The U.S. joined international organizations and at least 25 other countries to launch a full-court press to improve global health security.
The so-called Global Health Security Agenda is aimed at improving the world's ability to prevent, detect, and respond to outbreaks of infectious diseases.
"A much safer world really is within our reach," CDC Director Thomas Frieden, MD, told a telephone press conference on the eve of this morning's launch of the project at a ministerial-level meeting in Washington, DC.
"The bad news is that there are too many blind spots around the world" where infectious disease outbreaks can get going without being noticed quickly, Frieden told reporters.
Given the ease of international travel and growth of global trade, such outbreaks are "only a plane ride away" from the U.S., said Laura Holgate, senior director for Weapons of Mass Destruction Terrorism and Threat Reduction at the National Security Council.
"In an inter-connected world, we are all vulnerable," Holgate said.
Whether natural or man-made, Holgate said, infectious disease outbreaks threaten loss of life, economic damage, and political instability.
The Washington meeting was kicked off by Health and Human Services Secretary Kathleen Sebelius and Lisa Monaco, the presidential advisor for homeland security.
Aside from those in Washington, participants joined the meeting electronically from Rome, New Delhi, and Geneva, where World Health Organization Director-General Margaret Chan, MD, also spoke.
An inter-connected world leads to "new vulnerabilities and new opportunities," Sebelius said.
"Microbes and diseases are moving faster and farther than ever and one thing we know for certain -- they do not recognize or stop at national borders,” she added. “A threat anywhere is indeed a threat everywhere."
But Sebelius also praised an “unprecedented willingness” among nations to work together to meet the threats.
Countries represented at the meeting include the small and the large -- from Finland to China and Canada to Russia, Holgate said.
In 2014, he said, the CDC will re-purpose $40 million of its budget to try to duplicate those projects in at least 10 other countries, ensuring they have the ability to prevent some key diseases, such as measles, as well as identify and respond to outbreaks of other illnesses.
In 2015, he said, President Barack Obama will ask that the CDC budget be increased by $45 million so that within five years 30 countries that have a total population of at least four billion and are not currently protected would have increased disease-fighting capacity.
At the end of the five-year project, Frieden said, the U.S. and its partners want the 30 target countries to have, among other things, the ability to:
- Monitor and slow antimicrobial resistance, with at least one reference laboratory that can identify and report on worrisome pathogens.
- Immunize at least 90% of the country's one-year-old population with at least one dose of measles-containing vaccine.
- Conduct real-time biosurveillance and deploy effective modern diagnostics that can reliably obtain and test specimens from at least 80% of the country.
- Quickly and accurately report disease outbreaks to international organizations.
- Have a workforce that includes physicians, veterinarians, biostatisticians, laboratory scientists, and at least one trained field epidemiologist per 200,000 population.
- Set up and maintain a public health Emergency Operation Center with staff that can respond within 120 minutes of a public health emergency.
The poster child for better health security is China, which was unprepared for and secretive about the 2002-2003 outbreak of SARS. The deadly and expensive outbreak caught the world's attention and in response China launched an ambitious program to improve its public health capacity.
In a commentary in The Lancet, timed to coincide with the Washington meeting, Frieden and colleagues noted that -- in contrast to SARS -- China's response to the outbreak of H7N9 avian influenza last year was a model of quick response and transparent reporting.
The SARS outbreak also led to the 2005 revision of the International Health Regulations by the World Health Organization, regulations that required the 194 signatory countries to improve their detection, prevention, and response capacity by 2012.
Only 20% of countries have reported to the UN agency that they have met those targets, Frieden noted, but rapid progress could be made in many of the laggards.
The CDC's Uganda project, he said, is a case in point: The country had limited existing health networks aimed at mainly at HIV.
With American assistance, those networks got faster, country-wide sample collection, additional lab capacity, better communications technology, and were expanded to cover more diseases -- initially Ebola, cholera, and drug-resistant tuberculosis.
They have "since been used to identify and help stop many different outbreaks including Zika virus and Crimean-Congo hemorrhagic fever," Frieden told reporters.
In such places, he said, "we do have the opportunity to make rapid progress."