Saturday, August 25, 2012

U.S. DEPARTMENT OF DEFENSE AND BIOSURVEILLANCE STRATEGY

FROM: U.S. DEPARTMENT OF DEFENSE
This electron micrograph shows virus particles called virions from an H1N1 flu sample. The virus was first detected in people in the United States in April 2009. On June 11, 2009, the World Health Organization signaled that a pandemic of 2009 H1N1 flu was under way. Courtesy of the Centers for Disease Control and Prevention


DOD Has Running Start on Biosurveillance Strategy
By Cheryl Pellerin
American Forces Press Service


WASHINGTON, Aug. 22, 2012 - The White House has issued the first U.S. National Strategy for Biosurveillance to quickly detect a range of global health and security hazards, and the Defense Department has a running start in implementing the new plan, a senior defense official said.

Andrew C. Weber, assistant secretary of defense for nuclear, chemical and biological defense programs, told American Forces Press Service that many of the activities described in the strategy are ongoing at DOD.

Such efforts, he said, "have been a little bit siloed."

"So much of what we're doing is integrating the efforts and working hard on the overlap between global security and global health, in what [President Barack Obama] refers to as global health security," he said.

Biosurveillance is defined as data gathering, analysis and interpretation of data related to disease activity and threats to human and animal health to achieve early warning, detection and situational awareness.

In a letter that introduces the new strategy, Obama said the United States "must be prepared for the full range of threats, including a terrorist attack involving a biological agent [and] the spread of infectious diseases and food-borne illnesses."

The strategy calls for a coordinated approach involving federal, state, local and tribal governments; the private sector; nongovernmental organizations; and international partners.

"It challenges us," the president wrote, "to take full advantage of the advanced technologies, new vaccines, the latest science, and social media that can help keep our citizens safe. It describes the core functions and critical capabilities we need to succeed."

Within 120 days, the White House will complete a strategic implementation plan that lays out the required actions and responsibilities of all partners in the mission, Obama said.

As the strategy is released, 43 U.S. states have reported West Nile virus infections in people, birds and mosquitoes, and about 700 cases and 26 deaths have been reported to the Centers for Disease Control and Prevention in Atlanta.

The virus was first isolated from a feverish woman in the West Nile District of Uganda in 1937, and from there it spread to Egypt, Israel, France and, in 1999, to the United States. According to CDC, the virus's spread in the U.S is a milestone in its evolving history.

Monitoring and understanding infectious disease always has been a DOD priority, Weber said, "because for much of our history we've been a global force, and we've had to understand what we call exotic infectious diseases."

Defense Department researchers developed many of the vaccines that protect against malaria, dengue fever and other diseases, he said, "and [Army Maj. (Dr.)] Walter Reed in the 19th century did groundbreaking work on the yellow fever virus."

The renewed focus on biosurveillance speeds up the convergence of traditional battlefield biodefense and health surveillance, Weber said.

"It's all about saving lives," he added. "The sooner you recognize that a biological event is happening, the greater your ability to isolate it, contain it and prevent it from spreading around the world, like H1N1," the novel swine flu virus whose spreading infections the World Health Organization announced as a pandemic on June 11, 2009.

Many DOD components have long been directly involved in global biosurveillance. These include Weber's office, the Defense Threat Reduction Agency, and Global Emerging Infections Surveillance and Response System Operations, called GEIS, which is part of the Armed Forces Health Surveillance Center.

"Through our Armed Forces Health Surveillance Network and our Medical Research and Materiel Command," Weber said, "we have a network of three U.S. Army and three U.S. Navy laboratories in places like Cairo, Egypt; Lima, Peru; Nairobi, Kenya; Bangkok, Thailand; and now in Tbilisi, Georgia."

Last week Weber, along with Sen. Richard Lugar of Indiana and Georgian President Mikheil Saakashvili, rededicated a central public health reference laboratory in Tbilisi built with funding from the Pentagon's Cooperative Threat Reduction Program.

"This is a partnership with the government of Georgia, the Walter Reed Institute of Research and the U.S. Centers for Disease Control that will provide a regional biosurveillance hub linked to the World Health Organization so we can map, detect and understand infectious diseases circulating in the South Caucasus and the Black Sea regions," Weber said.

The other six GEIS laboratories focus on human health and disease carriers, or vectors, like birds and mosquitoes, he added, but the Georgia center will be different.

"From the beginning on the Georgian side, [work on the center's mission] includes their agricultural ministry, their health ministry and their national center for disease control," Weber said.

"On the U.S. side, we have participation from different parts of DOD, including the GEIS program and the Medical Research and Materiel Command, as well as other U.S. government partners like [CDC]."

Internationally, he added, "we're working with OIE -- the World Organization for Animal Health. ... We're also working with the Food and Agriculture Organization in Rome, and ... we're discussing a new partnership with FAO as well as WHO, both their headquarters in Geneva and their regional offices, including the European regional office based in Copenhagen, Denmark."

With the government of Kazakhstan, he added, "we are building a similar laboratory capability in Almaty. When it's complete, the project will involve on ... [Kazakhstan's] side the animal health authorities and their agriculture ministry, their ministry of education and science on the research side and the health ministry. On the U.S. side, the Centers for Disease Control will be a strategic partner."

Much of the DOD global network was developed in response to the outbreak of highly pathogenic H5N1 -- which spread rapidly westward in wild birds from Qinghai Lake, China, in 2005 -- and later, the H1N1 swine flu outbreaks, Weber said.

"There was a lot of one-time funding for pandemic flu that we were able to build on and broaden beyond the focus on one infectious disease," he added.

Weber said DOD's preparedness domestically and globally increased as a result of its response first to the outbreak of severe acute respiratory syndrome, or SARS, in 2002, but especially to H5N1 avian flu three years later.

"What was important about both outbreaks is that they helped give birth to the 'One Health' concept," he said. "Because H5N1 was a poultry disease that jumped species to humans, it got the veterinarian community, the animal health community and the human health community to work together."

One Health is an international effort by veterinarians, physicians and other health professionals to integrate health care for people, animals, agriculture and the environment.

"Biosurveillance is about early detection and prediction of biological events no matter what their cause," Weber said, "so we can save lives, so we can continue military operations, and protect American citizens and our forces and families around the world."

The new strategy and the implementation plan that will come out of it, he added, "will help us improve integration, accelerate activities and increase resources to make it an even higher priority."

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