enter title of presentation on master slide 1 department of health and human services (dhhs)...
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Department of Health and Human Services (DHHS)
Overview of FY04 DHHS Cooperative Agreements on Public Health (CDC)
and Hospital (HRSA) Emergency Preparedness and Response
William Raub, PhD
Principal Deputy Assistant Secretary
Office of Public Health Emergency Preparedness
14 January 2005
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Office of Public Health Emergency Preparedness (OPHEP)
To ensure sustained public health and medical readiness for our
communities and our nation against:
• Bioterrorism
• Other Infectious disease outbreaks
• Other public health threats and emergencies
Goal
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CDC Cooperative Agreements forPublic Health Emergency Preparedness and Response
CDC Focus Areas
Preparedness Planning/Readiness Assessment
Surveillance and Epidemiological Capacity
Biological Laboratory Capacity
Chemical Laboratory Capacity
Communications and Information Technology
Risk Communication
Education and Training
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CDC Cooperative Agreements forPublic Health Emergency Preparedness and Response
CDC Funding History
Allocations since September 11, 2001:
FY02 ~ $949.70 million
FY03 ~ $1.04 billion
FY04 ~ $849.59 million
FY02-04 total ~ $2.84 billion
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HRSA Cooperative Agreements forHospital Emergency Preparedness and Response
. HRSA Priority Areas
• Regional Hospital Surge Capacity
• Beds, Personnel, Equipment
• Isolation capacity
• Mental health services
• Trauma/burn care
• Emergency Medical Services
• Linkages to Public Health
• Hospital Laboratories
• Surveillance & Patient Tracking
• Education and Preparedness Training
• Exercises
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HRSA Cooperative Agreements forHospital Emergency Preparedness and Response
HRSA Funding History
Allocations since September 11, 2001:
FY02 ~ $125 million
FY03 ~ $498 million
FY04 ~ $498.00 million
FY02-04 total ~ $1.121 billion
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Public Health and Hospital Preparedness and Response Cooperative Agreements
CDC/HRSA Combined Funding History
Combined Allocations since September 11, 2001:
FY02 ~ $1.07 billion
FY03 ~ $1.53 billion
FY04 ~ $1.34 billion
FY02-04 Grand-total ~ $3.9 billion
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Public Health and Hospital Preparedness and Response Cooperative Agreements
FY04 Cross-Cutting Activities
To ensure that selected CDC and HRSA supported preparedness
activities are coordinated and integrated at the state and local levels
Cross-cutting section identical in both CDC and HRSA guidance documents
Responses were to be identical whether submitting for CDC or HRSA funding
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Public Health and Hospital Preparedness and Response Cooperative Agreements
Six Cross-Cutting Critical Benchmarks
Incident Management
Joint Advisory Committee
Laboratory Connectivity
Laboratory Data Standards
Jointly Funded Health Department/Hospital Activities
Preparedness for Pandemic Influenza
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Public Health and Hospital Preparedness and Response Cooperative Agreements
Eight Cross-Cutting Activities
Surveillance
Coordination with Indian Tribes
Populations with Special Needs
Planning for Psychosocial Consequences
Education and Training
Academic Health Centers Involvement
IT System Interoperability
Border States (Mexico and Canada)
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Public Health and Hospital Preparedness and Response Cooperative Agreements
CDC/HRSA FY04 Funding Formulas
Eligible Applicants (N = 62) and Formulation of Funding Allocations:
Each of the 50 States and Puerto Rico received a base amount + an amount equal to its proportional share of the nation’s population
The District of Columbia received two times the base amount + an amount equal to its proportional share of the nation’s population
The nation’s three largest Municipalities (New York City, Los Angeles County and Chicago) received a base amount + an amount equal to its proportional share of the nation’s population
The Commonwealth of the Northern Mariana Islands and the Territories of American Samoa, Guam and the U.S. Virgin Islands received a base amount + an amount using a population-based formula
The Federated States of Micronesia and the Republics of Palau and the Marshall Islands received a base amount + an amount using a population-based formula
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The Cities Readiness Initiative
End: Prevent mass mortality and morbidity from diseases for which antibiotics are an appropriate medical countermeasure.
Means: Mass distribution and dispensing of antibiotics provided by the CDC-based Strategic National Stockpile
Strategy: Address potential threat from aerosolized Bacillus anthracis
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Bacillus anthracis:A Long-Standing Threat (1)
Lends itself to terrorist use
Spore form (vegetative state) can be made into a powder with some difficulty
N.B.: 2001 Mailings; USPS BDS System
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Bacillus anthracis:A Long-Standing Threat (2)
Ubiquitous; easy to obtain
Easy to grow in large quantities
Easy to work with surreptitiously
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Slurry of B. anthracis Spores:New Twist on Old Threat
Dispersal as aerosol with commercially available equipment
B. thuringensis sprayed for pest control
Plume can cover many square miles
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Connecting the Dots (1)
Terrorists have ready means to expose densely populated areas to aerosolized B. anthracis spores.
Those who inhale an infectious dose will be at high risk for inhalational anthrax.
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Connecting the Dots (2)
The appearance of symptoms of inhalational anthrax will be the first indication that someone has inhaled an infectious dose.
The first cases of inhalational anthrax are likely to occur within 48 hours.
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Connecting the Dots (3)
Untreated, inhalational anthrax is 90% fatal.
Even with intensive care, survival is 50% at best.
A hundred cases could overwhelm the healthcare system of a typical large city.
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Connecting the Dots (4)
A large outdoor release of aerosolized B. anthracis spores could put hundreds of thousands (and possibly millions) of people at risk.
With healthcare facilities overwhelmed, fatalities could number in the tens of thousands.
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Connecting the Dots (5)
Mass chemoprophylaxis is the only means to prevent catastrophic loss of life following such an exposure.
Given the characteristics of the anthrax organism, the entire at-risk community should receive chemoprophylaxis as soon as possible after exposure.
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CRI Objective
Provide Antibiotics to At-Risk Population
– Which Could be the Entire Metropolitan Area Plus Commuters and Transients –
Within 48 Hours of Decision to Do So
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CRI Significance
How well we implement CRI may be the difference between life and death for tens of thousands of people.
We have a moral imperative to explore every potential modality for mass chemoprophylaxis.