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 .