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Indonesia Takes a Leadership Position in the Global Health Security Agenda

Categories: global health security

Maluku mom and kid with mosquito bed net (Photo courtesy of Edi Purnomo, UNICEF)

Photo courtesy of Edi Purnomo, UNICEF

Dr. William Hawley, Country Director for CDC-Indonesia

Dr. William Hawley, Country Director for CDC-Indonesia

As the world’s fourth most populated country, Indonesia plays an important strategic role in protecting the global community from infectious disease threats. As one of the early countries to take a leadership role in the Global Health Security (GHS) Agenda, the Government of Indonesia will welcome senior health and agricultural leaders from 36 countries and 12 international organizations for the next commitment meeting August 20-21. The meeting, “Building Global Commitment to Multisectoral Approaches to Manage Emerging Zoonotic Diseases in Support of the Global Health Security Agenda within the Framework of Public Health”, demonstrates the progress and growing momentum of the GHS Agenda.

CDC has collaborated with Indonesia for more than fifty years. Short- and long-term technical assistance from CDC staff has helped the Indonesian Ministry of Health (MoH) address a wide range of high-priority public health needs, including communicable diseases, noncommunicable diseases, injuries, and strengthening surveillance. As CDC Country Director in Indonesia for the last three years, it has been an honor and privilege to work alongside our Indonesian counterparts to advance public health and the GHS Agenda.

Recent CDC and Indonesia MoH collaborations include support for maternal and child health and malaria control and elimination, surveillance for influenza and respiratory diseases, immunizations, enhancing laboratory-based early warning surveillance systems, and the Field Epidemiology Training Program. CDC works closely with the World Health Organization (WHO), UNICEF, and USAID in supporting collaborations with the MoH.

IndonesiaThe GHS Agenda is a WHO Member State-driven effort to accelerate progress toward global implementation of the International Health Regulations (IHR), building on the IHR obligations of all Member States to collaborate in the development, strengthening, and maintenance of IHR core capacities. Participation in the GHS Agenda is open to all Member States who can make a specific commitment to accelerate measurable progress toward the GHS Agenda objectives.

Through focused leadership and high-level political will, the GHS Agenda aims to bring together other sectors in addition to health (including agriculture, security, development, and foreign affairs) in a whole-of-government—as well as a whole-of-society—approach to address infectious disease threats.

As we look ahead to the next GHS Agenda event at the White House on September 26, when nations around the world will present their comprehensive and integrated commitments, the meeting this week in Indonesia underscores Indonesia’s commitment to global health security and its important role in the international community and the Association of Southeast Asian Nations (ASEAN).

Learn more about CDC’s work in Indonesia.

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The High Stakes in Fighting Ebola: Leave One Burning Ember and the Epidemic Could Re-Ignite

Categories: Ebola, global disease detection, global health security, health systems strengthening, infectious disease

 

This blog was originally posted on the Huffington Post on August 7, 2014.

 

A banner encouraging people suffering from Ebola to go immediately to a health center for treatment is seen on a sidewalk in the city of Freetown, Sierra Leone, Thursday, Aug. 7, 2014. While the Ebola virus outbreak has now reached four countries, Liberia and Sierra Leone account for more than 60 percent of the deaths, according to the World Health Organization. The outbreak that emerged in March has claimed at least 932 lives. (AP Photo/Michael Duff)

(AP Photo/Michael Duff)

CDC and our partners are currently fighting the biggest and most complex outbreak of Ebola virus disease ever recorded.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

There are hundreds of cases in West Africa and now a new cluster of cases in Nigeria is very concerning. The spread of Ebola shows what happens if we don’t have meticulous infection control, contact tracing, and proper isolation of those with symptoms of the disease.

There are two things that are very important to understand about how Ebola spreads.

The evidence suggests that Ebola only spreads from sick people—not from people who have been exposed to the disease but haven’t yet become sick from it. The illness has an average 8-10 day incubation period, although in rare instances the incubation period may be as short as two days or as long as 21 days, which is why we recommend monitoring for 21 days after any potential exposure.

Global Health Security in Africa: Collaborations Between CDC and African Partners

Categories: global health security

2012 investigation of Ebola virus in Uganda

2012 investigation of Ebola virus in Uganda

Thomas Kenyon, MD MPH, Director of CDC Center for Global Health

Thomas Kenyon, MD MPH, Director of CDC Center for Global Health

The ambition and scope of the Global Health Security Agenda are clear. Its reach can be discerned from the very first word: global. The Agenda’s overarching goal is just as expansive—making the world safer and more secure by preventing epidemics and outbreaks, detecting them more rapidly, and responding effectively to lessen the health, economic, and societal consequences from disease threats.

