The National Biosurveillance Advisory Subcommittee (NBAS)

Transcription

1 The National Biosurveillance Advisory Subcommittee (NBAS) Second Report: Improving the Nation s Ability to Detect and Respond to 21 st Century Urgent Health Threats Jeffrey Engel, M.D. Former NC State Health Director Executive Director, CSTE

2 Biosurveillance - Defined Biosurveillance in the context of human health is the science and practice of managing health-related data and information for early warning of threats and hazards, early detection of events, and rapid characterization of the event so that effective actions can be taken to mitigate adverse health effects. (National Biosurveillance Strategy for Human Health, V2.0, February 2010)

3 HSPD-21 (October 2007) Background Called for a nationwide, integrated biosurveillance capability Provided foundation for establishment of NBAS NBAS Goal/Perspective Independent input on biosurveillance from best minds available Broad representation from public health, healthcare, academia, private sector NBAS Organization Co-chairs; Steering Committee; Working Groups CDC and federal liaison support role CDC Office of Surveillance, Epidemiology and Laboratory Services Report submitted to Advisory Committee to the Director, CDC

4 1 st NBAS Report ( released10/16/09) General Findings Wide variations in biosurveillance systems/capabilities Biosurveillance capacity dependency on state and local programs Collaboration complexities and challenges of sustaining funding have impeded efforts Five Broad Recommendations Strong Executive Branch leadership in coordination Due consideration of global health threats Adequate funding of personnel for biosurveillance programs Investment in electronic health records and lab data Strategic investments in new technologies

5 NBAS Scope and Leadership Realignment, 2010 Drs. Jeff Engel and Ian Lipkin Co-Chairs New Work Groups; parallel to National Biosurveillance Strategy for Human Health priority areas Governance (Interagency Collaboration and Engagement) Healthcare and Public Health Information Exchange Innovative Information Sources Global and Regional Biosurveillance Collaboration Biosurveillance Workforce, New Professions, Cross-Training Integrated Multi-Sector Information Significant membership additions Dr. Frieden thoughts to action mandate

6 NBAS Membership Matrix NBAS Co Chairs: Jeff Engel and Ian Lipkin NBAS Members by Work Group Governance (Interagency Collaboration and Engagement) Healthcare & Public Health Information Exchange Innovative Information Sources Global and Regional Biosurveillance Collaboration Biosurveillance Workforce, New Professions & Crosstraining Integrated Multi-Sector Information CHAMPION CHAMPION CHAMPION CHAMPION CHAMPION CHAMPION Robert Kadlec Steve Hinrichs James Heywood Jim Hughes Don Burke Lonnie King MEMBERS MEMBERS MEMBERS MEMBERS MEMBERS MEMBERS Tom Inglesby Cecil Lynch Rita Colwell Jim LeDuc Jim Hadler Heather Case Paul Jarris Julia Gunn Tom Slezak David Franz Linda McCauley Richard Platt Perry Smith Ken Mandl Ian Lipkin Ann Mari Kimball Tomas Aragon Art Reingold Larry Brilliant Mary Wilson Kathy Miner Al Bronstein Marci Layton Stephen Ostroff

7 NBAS 2 nd Iteration Preparatory Work (Aug 2010 March 2011) 46 meetings; 74 briefings; 230 supporting documents More focus on specificity thoughts to action Group cohesiveness; joint input into all recommendations; active involvement by membership Identification of cross-cutting issues Building on previous NBAS effort; focus on identifying and prioritizing what is practical to achieve

8 2 nd NBAS Report Public document on June 20 th Identifies four overarching areas of focus Governance Achieving comprehensive, effective biosurveillance Information Exchange Promoting data sharing and analysis Workforce Ensuring a sustainable interdisciplinary biosurveillance workforce Research and Development Enhancing the efficiency and sensitivity of biosurveillance Working Group reports - included as appendices; detailed; provide specifics and granularity

