Walter Randolph Daley, DVM, MPH Chief, Field Services Branch CDC Support to the US-Affiliated Pacific Islands for Public Health Preparedness and Response Walter Randolph Daley, DVM, MPH Chief, Field Services Branch Pacific Island Health Officers Association Executive Board Meeting August 30, 2016 Office of Public Health Preparedness and Response Division of State and Local Readiness

Adaptation: Shifting the Coping Range

Office of Public Health Preparedness and Response Division of State and Local Readiness (DSLR) MISSION: To assure the nation's public health system is prepared to respond to and recover from a public health event or emergency. Through: Partnerships with Health and Human Services (HHS) and Department of Homeland Security (DHS) Capabilities-based standards for state and local public health Funding Strategic placement of CDC field staff Technical assistance strategies and guidance Translation of science into practice

Division of State and Local Readiness: 2009-2015 Major Activities Established response role for state coordination within CDC’s Incident Management System H1N1, H7N9, MERS-CoV (2013 and 2014), Deep Water Horizon, Hurricane Sandy; Unaccompanied Minors, Ebola Implemented emergency response funding mechanism Established 15 public health preparedness capabilities Aligned PHEP cooperative agreement with ASPR Hospital Preparedness Program Added medical countermeasure planning function with transition of DSNS Program Preparedness Branch to DSLR Stood up new Field Services Branch (CEFOs and PFAs) and new Capacity Building Branch

Division of State and Local Readiness Administeres Public Health Emergency Preparedness (PHEP) Cooperative Agreement Provides guidance and funding to 62 state, local, and territorial public health departments to strengthen preparedness Faciliates technical assistance and consultation provided by DSLR staff and CDC subject matter experts Collects and analyzes capabilities-based performance data on exercises and real incidents to demonstrate accountability and support program improvement DSLR administers the PHEP Cooperative Agreement which supports preparedness nationwide. CDC does not do its work alone. State and local health departments play a critical role. All disease monitoring and initial response is local. State and Local Preparedness and Response provides funding, guidance and training to the states, local health departments, territories, tribal governments and some cities to enable them to acquire the tools, personnel and skills to respond to all types of public health threats including terrorist attacks and natural disasters.

PHEP Program Intent Establish robust, organized, and capable public health emergency management and response programs within state, local, and territorial public health agencies Support key public health capabilities necessary for emergency planning and response Assure response readiness within the nation’s public health system for public health emergencies and disasters Assure the health security of our communities DSLR administers the PHEP Cooperative Agreement which supports preparedness nationwide. Established in 1999 as a $40 million competitive grant with a bioterrorism focus and 53 awardees Today, the PHEP cooperative agreement supports all-hazards preparedness nationwide Formula-based, providing more than $9 billion as of fiscal year 2014 CDC does not do its work alone. State and local health departments play a critical role. All disease monitoring and initial response is local. State and Local Preparedness and Response provides funding, guidance and training to the states, local health departments, territories, tribal governments and some cities to enable them to acquire the tools, personnel and skills to respond to all types of public health threats including terrorist attacks and natural disasters.

Public Health Preparedness Standards 1 Community Preparedness 2 Community Recovery 3 Emergency Operations Coordination 4 Emergency Public Information and Warning 5 Fatality Management 6 Information Sharing 7 Mass Care 8 Medical Countermeasure Dispensing 9 Medical Materiel Management and Distribution 10 Medical Surge 11 Non-Pharmaceutical Interventions 12 Public Health Laboratory Testing 13 Public Health Surv and Epi Investigation 14 Responder Safety and Health 15 Volunteer Management In March 2011, CDC released Public Health Preparedness Capabilities: National Standards for State and Local Planning, which defines and describes standards for public health preparedness at the state and local levels. Foundational guidance document for state and local public health preparedness planning Developed in response to awardee requests to help prioritize public health preparedness capabilities, especially as resources become more scarce. Consensus document developed by CDC and its federal partners, the practice community, and national professional organizations. Helps public health departments organize work and identify gaps Capabilities are designed to be scalable depending upon jurisdictional needs, priorities No CDC expectations that every local health department will be able to perform all aspects of the capabilities States determine how to manage preparedness, response, and recovery activities in their jurisdictions

Cooperative Agreements PHEP Epidemiology and Laboratory Capacity Annual Zika virus Public Health Preparedness and Response – Zika DSLR PIHOA Coordination Zika staffing

Technical Assistance and Coordination PHEP Project Officer Guidance documents and tools State Coordination Task Force OSTLTS Liaison – Bill Gallo Response deployments

Field Assignees Career Epidemiology Field Officer Immunization Program Chronic Disease Program

Countries with Active Zika Virus Transmission www.cdc.gov/zika 8/26/2016

Zika Cases Reported in the United States www.cdc.gov/zika 8/26/2016

Zika Virus Coordination in the Pacific CDC Incident Response State Coordination Task Force Other Task Forces

Zika Virus Coordination in the Pacific CDC Incident Response State Coordination Task Force Other Task Forces Territorial Zika Coordinator Pacific Zika Coordinator

Building Resilience Against Climate Effects Against Climate Effects 01 Forecasting Climate Impacts and Assessing Vulnerabilities Projecting the Disease Burden 02 05 BRACE Evaluating Impact and Improving Quality of Activities Building Resilience Against Climate Effects Assessing Public Health Interventions 04 03 Developing and Implementing a Climate and Health Adaptation Plan

Climate Ready Tribes and Territories Initiative New 2016 funding will be awarded later this year Will support climate and health adaptation activities within tribal groups and territories Will work with partners to identify vulnerable areas and populations Approximately 3 tribes and 2 territories will be funded http://planetsave.com/wp-content/uploads/2012/02/young-navajo-climate-activist.png

Acknowledgements George Luber, Chief, NCEH Climate and Health Program CDC Zika Response Pacific Island Public Health Practitioners PIHOA