Global Health Security: How is the U.S. doing?

A team of evaluators takes an independent look at our systems

The Story Behind the Snapshot

At first glance, this photo taken on a set of concrete steps in Washington, D.C., may look like an ordinary group shot—but it took an extraordinary series of events to make it happen.

The photo shows colleagues from U.S. Department of Health and Human Services (HHS) and U.S. Department of Agriculture (USDA) standing alongside a team of 15 international experts from 13 different countries, known as the Joint External Evaluation Team. The team had been invited by the U.S. government to assess how well the country is prepared to prevent, detect, and respond to major public health threats. The goal was to receive an independent and unbiased evaluation of our capabilities.

We would never have arrived at this moment without these things: a wake-up call, a historic agreement, and a renewed commitment to work together to protect the world’s health.

Leading up to now: A brief timeline

Near the turn of this century, the emergence of diseases like severe acute respiratory syndrome (SARS) and H5N1 influenza was a big wake-up call and showed the world more clearly than ever that a health threat anywhere is a threat everywhere — what affects one country affects us all.

Eleven years ago, countries came together to sign the International Health Regulations (IHR), a historic agreement which gave the world a new framework for stopping the spread of diseases across borders. The IHR obligates every country to prepare for, and report on, public health events that could have an international impact.

However, five years after the IHR went into effect, nearly 2/3 of countries were still unprepared to handle a public health emergency.

Two years ago, the Global Health Security Agenda (GHSA) gave countries common targets they can work toward to stop infectious disease in its tracks. This led to the need for the Joint External Evaluation Team, an independent group that travels to countries to report on how well public health systems are working to meet global health security goals.

Last October, the Centers for Disease Control and Prevention (CDC) and the Office of the Assistant Secretary for Preparedness and Response (ASPR) began working together to arrange for the team to visit the U.S.

In May, the team’s five-day visit took place. Two days were spent in Washington, D.C., assessing federal response capabilities. The remaining three days were spent at CDC, because the agency works in nearly all of the 19 technical areas included in the evaluation.

On the final day of their visit in Atlanta, the evaluation team shared their preliminary results. The final, full report is now available online.

What the team found

In the final report, the assessment team concluded that, “the U.S. has extensive and effective systems to reduce the risks and impacts of major public health emergencies, and actively participates in the global health security system established by the IHR.” They recognized the high level of scientific expertise within CDC and other federal agencies, and the excellent reporting mechanisms managed by the federal government.

They also identified opportunities for improvement in some areas, such as:

• Combining and utilizing data from multiple surveillance systems, including systems that monitor human, animal, environmental, and plant health
• Conducting triage and long-term medical follow-up during major radiological disasters
• Communicating risks quickly and consistently with communities across the country
• Improving overall One Health surveillance systems for antimicrobial resistance and zoonotic diseases

They specifically recognized the challenges any federal public health system faces, and advised the U.S. to continue improving the understanding of the IHR among different federal and state agencies. Their observations will help drive improvements for programs throughout CDC and the nation.

The U.S. requested this unbiased review of its response capabilities and hopes that the entire world will do the same.

For More Information

• Global Health Security Agenda: https://ghsagenda.org/
• Joint External Evaluation: https://ghsagenda.org/assessments.html
• CDC and the Global Health Security Agenda: http://www.cdc.gov/globalhealth/security/ghsagenda.htm
• Global Health Security: http://www.cdc.gov/globalhealth/healthprotection/ghs/index.html
• International Health Regulations: http://www.cdc.gov/globalhealth/healthprotection/ghs/ihr/index.html