9 Federal Policy Oversight Governance Establish a robust mechanism for federal policy oversight, through the EOP with the NSS as lead entity Ensure input from federal, state, local and private sectors Stakeholder Interface Create collaborative mechanisms for stakeholder interface with White House coordinating groups Establish a lead advisory group to provide ongoing input regarding biosurveillance events The President s Global Health Initiative (GHI) Identify a federal lead entity with responsibility for coordination of biosurveillance activities supporting GHI

10 The Executive Office of the President (EOP) Functional Offices with Biosurveillance Responsibilities White House Chief of Staff Office of Management & Budget National Security Staff National Security Council Office of Science &Technology Policy Health Programs Resilience Directorate Coordinator for WMD terrorism & Arms Control NSC Global Development Associate Director for National Security & International Affairs Public Health Branch

11 Information Exchange State-Federal Data Sharing Establish a legal framework for state-federal data sharing IHR 2005 Support implementation of IHR in cooperation with WHO, targeting efforts toward areas that need support to develop biosurveillance capacity Integration of Surveillance Systems Integrate domestic animal, wildlife, plant, food, vector, disease and environmental surveillance systems into a national biosurveillance strategy for human health Environmental Threats Expand biosurveillance to include environmental sites of greatest threat to human health

12 Workforce Enhancement of Key Professions Enhance the public health informatics, social and behavioral epidemiology, vector biology and environmental health professions Support masters, doctoral and fellowship programs Develop the science of public health informatics through grant research programs Provide tuition support for state and local public health professionals & support sustainable biosurveillance career paths Integration of Key Professions Encourage cross training and collaboration of clinicians and basic scientists in human and animal health

13 Research and Development Real Time Data Collection Develop, evaluate and implement new platforms and algorithms for real time data collection and analysis Detection Develop, evaluate and implement new, easily deployable methods for detection of pathogens, and biomarkers for health, disease, chemical and radiation exposure, and personalized medicine Assay Optimization Facilitate access to specimens and data and streamline the assay validation and selection processes Models Invest in nominal and computational models descriptive of individual health and the behaviors of healthy populations

14 Progress Since Release of the NBAS 2 Report CDC creating NBAC, i.e. upgrade from a subcommittee of the ACD, similar to: Immunizations Advisory Committee Health Care Infection Control Practices Advisory Committee Executive Office of the President: National Strategy for Biosurveillance released July 2012 builds on the capabilities already in place and further institutionalizes our efforts to ensure that we are doing everything possible to identify and understand threats as early as possible. a coordinated approach that brings together Federal, State, local and tribal governments President Barack Obama, July 31, 2012

15 2012 National Strategy for Biosurveillance Highlights Strategy draws heavily from NBAS 2 nd Report Guiding Principles Leverage Existing Capabilities (e.g. electronic reporting; integrating knowledge of human, animal and plant health) Embrace an All-of-Nation Approach (distributed biosurveillance activities, novel information sources, broader array of sentinel point-of-care diagnostics) Add Value for All Participants (e.g. biosurveillance should inform health care decisions, improve industry performance) Maintain a Global Health Perspective (integration of transnational surveillance systems)

16 2012 National Strategy for Biosurveillance Highlights Biosurveillance Goal and Core Functions Scan and Discern the Environment Identify and Integrate Essential Information Alert and Inform Decisionmakers Forecast and Advise Impacts Enablers for Strengthening Biosurveillance Integrate Capabilities Build Capacity Foster Innovation Strengthen Partnerships Aug-Oct: Implementation Plan and Action Steps

17 NBAS Summary 2007 HSPD-21 Federal HHS/CDC charged as the Secretariat for Biosurveillance of human health Governance of Biosurveillance coordinated by the EOP and distributed to federal, state, local, private sector public health enterprise Technology, Integration, Innovation Global Mission and Context Requires a Sustained Public Health Capacity