiating phase I trials in humans in September 2014 and initiating phase II/III trails in February 2015. Each of the three Ebola virus disease-affected countries, Sierra Leone, Guinea, and Liberia, conducted a phase II/III Ebola virus vaccine trial. Only one of these trials evaluating recombinant vesicular stomatitis virus expressing Ebola virus glycoprotein demonstrated vaccine efficacy using an innovative mobile ring vaccination trial design based on a ring vaccination strategy responsible for eradicating smallpox that reached areas of new outbreaks. Thoughtful and intensive community engagement in each country enabled the critical community partnership and acceptance of the phase II/III in each country. Due to the delayed clinical trial initiation, relative to the epidemiologic peak of the outbreak in the three countries, vaccine interventions may or may not have played a major role in bringing the epidemic under control. Having demonstrated that clinical trials can be performed during a large outbreak, the global research community can now build on the experience to implement trials more rapidly and efficiently in future outbreaks. Incorporating clinical research needs into planning for future health emergencies and understanding what kind of trial designs is needed for reliable results in an epidemic of limited duration should improve global response to future infectious disease outbreaks.
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Affiliation(s)
- Elizabeth S Higgs
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | | | | | | | - Laura Bollinger
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
| | - Robert A Sorenson
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Martha C Nason
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lisa E Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
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Bell BP, Damon IK, Jernigan DB, Kenyon TA, Nichol ST, O’Connor JP, Tappero JW. Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014–2016 Ebola Epidemic. MMWR Suppl 2016; 65:4-11. [DOI: 10.15585/mmwr.su6503a2] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Beth P. Bell
- Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Inger K. Damon
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Daniel B. Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | - Stuart T. Nichol
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - John P. O’Connor
- Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC
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Abstract
Stronger systems are needed for disease surveillance, response, and prevention worldwide. Since Ebola virus disease was identified in West Africa on March 23, 2014, the Centers for Disease Control and Prevention (CDC) has undertaken the most intensive response in the agency’s history; >3,000 staff have been involved, including >1,200 deployed to West Africa for >50,000 person workdays. Efforts have included supporting incident management systems in affected countries; mobilizing partners; and strengthening laboratory, epidemiology, contact investigation, health care infection control, communication, and border screening in West Africa, Nigeria, Mali, Senegal, and the United States. All efforts were undertaken as part of national and global response activities with many partner organizations. CDC was able to support community, national, and international health and public health staff to prevent an even worse event. The Ebola virus disease epidemic highlights the need to strengthen national and international systems to detect, respond to, and prevent the spread of future health threats.
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GHSA Preparation Task Force Team. Global Health Security: The Lessons from the West African Ebola Virus Disease Epidemic and MERS Outbreak in the Republic of Korea. Osong Public Health Res Perspect 2015; 6:S25-7. [PMID: 27429901 PMCID: PMC4907786 DOI: 10.1016/j.phrp.2015.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The Ebola virus disease outbreak in West Africa and the Middle East Respiratory Syndrome outbreak in the Republic of Korea have given huge impacts in different aspects. Health security is no more a new coinage. Global health security became more realistic in its practical application. In the perspective of global health, it will be helpful to peruse lessons learned from the Ebola outbreak in West Africa and MERS outbreak in Korea.
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38
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Shaikh AT, Ferland L, Hood-Cree R, Shaffer L, McNabb SJN. Disruptive Innovation Can Prevent the Next Pandemic. Front Public Health 2015; 3:215. [PMID: 26442242 PMCID: PMC4585064 DOI: 10.3389/fpubh.2015.00215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/31/2015] [Indexed: 11/13/2022] Open
Abstract
Public health surveillance (PHS) is at a tipping point, where the application of novel processes, technologies, and tools promise to vastly improve efficiency and effectiveness. Yet twentieth century, entrenched ideology and lack of training results in slow uptake and resistance to change. The term disruptive innovation - used to describe advances in technology and processes that change existing markets - is useful to describe the transformation of PHS. Past disruptive innovations used in PHS, such as distance learning, the smart phone, and field-based laboratory testing have outpaced older services, practices, and technologies used in the traditional classroom, governmental offices, and personal communication, respectively. Arguably, the greatest of these is the Internet - an infrastructural innovation that continues to enable exponential benefits in seemingly limitless ways. Considering the Global Health Security Agenda and facing emerging and reemerging infectious disease threats, evolving environmental and behavioral risks, and ever changing epidemiologic trends, PHS must transform. Embracing disruptive innovation in the structures and processes of PHS can be unpredictable. However, it is necessary to strengthen and unlock the potential to prevent, detect, and respond.
