PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Ensuring Readiness for Rabies in Puerto Rico
by Sean Page, associate specialist, Public Health Preparedness and Response
In late 2018, APHL was awarded a
two-year, $15.1 million cooperative
agreement by the US Centers for Disease
Control and Prevention (CDC) to provide
technical assistance for response to public
health crises in three jurisdictions—
Puerto Rico (PR), US Virgin Islands (USVI)
and Houston—impacted by hurricanes.
The Center for State, Tribal, Local and
Territorial Support (CSTLTS) Office of
Insular Affairs manages this cooperative
agreement with APHL and coordinates
across CDC to provide leadership for crisis
response in the impacted jurisdictions.
Key activities for APHL encompass human
capacity building in the jurisdictions – to
date, APHL has hired over 30 local staff to
support Puerto Rico and four local staff to
support USVI. The range of these activities
include procurement of equipment,
reagents, vaccines and other supplies,
training of staff and travel support. To
accomplish these activities, APHL is using
a modified approach, which facilitates
expedited delivery of much needed goods
and services.
APHL engaged in discussions with
PR Department of Health State
Epidemiologist, Dr. Carmen Deseda, and
other key personnel to gather information
on rabies needs on the island. Rabies is
an immediate threat for the residents of
PR due to large populations of stray dogs
and mongooses. Given the urgent need for
rabies treatment in PR, APHL collaborated
across CDC and externally to procure over
1,000 vials of rabies vaccines and over 700
vials of human rabies immunoglobulin
(HRIG).
Finding a Cost-Effective
Procurement Process
In order to expedite the procurement of
vaccines and HRIG, APHL turned to local
vendors in Puerto Rico for a fast solution.
As APHL researched and obtained quotes,
however, it discovered that pricing of
vaccines and HRIG were much higher at
the local level than what was originally
budgeted.
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LAB MATTERS Spring 2019
Rabies is an immediate threat for the residents of PR due to large populations
of stray dogs and mongooses. Given the urgent need for rabies treatment in
PR, APHL collaborated across CDC and externally to procure over 1,000 vials of
rabies vaccines and over 700 vials of human rabies immunoglobulin (HRIG).
APHL turned to vaccine producers with
offices on the mainland US to identify
more cost-effective products. With much
persistence and collaboration, APHL
procured the vast amount of vaccines
and HRIG. Additionally, APHL collaborated
with FedEx and Worldwide Diagnostics to
ensure cold chain was maintained during
shipment.
FedEx and Worldwide Diagnostics worked
to ensure both shipments cleared the PR
customs process in an expedited manner.
In addition, APHL coordinated with the
PR Department of Health and CDC staff in
Puerto Rico to confirm the vaccines and
HRIG reached the OCASET Pharmacy. The
partners also confirmed the shipment’s
temperature of 2°C–8°C was maintained.
This procurement story demonstrates the
importance of public-private partnerships
to support readiness and response to
major public health threats, such as
rabies. n
Sean Page along with PHPR staff organized a FedEx shipment
of rabies vaccines from APHL
PublicHealthLabs
@APHL
APHL.org