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Public Health Division
Pandemic Prevention, Detection, and Response
National Defense Industrial Association
Planning Pandemic Prevention - Preserving Posterity
21 October 2016
CDR Franca R. Jones
Chief, GEIS Armed Forces Health Surveillance Branch
“Medically Ready Force…Ready Medical Force” 1
Defense Health Agency
17
DEFENSE HEALTH AGENCY A000000
Equal Employment Opportunity
Office of Inspector General
Small Business Program
Resources and Management (J1/8)
Operations (J3)
Health Information Technology
(J6)
Professional Development,
Sustainment, & PM
Academic Review and Oversight
Medical Education & Training Campus
Defense Medical Readiness Training
Institute
Joint Medical Executive Skills
Institute
J7 Business Operations
Strategy, Plans and Functional Integration
(J5)
Education and Training (J7)
Trust Fund and Revenue Cycle Management
DHP Budget and Execution
Contract Resource Mgmt
Office of the General Counsel
Human Resources
Military Personnel Support
DHA Learning and Development
Combat Support Agency Operations
Readiness
Warrior Care Program
Facilities
Public Health
Strategy Management
J6 Business Operations
Portfolio Mgmt & Customer Relations
Cyber Security
Research and Development (J9)
National Museum of Health and Medicine
Armed Forces Medical Examiner
Solutions Delivery
Decision Support
MHS Functional Champion
DHA Comptroller
MHS Governance
DoD/VA Program Support
Communications
Component Acquisition Executive
(J4)
Manpower and Organization
TRICARE Health Plan (J10)
National Capital Region-
Medical
(J11)
Clinical Operations
J11 Business Operations
Walter Reed National Military Medical Center
Fort Belvoir Community Hospital
Joint Pathology Center
Defense Health Board Support
Strategic Acquisition Program
Management
Head Contracting Activity/Contracting
Operations
DHMS Program Executive Office
Chief of Staff SHARED SERVICE
Military Treatment Facility
DHA Admin & Management
Executive Secretariat
DHP
Programming
TRICARE Regional Offices
Infrastructure Design and Engineering
Infrastructure Operations
Acquisition Process Support
J4 Business Operations
Innovation and Advanced Tech Development
Performance Analysis, Transition
and Integration
Pharmacy
Program Integration
TRICARE Overseas Area Offices
TRICARE Policy and Benefits
Defense Centers of Excellence
Clinical Support
DoD Medical Examining Review
Board
Acquisition Policy and Control
Reserve and Service Member Support
Medical Benefits and Reimbursement
TRICARE Dental Care
Medical Logistics
Program Integrity
Defense Health Program Audit
Global Health Security Agenda (GHSA) Vision
3
A world safe and secure from global health threats posed by
infectious diseases, whether naturally occurring, deliberate or accidental
Role of DoD in Global Health Security
4
• The mission of the Department of Defense is to provide the military forces needed to deter war and to protect the security of our country
• Military forces need to be healthy to execute this mission • Outbreaks of infectious diseases threaten not only health but also geopolitical stability • Infectious diseases know no borders
• DoD efforts in biosurveillance, diagnostics and medical countermeasures development, and cooperative
biological threat reduction contribute to protecting health of U.S. forces and mitigating infectious disease threats to the homeland
• These efforts also enhance the abilities of our international partners to prevent, detect, and respond to
infectious disease threats
• DoD collaborations with partner nations contribute to global transparency of disease risk, which improves pandemic preparedness and the ability to provide for force health protection and national defense
• GHSA can be leveraged as an engagement framework for activities with partner nations that might otherwise be reluctant to engage with DoD in the health space and thereby facilitates DoD mission execution.