Less obvious, but no less true, is that African ownership will be central and fundamental in shaping the way the Global Health Security Agenda evolves worldwide, the way it is enacted and refined, and to a large extent, how it succeeds.

CDC and African nations have been close and successful partners for many decades in the battle to protect and improve public health. In many ways, the concepts, practices, and tools that are central to the Global Health Security Agenda are drawn from experiences honed with our partners in Africa over many years.

Strengthening Vaccination Systems – how it STARTs

Categories: immunization

On the road to Bukwo District (photo courtesy of George Momanyi)

On the road to Bukwo District (photo courtesy of George Momanyi)

George Momanyi, Public Health Nurse, START Consultant

George Momanyi, Public Health Nurse, START Consultant

George Momanyi, a public health nurse from Kenya, has twice served as a consultant with CDC’s Strengthening Technical Assistance for Routine Immunization Training (START) project in Uganda.  START, funded through a grant from the Bill & Melinda Gates Foundation, provides mentoring and on-the-job training to district-level immunization officers and service providers in areas with high numbers of unimmunized children. START consultants make regular visits to district health officers and service providers, delivering training and reinforcing the application of practical job skills.  START’s objective is to build the capacity of program staff and thereby strengthen the overall immunization system. 

As a START consultant, George worked in eastern Uganda from July-December 2013, and in northern Uganda from February-June 2014. As he was ending his service on the 2nd START team in June, he sent us this blog about his experience.

CDC Scientist Fights Chikungunya

Categories: chikungunya, mosquito-borne disease

investigation in Comoros in 2005.

Investigation in Comoros in 2005.

Ann Powers, Ph.D., Research Microbiologist and Chief of the Alphavirus Laboratory in CDC’s Division of Vector-Borne Diseases

Ann Powers, Ph.D., Research Microbiologist and Chief of the Alphavirus Laboratory in CDC’s Division of Vector-Borne Diseases

One of the most telling signs of the complexity surrounding chikungunya is that educating people on pronouncing the name correctly is perhaps the easiest challenge.

I’m exposed to that truth more than most.  And for the record, it’s pronounced chick-un-goon-ya.

As a research microbiologist for CDC’s National Center for Emerging Zoonotic and Infectious Diseases, my job is to better understand and occasionally chase (literally) an often overlooked, mosquito-borne, threat to public health; one that holds the potential to spread sickness and misery in the United States.

Chikungunya is viral disease that is transmitted to people by two species of mosquitoes that are present in the United States. Aedes aegypti and Aedes albopictus, often called the Asian tiger mosquito, can be found in about a third of the U.S.  They are the same mosquito species that transmit dengue in much of the tropics.  And while chikungunya does not kill people, the toll it inflicts ranks high on the misery index; it hits fast and hard and with almost no subtlety. People infected with chikungunya typically experience high fever and severe joint pain soon after they are exposed. Sometimes those problems are long-lasting.

World Cup serving as real-world test for new disease detection technology

Categories: global disease detection, global health security, health systems strengthening, infectious disease

 

World Cup soccer ball

 

With the World Cup underway in all its frenzied glory, you can be forgiven for missing another major effort currently underway in Brazil that represents the first large scale, real-life, real-world test of important new technology.

And no, it’s not the goal-line technology that’s being used for the first time at soccer’s biggest competition.

This technology uses computer tablets, sophisticated software designed by CDC and public health experts from Brazil’s Ministry of Health (MOH) trained in the Field Epidemiological Training Program (FETP) to provide the most complete, detailed and timely information about disease threats and other public health concerns.

Polio Eradication, Microplanning and GIS

Categories: child health, immunization, polio

A Bugagi child travels by camel near Lake Chad in Borno State, Nigeria. Photo courtesy of Thomas Moran/WHO.

A Bugagi child travels by camel near Lake Chad in Borno State, Nigeria. Photo courtesy of Thomas Moran/WHO.

Victoria Gammino, PhD, MPH, Epidemiologist, CDC Global Immunization Division

Victoria Gammino, PhD, MPH, Epidemiologist, CDC Global Immunization Division

Geospatial data have been used in public health since John Snow mapped cholera cases around the Broad Street water pump during the London cholera epidemic of 1854.  And, while global positioning system technologies (GPS) are so ubiquitous in the United States that virtually all new smartphones, tablets and cars have this technology embedded, in many areas of the world, health care workers in the field are often without the most basic two-dimensional paper maps.

