Lab Matters Winter 2020 - Page 15

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. Winter 2020 LAB MATTERS 13