CDC Support of the US-Affiliated Pacific Islands for Public Health Preparedness and Response Walter Randolph Daley, DVM, MPH Chief, Field Services Branch Division of State and Local Readiness Pacific Island Health Officers Association Executive Board Meeting March 29, 2017 Office of Public Health Preparedness and Response Division of State and Local Readiness

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 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

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

DSLR Projects in the Pacific Public Health Emergency Preparedness (PHEP) Cooperative Agreement: $2.3 million PHPR Zika Cooperative Agreement: $2.6 million Regional Career Epidemiology Field Officer Cooperative Agreement with PIHOA Training/Technical Assistance/Assessment Data for Decision Making Enhanced Laboratory Capability Zika Surge Staffing and Training Support Training/TA/Assessment - $50,000 DDM Microbiology/Infectious disease diagnostic capacity Improve existing lab info systems/lab SOPs Assess 10 USAPI labs Zika Surge Staffing - $2.7 million 39 (1 year term) positions 6-month training stints for preparedness and response FY2017 – planned $25,000 to support administrative preparedness

Career Epidemiology Field Officer US-Affiliated Pacific Islands Public Health Systems and Workforce Development Data for Decision Making Surveillance Enhancement Pacific Basin Medical Association Emergency Response Typhoons (Maysak, Souldelor) Zika Virus FestPac Consultation and Coordination Foodborne Illness, Dengue, Chikungunya, MERS, Hepatitis A … Pacific Public Health Surveillance Network Epidemiology and Laboratory Capacity Workgroup Surveillance Enhancement – CNMI (post Souldelor) DDM – AS (Samoa), FSM Pacific Basin Medical Association – Palau Typhoon Maysak – Yap, FSM; Typhoon Soudelor – CNMI Zika Deployments – AS, FSM (add on to DDM) FestPac – GU Foodborne illness – typhoid in US Marshallese community (OK, IA) Chik - RMI MERS – Guam, Hepatitis A – RMI

PHEP Cooperative Agreement US-Affiliated Pacific Islands Unliquidated Funds Activity Areas Incomplete Laboratory Preparedness Epidemiologic Capacity Planning for Response Budget Period Total Percent 1 & 2 $681,354 15 3 $213,785 9 Total Awards Unexpended Budget Period 1 & 2 $4,670,965 $681,354 Budget Period 3 $2,340,630 $213,785

DSLR Support to the Pacific Islands in the Future Topics for Discussion Is funding meeting the need? Can alternative fiscal methods overcome obstacles? Should some financial assistance be converted to direct assistance? What could be the role of DSLR field staff? Would a different approach to preparedness requirements improve outcomes?

CDC 24/7: Saving Lives. Protecting People. Office of Public Health Preparedness and Response Division of State and Local Readiness