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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

EXAMINING CHALLENGES AND
POSSIBLE STRATEGIES
TO STRENGTHEN
U.S. HEALTH SECURITY

PROCEEDINGS OF A WORKSHOP

Anna Nicholson, Lisa Brown, and Justin Snair, Rapporteurs

Forum on Medical and Public Health Preparedness for
Disasters and Emergencies

Board on Health Sciences Policy

Health and Medicine Division

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This project was jointly supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; American Red Cross; Association of Public Health Laboratories; Association of State and Territorial Health Officials; Child Care Aware of America; Council of State and Territorial Epidemiologists; East West Protection; Emergency Nurses Association; GlaxoSmithKline; Healthcare Ready; Infectious Diseases Society of America; Meridian Medical Technologies; National Association of Chain Drug Stores; National Association of County & City Health Officials; National Association of Emergency Medical Technicians; Robert Wood Johnson Foundation (Contract No. ID#: 73289); Seqirus; Trauma Center Association of America, U.S. Centers for Disease Control and Prevention (Contract No. 200-2011-38807, TO #54); U.S. Department of Defense (Contract No. HHSP233201400020B/HHSP23337014); U.S. Department of Defense, Uniformed Services University of the Health Sciences (Contract No. HU0001-16-1-0022); U.S. Department of Health and Human Services’ Administration for Children and Families (Contract No. HHSP233201400153P); U.S. Department of Health and Human Services’ National Institutes of Health: National Institute of Allergy and Infectious Diseases, National Institute of Environmental Sciences, and National Library of Medicine (Contract No. HHSN26300084); U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201550005A); U.S. Department of Health and Human Services’ U.S. Food and Drug Administration (Contract No. 1R13FD005495-01); U.S. Department of Homeland Security, Office of Health Affairs (Contract No. HSHQDC-15-C-00079); and U.S. Department of Transportation and the National Highway Traffic Safety Administration (Contract No. DTNH22-14-H-00468). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-46375-1
International Standard Book Number-10: 0-309-46375-0
Digital Object Identifier: https://doi.org/10.17226/24856

Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Examining challenges and possible strategies to strengthen U.S. health security: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24856.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

Image

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

Image

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

PLANNING COMMITTEE ON OPPORTUNITIES FOR THE FUTURE OF HEALTH CARE AND PUBLIC HEALTH PREPAREDNESS, RESPONSE, AND RECOVERY1

THOMAS V. INGLESBY (Chair), Director, Center for Health Security, Johns Hopkins Bloomberg School of Public Health

DAVID M. ABRAMSON, Professor, College of Global Public Health, New York University

MARY CASEY-LOCKYER, Senior Associate, Disaster Health Program Development, American Red Cross

BROOKE COURTNEY, Senior Regulatory Counsel, Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration, U.S. Department of Health and Human Services

JON R. KROHMER, Director, National Highway Traffic Safety Administration, U.S. Department of Transportation

EMILY LORD, Executive Director, Healthcare Ready

SUZET M. McKINNEY, Executive Director, Illinois Medical District Commission

JOHN OSBORN, Operations Manager, Assistant Professor, Health Care Systems Engineering, Department of Surgery, Mayo Clinic College of Medicine

TARA O’TOOLE, Senior Fellow, Executive Vice President, In-Q-Tel

RAJIV RAMNATH, Director, National Science Foundation

TIMOTHY L. SELLNOW, Professor, University of Central Florida

W. CRAIG VANDERWAGEN, Co-Founder and Director, East West Protection, LLC

SANDRA WHITEHEAD, Manager, Program and Partnership Development, National Environmental Health Association

LAURA WOLF, Chief, Critical Infrastructure Protection Branch, U.S. Department of Health and Human Services

Health and Medicine Division Staff

JUSTIN SNAIR, Senior Program Officer (until September 2017)

CLAIRE GIAMMARIA, Associate Program Officer

ALEXA EDMIER, Research Assistant

ALEX REPACE, Senior Program Assistant

ANDREW M. POPE, Director, Board on Health Sciences Policy

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

Consultants

ANNA NICHOLSON, Doxastic Communications

LAURA RUNNELS, LAR Consulting

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR DISASTERS AND EMERGENCIES1

DAN HANFLING (Co-Chair), Clinical Professor, Department of Emergency Medicine; Contributing Scholar, Center for Health Security, Johns Hopkins Bloomberg School of Public Health

SUZET M. McKINNEY (Co-Chair), Executive Director, Illinois Medical District Commission

