partner profile

As CDC’ slead onlaboratorysupportforthe GlobalHealthSecurity Agenda( GHSA), what are you hoping to achieve?

That’ s a big question. The short answer is, eliminate the need for me. Our goal literally is altruistic and lofty, way up on the mountain, trying to get the world compliant with the International Health Regulations( IHR). Revised IHR guidelines were approved in 2005, and all signatories to this legally binding document are supposed to be compliant by June 2016. But we’ re not ready globally. We aim to help countries be self-sufficient because pathogens know no borders. We want them to know they can share information; it is not an indictment of your country if you have a disease outbreak. We want everyone to be interconnected to other countries and regions. Then we won’ t have to be the 911 or 411 for public health emergencies.

Andwhatareyourbiggestchallenges?

That’ s easy. It’ s always the same no matter where you go: time and money. Time equates to having enough hours in the day with people and not do things quickly to simply“ check the box.” The second aspect, money, could be funding to help travel people for training or provide equipment or have enough staff to work with people who need assistance. Quite frankly, the US government does miracles with what the US tax payers provide. And when you look at the state labs, what some of them are able to accomplish is even more miraculous. I use our own Georgia public health laboratory as an example; they are absolutely phenomenal. I quite frankly at times don’ t know how states manage it with their limited resources.

DoyoureallythinkwecaneverattaintheGHSAvisionofaworld“ secure from infectious disease threats?”

Yes, I do. Is it a huge and idealistic goal, of course. But it can be done. Just look at the Americas. We’ ve eliminated smallpox from the very northern reaches of North America all the way down to Tierra del Fuego. We were the first in the world to eliminate polio and measles and rubella, and we’ re on the way to eliminating malaria and onchocerciasis. This is a public health success story that is still, to my knowledge, largely unsung. And if we can do it here— with all the different economies and education levels and public health systems— we can do elsewhere.

How can US public health laboratories support CDC and other partnersworkingtowardGHSAgoals?

That’ s so easy. Just keep doing what they’ re doing. APHL is one of our key implementing partners, not just in the US, but around the world. APHL is also a model. For example, the state laboratories are models for other countries on how to set up their own systems. The US public health laboratory system was built up over a century or more and tried by fire. We know what works. APHL and its members have been helping with everything from wet bench training to systems analysis to setting up“ twinning” and mentoring relationships that go on for years. It’ s been an amazing partnership, and one we are gratified for.

As youknow, APHLis developingaPublicHealthLaboratoryService FellowshipinpartnershipwithCDC. Whyis thissoimportant?

We need to train the next generation of public health laboratorians, and APHL has so much experience doing this. This type of fellowship is critical for low- and middle-resource countries to give them the next generation of leaders or programs will not be truly sustainable. A case in point, which was so surprising to me coming out of an academic environment, is a country I visited and worked in did not have a single PhD program in the entire country. They did not have an accredited“ med tech” program. So the questions is: Where do you get your basic laboratory scientist, not just to do the bench work, but also to manage the laboratory? Most of the people working in the laboratory did not have the background to do that. They would expend large amounts of money and effort to send people abroad for training, usually to the US. The problem is that many times those people didn’ t want to come back, resulting in a brain drain. When they came to CDC for training, they viewed it as coming to Disney World- a magical kingdom of public health. They say, We can never achieve that back home. I always point out that CDC started with rented space in downtown Atlanta in 1946. Everything has to begin somewhere. So the APHL fellowship will grow that next generation of bench scientists and mid-tier and upper-tier managers who will build and sustain laboratories. In the end, it’ s the people who make the laboratory technology successful, and APHL’ s participation in this process is simply mission critical.

So I know we can. Is it going to take a long time? Yes. Is it worth doing? Yes. One of the seminal moments in my career was when I arrived in Egypt and watched a child dying from rabies. Human rabies is almost non-existent in the US. I had two [ Egyptian ] staff members who had survived polio, a disease that was only textbook for me. This is why we need to achieve the goals of the GHSA.