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1 4 7 10 13 16 19 22 25 28 31 34 37 40
DAY
CASES
Lab
Confirmation Response
Opportunity
for control
Detection/
Reporting
First
Case
Source: P. Nsubuga IANPHI presentation and developed
from Pinner et al., J Infect Diseases1992 Source: Dr. Helen Perry, U.S. CDC
National Security Challenge: Early Disease Detection/Diagnosis
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1 4 7 10 13 16 19 22 25 28 31 34 37 40
DAY
CASES
First
Case
Detection/
Reporting
Lab
Confirmation
Response
Potential cases
prevented
Source: Dr. Helen Perry, U.S. CDC 6
Solving the Problem: Surveillance
• Provides early detection of the threat
• Provides essential information for understanding the potential severity and spread of disease (who, what, where, when, why)
• Informs policy and decision makers
• Informs response actions (prevention, control, treatment)
Surveillance
7 “Medically Ready Force…Ready Medical Force”
How GEIS got Started
8 “Medically Ready Force…Ready Medical Force”
NSTC-7, Emerging Infectious Disease (EID) (1997)
• Improve infectious disease surveillance, prevention, and response
Tasks DoD to:
• Strengthen efforts through: − Centralized Coordination
− Improved Preventive Medicine, Health and Epidemiology
− Enhanced involvement with military treatment facilities and OCONUS Labs
• Ensure Availability of: − Diagnostic capabilities of US military overseas
research laboratories
− Labs are focal point for partnership and training
GEIS Vision and Mission
9 “Medically Ready Force…Ready Medical Force”
Enhanced force health protection and national security through
support to the Geographic Combatant Commands and a global
network poised to prevent, detect, and respond to infectious
disease threats
VISION
MISSION
GEIS Surveillance Priorities
10 “Medically Ready Force…Ready Medical Force”
• Antimicrobial Resistant Infections (& Sexually-Transmitted Infections)
―Hospital acquired infections and the Multidrug-resistant Organism Repository and Surveillance Network (MRSN)
―Carbapenem-resistant Enterobacteriaceae; Antibiotic-resistant Clostridium difficile
―Cephalosporin-resistant Neisseria gonorrhoeae
• Enteric Infections
― Norovirus surveillance within U.S. military forces
― Global traveler’s diarrhea in naive populations, including expatriates
― Etiology of acute gastroenteritis in host nation military/civilian populations
• Febrile and Vector-Borne Infections
―Malaria drug resistance testing & surveillance
―Arbovirus, and associated vector, surveillance (e.g., Dengue, Chikungunya, Zika)
• Respiratory Infections
―Influenza virus surveillance for vaccine development, including emerging strains such as H3N2v, H7N9
―Zoonotic and novel pathogen detection (e.g., MERS-CoV)
FY16 Global Infectious Disease Surveillance
11 “Medically Ready Force…Ready Medical Force”
USCENTCOM
USPACOM
USAFRICOM
USEUCOM
USSOUTHCOM
USNORTHCOM
Surveillance to inform FHP for: • Joint Operational Forces • Military Recruit Training • DoD Beneficiaries
Number of Countries: 57 Number of Projects: 162
• The risk of the emergence of a novel infectious agent and/or a pandemic is increasing.
• Recent examples include Zika, Ebola, influenza H7N9 and Middle East respiratory syndrome coronavirus.
• Scientific and technological advancements are generating more data than ever before including from: • remote sensors; • social media sites; • flight databases; • medical records; and • laboratory networks.
• Given the trends in Big Data, how can big data can be harnessed to develop a
predictive capability that can improve public health and national security decision making?
Leveraging Big Data to Predict Infectious Disease Outbreaks
Predicting Infectious Disease Outbreaks
Predict Emergence or Reemergence of
Novel Disease
Predict Pandemic Potential of Emerged
Disease
Forecast Impact of Disease or Effects of Mitigation on
Disease
Lab Networks
Satellite Imagery
Detection/ Diagnostic Technology
Social Networks
Bio-informatics
Digital Disease
Detection
PREDICTIVE CAPABILITY
14 “Medically Ready Force…Ready Medical Force”
QUESTIONS
CDR Franca Jones, PhD Tel: 301-319-3268
E-mail: [email protected]