ROY L. ALSON, Associate Professor, Emergency Medicine, Wake Forest School of Medicine; Representative, American College of Emergency Physicians

STACEY J. ARNESEN, Branch Chief, Disaster Information Management Research Center, National Library of Medicine, National Institutes of Health, U.S. Department of Health and Human Services

PAMELA BLACKWELL, Director, Center for Emergency Preparedness and Response, Cobb/Douglas Boards of Health; Representative, National Association of County & City Health Officials

ERIC C. BLANK, Senior Director, Public Health Programs and Systems, Association of Public Health Laboratories

JAMES S. BLUMENSTOCK, Chief, Health Security, Association of State and Territorial Health Officials (since October 2017)

KATHRYN BRINSFIELD, Assistant Secretary of Health Affairs and Chief Medical Officer, Office of Health Affairs, U.S. Department of Homeland Security (until January 2017)

MARY CASEY-LOCKYER, Senior Associate, Disaster Health Program Development, American Red Cross (since May 2017)

BROOKE COURTNEY, Senior Regulatory Counsel, Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration, U.S. Department of Health and Human Services

RICHARD N. DANILA, Epidemiology Program Manager, Deputy State Epidemiologist, Minnesota Department of Health; Representative, Council for State and Territorial Epidemiologists (until October 2017)

DAVID EISENMAN, Director, Center for Public Health and Disasters, David Geffen School of Medicine and the Fielding School of Public Health, University of California, Los Angeles (since August 2017)

BRUCE EVANS, Fire Chief, Upper Pine River Fire Protection District; Representative, National Association of Emergency Medical Technicians

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

LARRY (DAVE) FLUTY, Acting Assistant Secretary, Office of Health Affairs, U.S. Department of Health and Human Services (since January 2017)

ROBERTO GARZA, Acting Deputy Director, Office of Public Health Preparedness and Response, Administration of Children and Families, U.S. Department of Health and Human Services (since May 2017)

JOHN L. HICK, Associate Medical Director, Emergency Medical Services; Medical Director, Emergency Medicine, Hennepin County Medical Center

ROBERT KADLEC, Office of Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services (since October 2017)

CLAUDIA M. KELLY, Senior Director, Value Access and Policy, Seqirus

THOMAS KIRSCH, Director, National Center for Disaster Medicine Public Health; Professor, Military and Emergency Medicine, Uniformed Services University of the Health Sciences, U.S. Department of Defense

GEORGE W. KORCH, Acting Assistant Secretary for Preparedness and Response, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services (until October 2017)

MICHAEL G. KURILLA, Director, Office of Biodefense Research Affairs; Associate Director, BioDefense Product Development, National Institute of Allergy and Infectious Diseases, National Institutes of Health, U.S. Department of Health and Human Services

DREW E. LEWIS, Medical Lead, Clinical Research and Medical Operations, Meridian Medical Technologies (since February 2017)

EMILY LORD, Executive Director, Healthcare Ready (until May 2017)

NICOLETTE A. LOUISSAINT, Director, Programming, Healthcare Ready (since June 2017)

NICOLE LURIE, Assistant Secretary for Preparedness and Response, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services (until January 2017)

FREDA GAIL LYON, Vice President, Emergency Services, WellStar Health System; Representative, Emergency Nurses Association

AUBREY K. MILLER, Captain, U.S. Public Health Service; Senior Medical Advisor, Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services

JOHN OSBORN, Operations Manager, Assistant Professor, Health Care Systems Engineering, Department of Surgery, Mayo Clinic College of Medicine

TARA O’TOOLE, Senior Fellow, Executive Vice President, In-Q-Tel

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

ANDREW T. PAVIA, Professor, Division Pediatric Infectious Diseases, University of Utah; Representative, Infectious Diseases Society of America

JENNIFER PIPA, Senior Director of Recovery Operations, American Red Cross (until April 2017)

ALONZO PLOUGH, Vice President, Research-Evaluation-Learning; Chief Science Officer, Robert Wood Johnson Foundation

TERRY RAUCH, Program Director, Defense Medicine Research and Development, Office of the Assistant Secretary of Defense for Health Affairs, U.S. Department of Defense (since June 2017)

STEPHEN C. REDD, Director, Office of Public Health Preparedness and Response, U.S. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services

MARY J. RILEY, Director, Office of Human Services Emergency Preparedness Response; Captain, U.S. Public Health Service, Administration for Children and Families, U.S. Department of Health and Human Services (until February 2017)

ANDREW R. ROSZAK, Senior Director of Emergency Preparedness, Child Care Aware of America (until January 2017)