So what do maps and map literacy have to do with polio?  Polio is a crippling and potentially fatal infectious disease. There is no cure, but there are safe and effective vaccines. Therefore, the strategy to eradicate polio is based on preventing infection by immunizing every child to stop transmission of the virus that causes polio, and ultimately make the world polio free.   The four pillars of polio eradication all rely on “microplans”— detailed logistical blueprints that guide the planning and implementation of vaccination campaigns, routine immunization outreach, and surveillance for polio cases by providing critical data on the size and location of the target population in a given geographic area.  These target population numbers determine the amount of vaccine required, the number of health care workers and supervisors to deliver the vaccine, and the cost of transportation to get the vaccine and health care workers where they need to go.

CDC Staffers Take No Refuge From Helping Refugees Around the World

Categories: infectious disease, refugee health

A child plays with a kite in a tent camp after the earthquake, Port-au-Prince, Haiti, 2010.

A child plays with a kite in a tent camp after the earthquake, Port-au-Prince, Haiti, 2010.

For anybody wondering why CDC has a branch dedicated to helping refugees or why the United Nations has formally recognized World Refugee Day every year since it was created in 2001, the answer can be found in a single, stark statistic: In 2013, a person became a new refugee or internally displaced person every 4.1 seconds.

Michelle Dynes, PhD, MPH, MSN, CNM, RN, EIS Officer/Epidemiologist, CDC Emergency Response and Recovery Branch

Michelle Dynes, PhD, MPH, MSN, CNM, RN, EIS Officer/Epidemiologist, CDC Emergency Response and Recovery Branch

Cyrus Shahpar, MD, MBA, MPH, Medical Epidemiologist, CDC Emergency Response and Recovery Branch

Cyrus Shahpar, MD, MBA, MPH, Medical Epidemiologist, CDC Emergency Response and Recovery Branch

That translates to “a population of concern” of nearly 40 million refugees or internally displaced people worldwide every year, according to the United Nations.

It also translates to a lot of illnesses and suffering. And that’s the reason Cyrus Shahpar, Michelle Dynes and approximately 50 other staff in CDC’s Emergency Response and Recovery Branch (Division of Global Health Protection) have their bags packed and are constantly ready to deploy to the field.

Communication Matters in Global Health Deployments

Categories: global health security, infectious disease

During the simulation exercise, ECN trainees deployed to the site of a mock disaster in Avully, Switzerland.

During the simulation exercise, ECN trainees deployed to the site of a mock disaster in Avully, Switzerland.

Communication matters.

Gaya Gamhewage, MD, Coordinator, WHO Communication Capacity Building Team; Founder, WHO Emergency Communication Network

Gaya Gamhewage, MD, Coordinator, WHO Communication Capacity Building Team; Founder, WHO Emergency Communication Network

That’s not a new idea. Many of us have learned this the hard way. This concept is being applied in a new, more comprehensive way for a key purpose—to help the World Health Organization (WHO) communicate more effectively, with more clarity and purpose during humanitarian and public health emergencies.

The idea is to better integrate communications specialists from WHO, CDC, ministries of health and a wide array of other humanitarian and global health organizations into a cohesive, specially trained team that can be dispatched on short notice when public health or humanitarian emergencies occur.

The logic is based on the idea that communications is part and parcel of emergency health response. Communicating in a crisis not only provides the public and policy maker clear and critical information, it also can help the technical side of the response. It connects those affected with those willing to help and can make sure that resources are aligned to the most important needs.

Voices from the Central African Republic: FELTP residents remain committed to strengthening disease surveillance and outbreak response in CAR

Categories: child health, immunization, infectious disease, refugee health

CAR refugees forced from their homes by rebels

CAR refugees forced from their homes by rebels

Dr. Els Mathieu, Resident Advisor, CAR- FELTP

Dr. Els Mathieu, Resident Advisor, CAR- FELTP

The Central African Republic (CAR) is a landlocked country in Central Africa, bordered by Chad in the north, Sudan in the northeast, South Sudan in the east, the Democratic Republic of the Congo and the Republic of the Congo in the south and Cameroon in the west.  CAR is one of the world’s least developed nations and has experienced several periods of political instability, as well as deadly attacks and violence by rebels that have forced nearly 1 million people from their homes in search of refuge.  With so many civilians fleeing to refugee camps in the capital, Bangui, and the provinces, there is an increased need to strengthen disease surveillance and response.

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