Excerpt

In an effort to increase our knowledge and understanding of the role of the private and public health sectors in emerging infectious disease surveillance and response, this workshop, entitled Public Health Systems: Assessing Capacities to Respond to Emerging Infections, explored how the privatization of public health laboratories and the modernization of public health care may effect infectious disease surveillance and outbreak detection. A central theme running throughout the workshop was the problematical capacity of public health systems at the state and local levels to detect and respond to an infectious disease outbreak. The workshop served to open a dialogue on public health systems to identify and discuss issues of mutual concern among representatives from the affected parties and groups. These issues were broken down into the following four thematic areas, which addressed various components of the public health system: 1. epidemiological investigation; 2. surveillance; 3. communication, coordination, and education and outreach; and 4. strategic planning, resource allocation, and economic support.

Representatives from the public health community, hospitals, government agencies, pharmaceutical companies, and academia were invited to give panel presentations moderated by Forum members. Each panelist was asked to highlight important issues, suggest possible practical solutions, and indicate impediments that must be overcome to improve infectious disease surveillance and response, communication and coordination, and education and outreach.

Contents

• THE NATIONAL ACADEMIES
• FORUM ON EMERGING INFECTIONS
• REVIEWERS
• Preface
• Summary and Assessment
  Joshua Lederberg, Ph.D.
  • ASSESSING THE CAPABILITY
  • STRENGTHENING THE CAPABILITY
  • CONCLUDING REMARKS
• 1. Introduction
  • BACKGROUND
  • CHANGING LANDSCAPE OF PUBLIC HEALTH
• 2. Epidemiological Investigation
  • OVERVIEW
  • NATIONAL PERSPECTIVE ON OUTBREAK INVESTIGATIONS
  • STATE PERSPECTIVES ON OUTBREAK INVESTIGATIONS
  • COUNTY-LEVEL PERSPECTIVE ON OUTBREAK INVESTIGATIONS
  • PERSPECTIVES OF PHYSICIANS’ COMMUNITY
  • PUBLIC HEALTH PRACTICE AND THE ROLE OF ACADEMIC PUBLIC HEALTH
• 3. Surveillance
  • OVERVIEW
  • GAO REPORT ON PUBLIC HEALTH SURVEILLANCE OF EMERGING INFECTIOUS DISEASES
  • EMERGING INFECTIONS PROGRAM COOPERATIVE AGREEMENT
  • LARGE NATIONAL COMMERCIAL LABORATORIES
  • ROLE OF THE PUBLIC-SECTOR LABORATORY AT THE NATIONAL LEVEL
  • ROLE OF THE PUBLIC-SECTOR LABORATORY AT THE STATE LEVEL
• 4. Communication, Coordination, and Education and Outreach
  • OVERVIEW
  • COMMUNICATION AND COORDINATION AT THE NATIONAL LEVEL: THE PULSENET MODEL
  • COMMUNICATION AND COORDINATION AT THE STATE LEVEL
  • NONGOVERNMENTAL ORGANIZATIONS AND STATE PARTNERSHIPS
  • CONTINUING EDUCATION: THE ROLE OF PROFESSIONAL ORGANIZATIONS
  • ROLE OF MEDICAL INFORMATION IN DETECTION AND MANAGEMENT OF EMERGING INFECTIONS
• 5. Strategic Planning, Resource Allocation, and Economic Support
  • OVERVIEW
  • LEGISLATION AND MANDATES AT THE FEDERAL LEVEL
  • CONGRESSIONAL RESPONSE TO THE THREAT OF INFECTIOUS DISEASES
  • STATE HEALTH OFFICIAL PERSPECTIVE
  • LABORATORY-BASED REPORTING ISSUES
• References
• APPENDIXES
  • APPENDIX A Glossary and Acronyms
  • APPENDIX B Workshop Agenda
  • APPENDIX C Emerging Infectious Diseases: Consensus on Needed Laboratory Capacity Could Strengthen Surveillance
  • APPENDIX D Forum Member and Staff Biographies

This report is based on the proceedings of a workshop that was sponsored by the Forum on Emerging Infections. It is prepared in the form of a workshop summary by and in the name of the editors with the assistance of staff and consultants, as an individually authored document. Sections of the workshop summary not specifically attributed to an individual reflect the views of the editors and not those of the Forum on Emerging Infections. The content of those sections is based on the presentations and the discussions that took place during the workshop.

Support for this project was provided by the U.S. Department of Health and Human Services’ National Institutes of Health, Centers for Disease Control and Prevention, and Food and Drug Administration; U.S. Department of State, Bureau of Oceans and International Environmental and Scientific Affairs; U.S. Department of Veterans Affairs; Abbott Laboratories; American Society for Microbiology; Applied Microbiology, Inc.; Bristol-Myers Squibb Company; Burroughs Wellcome Fund; Eli Lilly & Company; Glaxo Wellcome; F. Hoffmann-La Roche, AG; Merck; Pfizer, Inc.; SmithKline Beecham Corporation; and Wyeth-Ayerst Laboratories.

The views presented are those of the editors and workshop participants, and are not necessarily those of the funding organizations.

NOTICE: The project that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.