Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response System A Program Review (2001) / Chapter Skim
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8 Summary Conclusions and Recommendations
8 Summary Conclusions and Recommendations
Pages 159-176
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From page 159... ...
ct;~5 goals, as outlined In the ct;~5 strategic plan, address the areas of mission expansion that NSTC-7 mandates. GEIS provides a means of coordinating DoD efforts to address "global surveillance, training, research, and response to emerging infectious disease threats" (NSTC, 1996, p.
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From page 160... ...
laboratories have been closed in the past, for reasons related both to insufficient funding and changes in mission priorities, and that further closings could jeopardize the United States' ability to detect and respond to emerging infectious disease threats. A new DoD research facility, the ninth largest biomedical research facility in the country, was recently completed in Maryland (Walter Reed Army Institute of Research, 1998~.
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From page 161... ...
Loss of laboratory infrastructure, particularly overseas, limits the DoD's global emerging infectious disease surveillance and response capacity and, accordingly, GEIS prospects. At some DoD laboratories, in the United States and overseas, the committee noted a lack of full integration between DoD research and infectious disease surveillance priorities.
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From page 162... ...
GEIS is active in both Thailand and Kenya. The CDC's new global strategy for addressing emerging infectious diseases identifies six priority areas: international outbreak assistance, support of a global approach to disease surveillance, applied research on diseases of global importance, application of proven public health tools, and public health training and capacity building (Dowel!
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From page 163... ...
Rigid adherence to a pillar construct can impinge upon the responsiveness of GEIS to regionally relevant emerging infectious disease threats. The committee notes, for instance, that disease areas of global importance, such as tuberculosis, are absent from the current GEIS pillar structure and are underaddressed within GEIS, even though host countries identify them as priorities.
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From page 164... ...
38~. DoD overseas laboratories have historically been active in responding to emerging infectious disease epidemics, typically in response to the request of host-country governments or partner agencies.
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aimed at preventing and controlling infectious diseases. The committee concludes that GEIS has generally contributed to national and international knowledge of emerging and reemerging infectious diseases as the result of these efforts.
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DoD will ensure the availability of diagnostic capacity at its [domestic and overseas laboratories] using existing DoD resources (NSTC, 1996, p.
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disseminate aggregate laboratory information about emerging infections and antimicrobial resistance obtained from DoD medical facilities worldwide to all DoD laboratories, hospitals, and practicing physicians (GEIS, 1998, p.
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From page 168... ...
It is also important for the GEIS Central Hub to collect surveillance data and other information from consortium members in a systematic, timely manner, analyze this information as appropriate, and report this information back to consortium members and other relevant DoD personnel, public health partners, and the public. Current GEIS information dissemination efforts include production of annual reports, publication of study results in the peer-reviewed literature, presentation of GEIS information at meetings and conferences, periodic publication of laboratory newsletters and updates, and posting of periodic updates on the GEIS website (GEISWeb)
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From page 169... ...
efforts to address emerging infectious diseases. GEIS has also done a noteworthy job of making use of existing DoD capabilities.
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From page 170... ...
entity that is devoted to infectious diseases globally and that has broad-based laboratory capacities in overseas settings. GEIS goals, as outlined in its strategic plan, Addressing Emerging Infectious Disease Threats: A Strategic Plan for the Department of Defense (GEIS, 1998)
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Research and public health surveillance missions are of critical importance to the DoD and are essential to national security. Emerging infectious disease surveillance is an important part of DoD capacity to assess potential threats to the health of U.S.
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From page 172... ...
· Current GEIS infectious disease-related training efforts (e.g., the Overseas Medical Research Laboratory Orientation Training Program) are laudable, but they are modest relative to the needs of the DoD and its public health partners and to the potential contributions of GEIS.
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From page 173... ...
and the CDC, need to be expanded and more closely coordinated to encourage joint planning and shared project implementation with these agencies. GEIS needs to have an identity within the global public health community such that when new initiatives related to global infectious disease surveillance and response activities are being considered by governmental and nongovernmental agencies, the potential usefulness of GEIS is considered by outside partners.
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From page 174... ...
These steps are needed to ensure that new systems and techniques contribute optimally to GEIS, to the DoD, and to global emerging infectious disease surveillance efforts. Recommendation: Novel surveillance systems and techniques, though potentially an important part of GEIS, should be thoroughly evaluated and plans for their development and use should be clearly defined before substantial GEIS investments in their implementation are made.
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From page 175... ...
Recommendation: Consideration should be given to revising the GEIS project review and approval process so that review and approval of GEIS projects is part of a more formally structured process based on a set of guidelines and timelines that are clearly understood by GEIS consortium members that includes input from individuals who represent various disciplines and interests. · Apart from the formal project review and approval process, Central Hub senior management staff should make additional periodic visits to the respective laboratory facilities to provide project guidance and to assess needs for assistance and opportunities for collaboration.
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