FEATURE
…This is really important work,
and I think Congress recognizes its
importance.”
Stephen Redd, MD
staffers she met with either “had no idea”
how GHSA funds are spent or were “only
vaguely aware” of the program.
Her advice for effective disease control
boils down to two words: sustained
funding. “The kind of changes that are
needed aren’t going to happen within a
single funding cycle.”
Stephen Redd, MD, deputy director for
public health service and implementation
science at CDC, said CDC is moving to a
new global health strategy precisely so
the agency can “have a global presence
that wouldn’t depend on disease-specific
funding or supplemental funding for an
emergency.”
While there is no immediate plan to
close country offices, CDC will segue from
“bilateral” staff to “regional” staff who
will develop and maintain connections
to multiple countries. Gains in efficiency,
Redd said, “would make health security
not dependent on funding sources that
wax or wane.”
“This is really important work,” he said,
“and I think Congress recognizes its
importance.”
In the US, public health laboratories have
employed their own strategies to cope
with funding losses. Kubin, for example,
has tapped an APHL bioinformatics fellow
to help establish a newborn screening
bioinformatics program, taken advantage
of the APHL Emerging Leader Program for
staff training and sent staff to meet with
clinical partners to assure specimens are
collected and shipped correctly.
Of course, sometimes, the only way to
balance the budget is to reduce services.
@APHL
One bright spot in the FY2020 budget is the $50
million appropriation for a new Public Health
Data Modernization Initiative. Although the
funding is half the annual amount requested by
APHL and partners—who cited a need for $100
million/year for ten years, with half going to CDC
and half to US jurisdictions and Tribal Nations—
it is a meaningful start for a campaign to build
near-real time public health surveillance and
analytical systems.
APHL and partners have identified six areas
where this much-needed support could be used
to generate a more complete and timely picture
of emerging and ongoing public health threats:
• Updating the National Notifiable Disease
Surveillance System
• Expanding and streamlining electronic case
reporting, whereby clinicians notify health
agencies about infectious diseases of public
health concern
• Enhancing syndromic surveillance at hospital
emergency departments
• Modernizing vital records systems
• Assuring public health laboratories are
equipped with the state-of-the-art laboratory
information management systems needed to
electronically report and analyze laboratory
data
Said Toney, “Anytime we are faced with
infectious diseases or other public health
situations that affect our communities
and individual lives and we do not have
the tools we need to respond, that’s
problematic. ...Knowing what we are
capable of doing, and what [capabilities]
we have lost...well, we owe it to our
citizens to provide a lot more.” n
PublicHealthLabs
From the Dark Ages to the Data Age:
Congress Funds Effort to Advance Disease Surveillance
“We have all this data in our [public health and
healthcare] systems, but limited ability to gather
all the information needed for a real time public
health response, with no delays,” said Grace
Kubin, PhD, director of the Texas Department of
State Health Services laboratory. “It is a costly
proposition to get real time information into
a system in a usable format. And these data
systems are very, very expensive; not only to
bring them up, but to maintain them is very
expensive. This funding will help.”
Alison Kelly, who oversees CDC’s appropriations
office, said the agency will “move rapidly
to address the most pressing and the most
impactful [data] needs.” As directed by
Congress, the agency is developing a multi-year
work plan.
Kelly said, “APHL has been at the forefront of a
number of important innovations in the area of
public health data modernization” demonstrating
proof-of-concept for messaging strategies that
can ultimately “improve health and save lives.”
The data initiative is APHL’s top federal priority
and a joint project with the Council of State and
Territorial Epidemiologists, National Association
for Public Health Statistics and Information
Systems and the Healthcare Information and
Management Systems Society.
• Developing a public health data science
workforce.
APHL.org
Winter 2020 LAB MATTERS
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