public health preparedness and response

by Samuel Abrams, MPH, specialist, Public Health Preparedness and Response

Need for Flexible Funding

Public health laboratories( PHLs) serve a keystone function to rapidly detect and characterize chemical, biological, radiological and emerging infectious agents. These laboratories rely heavily on CDC to resource preparedness and response activities— with 90 %( approximately $ 70 million annually) of their funding for preparedness coming via the PHEP Cooperative Agreement. The funds are divided among the laboratories in all 50 states, Washington, DC, Los Angeles County, New York City and Puerto Rico. These laboratories allocate PHEP funds to personnel, equipment, support of other local governmental labs, a variety of laboratory necessities such as upgrades and maintenance contracts for the latest technologies, rigorous biosafety and threat mitigation trainings, and general laboratory supplies needed to run critical assays. Yet, when accounting for inflation, annual appropriations for PHEP have continually fallen, leading to increased pressure for laboratories to keep Americans healthy while operating on razor thin budgets.

When accounting for inflation, annual appropriations for PHEP have continually fallen, leading to increased pressure for laboratories to keep Americans healthy while operating on razor thin budgets.

Information is Power

APHL administers its annual All-Hazards Laboratory Preparedness Survey to the 50 state PHLs and Washington, DC, Los Angeles County, New York City and Puerto Rico PHLs to evaluate issues they are facing, and gather specific information on their readiness to respond to threats and factors that may hinder their ability to effectively launch a rapid response. Survey data provide informative statistics on demographics, funding, response planning, current threats and communications infrastructure. The most recent survey, conducted in fall 2016, showed common issues related to funding cuts:

• Inability of PHLs to expand capabilities for new assays( 58 %);

• High costs of service contracts necessary to maintain critical equipment( 48 %);

• Inability to hire new staff( 42 %).

To be ready to respond to the next threat, PHLs must have trained personnel, well-maintained and modern equipment, and safe and secure facilities.

PHLs must also maintain strong partnerships with diverse stakeholders such as sentinel clinical laboratories and first responders. All 54 PHLs surveyed by APHL indicated that they maintain a database of sentinel clinical laboratories in their jurisdiction and rely on their assistance for ruling-out and referring potential threats, including the timely submission of sample information. In fact, 82 % of PHLs provided training on sample testing and shipping procedures, as well as biosafety courses necessary to maintain the safety of employees and the public.

Protecting the US from the many public health threats it faces is no simple task. PHLs play a vital role in quickly identifying emerging threats and providing information necessary for government leaders to shape public health and biothreat policy. Lack of funding— both to prepare and respond— is the one threat that needs to be at the top of the list.