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Stopping Viruses that Don’t Respect Borders

Posted on by Peter Bloland, DVM, MPVM

CDC’s Global Immunization Plan

 Peter Bloland, DVM, MPVM
Peter Bloland, DVM, MPVM

In the first seven months of 2016 alone, 13 states reported outbreaks of measles, a highly infectious disease that killed 400 to 500 Americans a year and hospitalized nearly 50,000 more as recent as the 1950s. With the advent of the measles vaccine, routine immunizations, and the federal Children’s Health Insurance Program, measles is no longer endemic (it was declared eliminated in the U.S. in 2000).

But regular measles outbreaks, caused by travel to places with outbreaks (such as England, France, India, Philippines) and pockets of communities with unvaccinated people, as well as other viruses newly imported into the U.S., underscore the importance of improving global immunization.

“There’s no reason measles and rubella (German measles) can’t be eliminated worldwide and not just in the Americas,” said Dr. Bloland, the acting director of CGH’s Global Immunization Division (GID). Dr. Bloland, an epidemiologist/veterinarian with a masters in preventive veterinary medicine, has witnessed the crucial link between well-functioning immunization programs and stopping the spread of vaccine-preventable diseases.

“It is far more humane to prevent death and suffering, and more economical than the intense efforts needed to stop repeated outbreaks and life-long care for many of those stricken.” Measles outbreaks in the U.S. for example, costs local governments up to $50,000 per case and families up to more than $100,000 per hospitalization.Community Health Volunteers in India

One of CDC’s goals is to eliminate measles and rubella worldwide. Despite the affordable MMR vaccine licensed in 1963, measles is still a leading cause of death among children under age 5 globally and rubella causes more than 100,000 cases of severe birth defects ―including microcephaly ― each year, making it the number one infectious cause of birth defects in the world.

“The number of measles deaths around the world was steadily declining since 2000 but progress has recently slowed,” explains Dr. Bloland. “We must do something different to reverse this trend.”

The Strategic Framework provides this roadmap. “GID’s activities in South Sudan are an example of a model that would be ideal to pursue elsewhere,” explains Dr. Bloland. South Sudan, plagued by war, is trying to get its health system operational. “We have an agreement with its ministry of health to assist by training new personnel and setting up a functional immunization program, for which South Sudan will take increasing financial responsibility.”

“CDC and WHO have supplied South Sudan with STOP advisors to eliminate polio for many years, but now STOP advisors also will be training and mentoring government employees to build and operate a well-functioning system.” Building capacity for data administration, surveillance, routine vaccine delivery, and communications enables the ministry to analyze its data and address its disease burden with public policies; detect and respond to outbreaks within and along its borders; and continuously improve its delivery programs.

“I have also seen tremendous, sustainable improvements by countries to control disease. I saw Malawi change its malaria treatment policy based on research despite contentious differing opinions,” said Dr. Bloland, whose research provided evidence for more efficacious malaria treatment globally. “Evidence and data can drive policy and decision-making at national levels so that the whole country benefits.

GID has proposed proven models and guiding principles for the next crucial years that it crafted with 17 divisions across CDC aimed at preventing death and disability from diseases with vaccines over the next 5 years, a critical period for global immunizations. These are outlined in CDC’s Strategic Framework for Global Immunization, 2016-2020.

“Uganda, for example, is concerned about the quality of its information about vaccine-preventable diseases.” GID is working closely with the Uganda Ministry of Health and other partners to improve immunization data quality so they can better analyze where there are immunization coverage gaps. “The MOH wants to run its immunization programs effectively and CDC can assist them to improve the quality of their information systems.”

“These next few years are very important to the health of all people,” said Dr. Bloland, “As the global community finishes eradicating polio, using the knowledge amassed and the assets CDC helped create from the more than $2 billion the U.S. government invested could propel the world to an even safer and more equitable place.

“CDC and our partners have a unique and urgent opportunity to save many millions of people for generations to come from vaccine-preventable diseases by transforming polio eradication infrastructure and achievements into durable immunization programs around the world.

“There’s no better way to protect Americans at home and abroad from vaccine-preventable diseases than for countries worldwide to use public health data to build strong, self-sufficient programs to protect its people,” said Dr. Bloland.

Peter Bloland, DVM, MPVM is a captain with the USPHS and the acting director of the Global Immunization Division in the Center for Global Health. Read CDC’s Strategic Framework for Global Immunization, 2016-2020.