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Affiliation(s)
| | | | | | | | - Scott J. N. McNabb
- Public Health Practice, LLC, Atlanta, GA, USA
- Emory University, Atlanta, GA, USA
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Courtney B, Bond KC, Maher C. Regulatory underpinnings of Global Health security: FDA's roles in preventing, detecting, and responding to global health threats. Biosecur Bioterror 2015; 12:239-46. [PMID: 25254912 DOI: 10.1089/bsp.2014.0046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas-antimicrobial resistance, food safety, and supply chain integrity-in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats.
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Heymann DL, Chen L, Takemi K, Fidler DP, Tappero JW, Thomas MJ, Kenyon TA, Frieden TR, Yach D, Nishtar S, Kalache A, Olliaro PL, Horby P, Torreele E, Gostin LO, Ndomondo-Sigonda M, Carpenter D, Rushton S, Lillywhite L, Devkota B, Koser K, Yates R, Dhillon RS, Rannan-Eliya RP. Global health security: the wider lessons from the west African Ebola virus disease epidemic. Lancet 2015; 385:1884-901. [PMID: 25987157 PMCID: PMC5856330 DOI: 10.1016/s0140-6736(15)60858-3] [Citation(s) in RCA: 264] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security--its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.
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Affiliation(s)
- David L Heymann
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Centre on Global Health Security, London, UK.
| | | | | | - David P Fidler
- Indiana University Maurer School of Law, Bloomington, IN, USA
| | | | | | | | | | - Derek Yach
- Vitality Institute, New York, NY, USA; World Economic Forum Global Agenda Council on Ageing, Geneva, Switzerland
| | | | - Alex Kalache
- International Longevity Centre (ILC) Global Alliance and ILC-Brazil, Rio de Janeiro, Brazil; New York Academy of Medicine, NY, USA; HelpAge International, London, UK
| | - Piero L Olliaro
- UNICEF/UNDP/World Bank/WHO Special Programme on Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Peter Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Els Torreele
- Public Health Program, Open Society Foundations, New York, NY, USA
| | - Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Daniel Carpenter
- Department of Government, Harvard University, Cambridge, MA, USA
| | - Simon Rushton
- Chatham House, Royal Institute of International Affairs, London, UK; Department of Politics, University of Sheffield, Sheffield, UK
| | - Louis Lillywhite
- Chatham House, Royal Institute of International Affairs, London, UK
| | - Bhimsen Devkota
- Chatham House, Royal Institute of International Affairs, London, UK; Tribhuvan University, Kathmandu, Nepal
| | | | - Rob Yates
- Chatham House, Royal Institute of International Affairs, London, UK
| | - Ranu S Dhillon
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Cambridge, MA, USA; Earth Institute, Columbia University, New York, NY, USA
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Affiliation(s)
- Mary J Hamel
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laurence Slutsker
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Mackey TK, Liang BA, Cuomo R, Hafen R, Brouwer KC, Lee DE. Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment. Clin Microbiol Rev 2014; 27:949-79. [PMID: 25278579 PMCID: PMC4187634 DOI: 10.1128/cmr.00045-14] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern.
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Affiliation(s)
- Tim K Mackey
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Division of Global Public Health, University of California, San Diego, Department of Medicine, San Diego, California, USA
| | - Bryan A Liang
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA
| | - Raphael Cuomo
- Joint Doctoral Program in Global Public Health, University of California, San Diego, and San Diego State University, San Diego, California, USA
| | - Ryan Hafen
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Internal Medicine, University of California, San Diego, School of Medicine, San Diego, California, USA
| | - Kimberly C Brouwer
- Division of Global Public Health, University of California, San Diego, Department of Medicine, San Diego, California, USA
| | - Daniel E Lee
- Department of Anesthesiology, University of California, San Diego, School of Medicine, San Diego, California, USA Pediatrics Department, University of California, San Diego, School of Medicine, San Diego, California, USA
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Abstract
In the USA, infectious diseases continue to exact a substantial toll on health and health-care resources. Endemic diseases such as chronic hepatitis, HIV, and other sexually transmitted infections affect millions of individuals and widen health disparities. Additional concerns include health-care-associated and foodborne infections--both of which have been targets of broad prevention efforts, with success in some areas, yet major challenges remain. Although substantial progress in reduction of the burden of vaccine-preventable diseases has been made, continued cases and outbreaks of these diseases persist, driven by various contributing factors. Worldwide, emerging and reemerging infections continue to challenge prevention and control strategies while the growing problem of antimicrobial resistance needs urgent action. An important priority for control of infectious disease is to ensure that scientific and technological advances in molecular diagnostics and bioinformatics are well integrated into public health. Broad and diverse partnerships across governments, health care, academia, and industry, and with the public, are essential to effectively reduce the burden of infectious diseases.
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Affiliation(s)
- Rima F Khabbaz
- Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Robin R Moseley
- Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Riley J Steiner
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alexandra M Levitt
- Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Beth P Bell
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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