Lab Matters Fall 2016 - Page 20

public health preparedness and response Pictured from l to r: Ava Onalaja, Tyler Wolford, Lucy Maryogo-Robinson, Ambassador Bonnie Jenkins, Ralph Timperi, Peter Kyriacopoulos, Chris Mangal and Kelly Wroblewski The Laboratory Response Network: A Blueprint for GHSA National Laboratory Infrastructure by Tyler Wolford, MS, senior specialist, Laboratory Response Network T he International Health Regulations (IHR) define the role of the World Health Organization (WHO) and its member states in identifying and responding to public health emergencies of international consequence. The IHR was first adopted by WHO member states in 1969 and applied to three infectious diseases: cholera, plague and yellow fever. But in 2005, the 58th World Health Assembly substantially expanded the IHR to include an all-hazards approach via a decision algorithm to determine whether an event may constitute a public health emergency of international concern. Since 1999, the LRN has proven itself as a premier network for responding to all-hazards threats, including biological, chemical, radiological and emerging threats—a requirement of the IHR (2005). Established through a collaborative effort involving APHL, CDC, the Federal Bureau of Investigation and the Department of Defense, it is an integrated network of local, state and federal public health, sentinel clinical, food, veterinary, environmental, military and international laboratories. These labs provide diagnostic capability and capacity for biological, chemical and radiological threat detection, emerging infectious diseases and other public health emergencies. The US officially adopted the IHR (2005) in 2006 and began regulation in 2007. But efforts to implement IHR (2005) and strengthen core capacities globally have been uneven. In February 2014, the Obama administration launched the Global Health Security Agenda (GHSA), a partnership of nations, international organizations and public and private stakeholders to support countries in achieving the core capacities of the IHR (2005). In 2012, public health laboratories in fifty states and the District of Columbia received over 4,000 samples from various agencies for LRN biological threat testing. In 2014, the LRN responded to Ebola virus disease and a release of over 5,000 gallons of the industrial chemical 4-methylcyclohexanemethanol into West Virginia’s Elk River. In 2016, the Zika virus is the top target for LRN laboratories. Over the years, the LRN has proven that it is not only a leader in biological and chemical threat testing but a system capable of responding to any unexpected crisis. Over the years, the LRN has proven that it is not only a leader in biological and chemical threat testing but a system capable of responding to any unexpected crisis. The GHSA National Laboratory System action package aims to build and expand national laboratory systems that employ effective laboratory-based diagnostics and national biosurveillance capabilities. Effective use of a nationwide laboratory system capable of safely, quickly and accurately detecting infectious disease, including known and emerging threats, will significantly strengthen core capacities outlined in IHR (2005). The US Laboratory Response Network (LRN) model is one example of a national laboratory system currently in use that can be leveraged internationally to support these efforts. The LRN represents an effective national laboratory infrastructure that can be leveraged to improve IHR (2005) core capacities and boost GHSA efforts internationally for public health and diagnostic laboratory testing of future threats. 18 LAB MATTERS Fall 2016 The 194 states that adopted IHR (2005) are required to meet eight minimum core capacities: 1. National legislation, policy, and financing 2. Coordination and national focal point communications 3. Surveillance 4. Response 5. Preparedness 6. Risk communication 7. Human resources 8. Laboratory PublicHealthLabs @APHL