Posted on by Peter Bloland, DVM, MPVMLeave a comment

Think NoHep this World Hepatitis Day

“Viral hepatitis – a group of infectious diseases known as hepatitis A, B, C, D, and E – affects hundreds of millions of people worldwide, causing acute and chronic liver disease and killing more than 1.4 million people every year, mostly from hepatitis B and hepatitis C. It is estimated that only 5% of people Read More >

Posted on by Dr. John W. Ward, Director, Division of Viral Hepatitis1 CommentTags , , ,

INSPIRE: Breaking the Cycle of Violence

INSPIRE: Seven Strategies for Ending Violence Against Children. Implementation and Enforcement of Laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, Education and life skills

This blog was originally posted on The Huffington Post on July 13, 2016 As a society, we have unanimity about few things, but one of these is that no child should be harmed by violence. And yet, every 5 minutes a child somewhere in the world dies a violent death, and half of all children in the Read More >

Posted on by Tom Frieden, MD, MPHLeave a commentTags ,

Laboratory Tests in the Fight to Save Sight

Village leaders meet with the field team to discuss the study, Kahe Mpya, Rombo District, Tanzania, June 2012.  Community engagement is critical to successful field studies.

Trachoma, a disease of the eye caused by a bacteria called Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. Repeated infections cause the eyelid to turn inward, at which point the eyelashes scrape and permanently scar the cornea. At one time, trachoma was endemic in parts of Europe and the United States. Trachoma Read More >

Posted on by Diana Martin, PhD (Microbiologist, Division of Parasitic Diseases and Malaria)Leave a comment

Saving Lives with Hand Hygiene in Sierra Leone

Float parade celebrating World Hand Hygiene Day at Pujehun, Sierra Leone

“See what is in your hands“ – Nanah Sesay Kamara, National IPC Coordinator, Sierra Leone Hundreds of millions of patients worldwide are affected by unsafe healthcare each year, and the burden is significantly higher in countries where resources are limited. Hand hygiene is one inexpensive and effective strategy to help ensure safe care. Clean hands Read More >

Posted on by Dr. Benjamin Park, Chief, International Infection Control ProgramLeave a commentTags , , ,

World No Tobacco Day – Tobacco Surveillance in Barangay Looc, Province of Zambales, Philippines; Reflections on GTCB’s Worldwide Impact

Global Adult Tobacco Survey pretest surveillance team, barangay Looc.

As an IT Specialist working for the CDC Foundation and assigned to the Office on Smoking and Health’s Global Tobacco Control Branch (GTCB), I have had the opportunity to travel to many places around the world.  We conduct several surveys and I mainly work with the Global Adult Tobacco Survey (GATS).  I provide technical support Read More >

Posted on by Edward Rainey, IT Specialist and Public Health Analyst with the CDC Foundation, assigned to GTCB.Leave a commentTags , , ,

Vietnam: Increased Surveillance Leads to Detection of Zika Virus

Vietnam EOC gathered for a briefing about the Zika virus.

Vietnam EOC gathered for a briefing about the Zika virus. Along with WHO, CDC experts Anthony Mounts, Trang Do, Michael Johansson, and Leisha Nolen provided consultation during the meeting. CDC Vietnam will enhance surveillance and temperature monitoring at border control areas and alert pregnant women to be aware and report any signs and symptoms. The Read More >

Posted on by Niki Pham, MSc.Leave a commentTags , ,

Vietnam: Empowering Communities to Detect Potential Outbreaks Early

Diseases may start in local communities before they spread and become widespread outbreaks. Vietnam is harnessing the power of community members to identify potential outbreaks earlier to shorten response times and avert epidemics. A parent hears rumors from other parents about several children bitten by a rabid dog. A teacher sees an unusually high number Read More >

Posted on by Niki Pham, MSc.Leave a commentTags , ,

A Ray of Hope for a Better-Prepared Ethiopia

Working alongside an EIS officer and an FETP resident on an investigation in Konso, Ethiopia, 2015.

I have called Ethiopia home for the past five years – it is a country that is very close to my heart. I was moved to humanitarian work by images of the famine when I was in college and subsequently adopted my daughter from here. As we face our worst drought in 50 years, I Read More >

Posted on by Lucy Boulanger, DGHP Program Director, EthiopiaLeave a commentTags ,

When It Was Even Scarier

Dr. Anne Schuchat with her mother Molly G Schuchat

This blog originally appeared on The Huffington Post on April 29, 2016 Four score and seven years ago, my mother was born into an America swarming with pathogens. Many were simply known as diseases of childhood; not all children survived them. My mother remembers how her family suffered when a cousin died during infancy from Read More >

Posted on by Anne Schuchat, MDLeave a commentTags , , , ,
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