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2010 Report: Public Health Preparedness

Appendix 2: Overview of CDC Organizations Involved in Preparedness Activities

The Centers for Disease Control and Prevention (CDC) builds and strengthens systems at local, state, and federal levels to respond to all hazards. For more information, see CDC’s Emergency Preparedness and Response website (emergency.cdc.gov).

CDC’s emergency preparedness and response is a collective effort among the different offices and national centers. The Office of Public Health Preparedness and Response (OPHPR) provides strategic direction, support, and coordination for CDC’s preparedness and emergency response activities that receive Terrorism Preparedness and Emergency Response funding. In addition to the programs that OPHPR manages directly, other CDC organizations and programs make significant contributions to emergency preparedness and response and are also listed below. (Please note: the listing below reflects the new structure developed as part of CDC’s 2009 organizational improvement process. For more information see www.cdc.gov/about/organization/cio.htm.)

Preparedness

The Office of Public Health Preparedness and Response (OPHPR) (formerly the Coordinating Office for Terrorism Preparedness and Emergency Response) coordinates terrorism preparedness and emergency response activities across CDC and strategically distributes funds that support a range of activities at CDC and state and local public health departments. OPHPR manages the following divisions and offices:

  • The Division of State and Local Readiness (DSLR) manages the Public Health Emergency Preparedness (PHEP) cooperative agreement, which funds state and local efforts to strengthen response to a public health emergency and provides technical assistance to promote these efforts. In response to the 2009 H1N1 influenza pandemic, DSLR also administered funds through the Public Health Emergency Response (PHER) grant to upgrade pandemic influenza preparedness and response capacity.
  • The Division of Strategic National Stockpile (DSNS) operates and maintains the Strategic National Stockpile, a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications, and medical supplies. During a public health emergency, state and local public health systems may become overwhelmed. The Stockpile is designed to supplement state and local public health departments in the event of such an emergency. DSNS also provides technical assistance to local officials to help ensure that local, state, and federal agencies can work together to receive, stage, store, distribute, and dispense medical assets from the Stockpile as well as other sources.
  • The Division of Emergency Operations (DEO) coordinates CDC’s preparedness, assessment, response, recovery, and evaluation prior to and during public health emergencies. DEO has overall responsibility for the CDC Emergency Operations Center (EOC), which maintains situational awareness of potential health threats 24 hours a day and is the centralized location for event management when activated. The EOC is equipped with state-of-the-art communications technologies to support information pipelines with state, federal, and international partners.
  • The Division of Select Agents and Toxins (DSAT) through the Select Agent Program regulates the possession, use, and transfer of biological agents and toxins (select agents) that have the potential to pose a severe threat to public health and safety. This program is designed to ensure compliance with the select agent regulations by providing guidance and evaluating and inspecting registered entities.
  • The Office of the Director (OD) manages strategy, budget, policy, workforce and career planning, communication, research, and science for terrorism preparedness and emergency response activities. In addition, OD manages the Career Epidemiology Field Officer program, which recruits and supports skilled epidemiologists in state and local public health departments. Through this program, state public health departments can choose to spend PHEP cooperative agreement funds to support a field officer in their agencies. OD also manages the Centers for Public Health Preparedness program (will be known as Preparedness and Emergency Response Learning Centers in FY 2011), a national network of colleges and universities that collaborates with state and local public health departments and other community partners to provide preparedness education and training resources to the public health workforce, healthcare providers, students, and others based on community need.

Global Health

The Center for Global Health (CGH) (formerly the Coordinating Office for Global Health) provides leadership and works with global partners to increase life expectancy and years of quality of life, and also to increase global preparedness to prevent and control natural and manmade threats to health. CDC’s global health presence includes more than 200 CDC staff assigned to more than 50 countries and international organizations.

CGH coordinates international response with the CDC Emergency Operations Center during international emergency response events and serves as the principal CDC point of contact for CDC programs, federal agencies, foreign governments, and other organizations concerned with international terrorism preparedness and response. CGH also works to build global public health capacity to identify, investigate, and contain outbreaks and other major public health emergencies. In addition, CGH provides epidemic aid and epidemiologic consultation and reference diagnostic services to state and local health departments, other federal agencies, and national and international health organizations.

Infectious Diseases

The Office of Infectious Diseases (OID) (formerly the Coordinating Center for Infectious Diseases) strives to protect the public’s health by preventing and controlling infectious diseases. OID’s ongoing public health preparedness activities include developing vaccine, improving diagnostic methods for select bioterrorism agents, and improving the Laboratory Response Network. Their mission is to lead, promote, and facilitate science, programs, and policies to reduce the burden of infectious diseases in the United States and globally.