SARA E. ROSZAK, Director, Research, National Association of Chain Drug Stores

ROSLYNE SCHULMAN, Director, Policy Development, American Hospital Association

RICHARD A. SERINO, Distinguished Visiting Fellow, National Preparedness Leadership Initiative; Senior Advisor, Harvard University School of Public Health

ALAN SINISCALCHI, Surveillance Coordinator for Influenza, Bioterrorism, and Public Health, State of Connecticut Department of Public Health; Representative, Council of State and Territorial Epidemiologists

MONCEF M. SLAOUI, Chairman, Global Vaccines, GlaxoSmithKline (until May 2017)

DAVID J. SMITH, Deputy Assistant Secretary of Defense, Health Readiness, Policy and Oversight, U.S. Department of Defense (until May 2017)

W. CRAIG VANDERWAGEN, Co-Founder and Director, East West Protection, LLC

JENNIFER WARD, President, Trauma Center Association of America

COLE WEEKS, Deputy Director, Office of Human Services Emergency Preparedness and Response, Administration for Children and Families, U.S. Department of Health and Human Services (until May 2017)

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

JOHN WIESMAN, Secretary of Health, Office of the Secretary, Washington State Department of Health; Representative, Association for State and Territorial Health Officials

GAMUNU WIJETUNGE, EMS Specialist, Office of Emergency Medical Services, National Highway Traffic Safety Administration, U.S. Department of Transportation

MATTHEW K. WYNIA, Director, Center for Bioethics and Humanities, University of Colorado Denver

Health and Medicine Division Staff

JUSTIN SNAIR, Senior Program Officer (until September 2017)

LISA BROWN, Program Officer

MORGAN BONAME, Associate Program Officer (until January 2018)

CLAIRE GIAMMARIA, Associate Program Officer (from February 2017)

JOANNA ROBERTS, Research Associate (until August 2017)

ALEXA EDMIER, Research Assistant (until November 2017)

ALEX REPACE, Senior Program Assistant

ANDREW M. POPE, Director, Board on Health Sciences Policy

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

KATIE SCHEMM DWYER, National Association of County & City Health Officials

DOUG HALLEY, CrossTown Connect

PUNEET KHAN, The Cadmus Group LLC

LEESA LIN, Harvard T.H. Chan School of Public Health

GAMUNU WIJETUNGE, National Highway Traffic Safety Administration, U.S. Department of Transportation

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by ELI Y. ADASHI, Brown University.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×

Acronyms and Abbreviations

ASPR

Assistant Secretary for Preparedness and Response

BARDA

Biomedical Advanced Research and Development Authority

CBRN

chemical, biological, radiological, or nuclear

CDC

U.S. Centers for Disease Control and Prevention

CIP

Critical Infrastructure Protection

DHS

U.S. Department of Homeland Security

DoD

U.S. Department of Defense

EHR

electronic health record

EMS

emergency medical services

FDA

U.S. Food and Drug Administration

FEMA

Federal Emergency Management Agency

FY

fiscal year

GHSA

Global Health Security Agenda

HHS

U.S. Department of Health and Human Services

HIE

health information exchange

HPP

Hospital Preparedness Program

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
×
ICS

incident command system

IHR

International Health Regulations

IRB

institutional review board

IT

information technology

JHSPH

Johns Hopkins Bloomberg School of Public Health

MCM

medical countermeasure

MERS-CoV

Middle Eastern respiratory syndrome coronavirus

MRC

Medical Reserve Corps

NACCHO

National Association of County & City Health Officials

NIH

National Institutes of Health

NLM

National Library of Medicine

PHEF

public health emergency fund

PHEMCE

Public Health Emergency Medical Countermeasure Enterprise

PHEP

Public Health Emergency Preparedness

PULSE

patient unified lookup system for emergencies

ROI

return on investment

USAID

U.S. Agency for International Development

WHO

World Health Organization

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Examining Challenges and Possible Strategies to Strengthen U.S. Health Security: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/24856.
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As the United States continues to adapt to a more digital, mobile, and interconnected world, health care and public health professionals have sought to better prepare for and respond to long-standing and emerging threats to the nation’s health security. Health security is the collective effort to prevent, protect against, mitigate, respond to, and recover from the health consequences of natural, man-made, and technological disasters. Although substantial progress has been made in the past 15 years toward improving health care and public health systems and capacities for health security threats, many complex challenges persist, and often the nation’s preparedness efforts are not sufficient.

On March 8–9, 2017, the National Academies of Sciences, Engineering, and Medicine’s Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop.

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