  • The Influenza Coordination Unit (ICU) is responsible for all aspects of CDC’s pandemic influenza preparedness, from strategy through implementation. The ICU coordinates and synchronizes all pandemic influenza-related activities within CDC to ensure preparedness for a possible pandemic. These activities include setting priorities and promoting science, policies for the programs related to CDC’s pandemic influenza activities, exercising readiness plans, and facilitating community preparedness.
  • The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) (formerly the National Center for Zoonotic, Vector-Borne, and Enteric Diseases and the National Center for Preparedness, Detection, and Control of Infectious Diseases) aims to detect, prevent, and control infectious diseases from spreading, whether they are naturally occurring, unintentional, or the result of terrorism. NCEZID manages the biological testing component of the Laboratory Response Network, an integrated network of national, reference or sentinel laboratories whose goal is to detect, characterize, and communicate about confirmed biological agents, decreasing the time needed to begin the response to an intentional act or accidental exposure. In addition, NCEZID tests the continuing effectiveness of existing drugs against bioterrorism agents and prepares U.S. ports of entry to reduce the risk of natural or intentional introduction of infectious diseases into the country.
  • The National Center for Immunization and Respiratory Diseases (NCIRD) works to prevent disease, disability, and death through immunization and by control of respiratory and related diseases. During the 2009 H1N1 influenza pandemic, NCIRD provided leadership; laboratory, epidemiology, and clinical subject matter expertise; and vaccine delivery expertise. To prepare against natural and intentional outbreaks, the center also conducts surveillance and laboratory activities for vaccine-preventable diseases and viral and bacterial respiratory diseases. As part of the Anthrax Vaccine Research Program, NCIRD has recently completed a large-scale human clinical trial of the anthrax vaccine and immunological studies in animals. NCIRD is also evaluating the use of anthrax immunoglobulin for severe systemic anthrax.

Noncommunicable Diseases, Injury and Environmental Health

The Office of Noncommunicable Diseases, Injury and Environmental Health’s (ONDIEH) (new office established as part of CDC’s 2009 organizational improvement) mission is to increase the potential for full, satisfying, and productive living across the lifespan for all people in all communities. ONCDIEH preparedness activities include providing technical expertise in epidemiology, surveillance, and communications during emergencies for populations with physical and developmental disabilities and chronic diseases as well as at-risk populations.

  • The National Center on Birth Defects and Developmental Disabilities (NCBDDD) is conducting ongoing projects to develop and strengthen intramural research and surveillance capacity related to emergency preparedness for at-risk populations.
  • The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) has produced a number of publications addressing issues surrounding persons with chronic diseases following natural disasters.
  • The National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) conducts ongoing projects to improve surveillance systems, laboratory capacity, and emergency response. NCEH/ATSDR manages the chemical testing component of the Laboratory Response Network, an integrated network of state and national laboratories whose goal is to detect, characterize, and communicate about confirmed chemical agents, decreasing the time needed to begin the response to an intentional act or accidental exposure. In addition, NCEH/ATSDR is improving various surveillance systems for chemical exposures, hazardous substance spills, and morbidity following disasters. NCEH/ATSDR also works with state and local public health departments to improve response to chemical, nuclear, and radiologic terrorism.
  • The National Center for Injury Prevention and Control (NCIPC) links to the injury care community to decrease morbidity and mortality from injuries caused by explosions. NCIPC is moving toward this goal through curriculum development for healthcare providers, development of clinical guidance resources for management of blast injuries, and translation of lessons learned from international and U.S. military experience. NCIPC is also working to improve surveillance systems for blast injuries due to bombings and behavioral/mental health outcomes associated with disasters and incidents of mass violence and is providing educational materials to prevent or reduce the impact of these events on mental health and behavioral health outcomes.

Occupational Safety and Health

The National Institute for Occupational Safety and Health (NIOSH) provides leadership to prevent work-related illness, injury, disability, and death through information gathering, scientific research, and translation of knowledge into products and services.

The mission of the NIOSH Emergency Preparedness and Response program is to advance research and collaborations to protect the health and safety of emergency response providers and recovery workers by preventing diseases, injuries, and fatalities when responding to emergencies.

State, Tribal, Local and Territorial Support

The Office for State, Tribal, Local and Territorial Support’s (OSTLTS) (new office established as part of CDC’s 2009 organizational improvement) vision is to improve the health of America by supporting state, local, tribal, and territorial public health agencies to expand and develop their capacity in programs and policies related to the improvement of the health status of the nation. OSTLTS’ activities will focus on public health systems (government relations, partners and strategic alliances, workforce development, and information technology and management which includes the Public Health Information Network), public health practice (Public Health Law program, technical assistance, and capacity development and improvement), and performance and accountability (public health standards and accreditation as well as program review, assessment and analysis).

Surveillance, Epidemiology and Laboratory Services

The Office of Surveillance, Epidemiology, and Laboratory Services’s (OSELS) (new office established as part of CDC’s 2009 organizational improvement) mission is to provide scientific service, expertise, skills, and tools in support of CDC’s national efforts to promote health; prevent disease, injury and disability; and prepare for emerging health threats. OSELS will lead the development, adoption, and integration of sound national and international public health surveillance and epidemiological practices, based on advances in informatics, epidemiology, laboratory science, and public health research.

  • The National Center for Health Statistics (NCHS) conducts and supports statistical, methodological, and epidemiological activities that will provide the data needed to improve the effectiveness, efficiency, and quality of health services in the United States.

    Among the surveys fielded by NCHS is the National Hospital Ambulatory Medical Care Survey. The survey is used annually to monitor emergency department crowding and has occasionally included supplements that help illustrate if emergency departments have the necessary training to recognize and treat patients suffering from diseases such as exposure to anthrax, and have formal plans to respond to mass casualty events. These data provide important context for planning and evaluating emergency preparedness programs at the national level, and may be used as benchmarks for individual states.

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