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| Objectives
for Priority Area 5 |
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Establish a Solid Foundation for Global Initiatives
- Expand the cohort of public health professionals at CDC who have
international expertise and can provide support for global initiatives
to combat infectious diseases. (See also Priority
Area 6.)
- Help suggest international priorities for current and future global
initiatives for disease control. Future initiatives might include antimicrobial
resistance monitoring, pandemic influenza preparedness planning, and
campaigns to control or eliminate measles, lymphatic filariasis, onchocerchiasis,
trachoma, rubella, neonatal tetanus, and hepatitis B.
- Provide technical assistance to national health authorities in public
health management of diseases targeted by global health initiatives,
working through the Sustainable Management Development Program and other
mechanisms. In some countries this will include integrating specialized
HIV, TB, and STD surveillance programs into national surveillance and
laboratory service systems for infectious diseases.
- Improve coordination among CDC personnel who work overseas in the
same country or region.
Enhance Support for Disease Control, Elimination, and Eradication
Programs
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Help complete the eradication of polio by 2005. The global effort to
eradicate polio is led by WHO, in partnership with an international
coalition that includes CDC, Rotary International, UNICEF, and the governments
of many countries (http://www.cdc.gov/nip/global).
The WHO Global Polio Laboratory Network (Box 7), which uses molecular
techniques to determine whether wild-type polio is circulating in areas
undergoing eradication efforts, should be expanded to include monitoring
for other vaccine-preventable diseases, such as measles and rubella.
- Work with PAHO to complete the elimination of indigenous (i.e., nonimported)
cases of measles in the Americas, and work with WHO, UNICEF, the UN
Foundation, USAID, the American Red Cross, the International Federation
of Red Cross and Red Crescent Societies (IFRC), and other partners to
reduce by 50% by 2005 the nearly 900,000 annual measles deaths worldwide.17
Participate in the Roll Back Malaria Initiative
- Contribute to Roll
Back Malaria
(RBM) through full endorsement and active promotion of RBM strategics
in malaria-endemic countries in sub-Saharan Africa, Southeast Asia,
and the Americas. Although RBM strategies vary by region and by local
malaria transmission dynamics, 90% of the world’s malaria is in
sub-Saharan Africa, where the strategies for malaria prevention and
control include
- Prompt effective case management of malaria illness
- Prevention of malaria and its consequences in pregnancy, through
prophylaxis or preventive intermittent treatment regimens with an
effective antimalarial drug
- Widespread use of insecticide treated bednets, particularly by
young children and pregnant women
- Prompt recognition and management of malaria epidemics
- Conduct operations research on
- Antimalarial drug efficacy and the management and prevention of
antimalarial drug resistance
- Malaria prevention in pregnancy
- Transmission reduction through the use of insecticide-treated bednets
and other strategies
- Malaria assessment in complex emergencies, such as outbreaks that
occur among refugees or outbreaks that occur after hurricanes or other
natural disasters
- Malaria diagnostics
- Social attitudes and practices that facilitate or hinder the effectiveness
of malaria control programs
- Malaria surveillance, monitoring, and evaluation strategies
- Provide technical assistance to the African
Integrated Malaria Initiative
(see also Appendix A), a USAID-sponsored
initiative that enhances integrated malaria treatment and prevention
in Kenya, Malawi, Zambia, and Benin by promoting the use of interventions
in the home (e.g., insecticide-impregnated bednets), in healthcare facilities
(e.g., chemoprophylaxis), and among pregnant women (e.g., protective
intermittent chloroquine therapy, as recommended by the USAID Safe Motherhood
Initiative). During 2001, the African Integrated Malaria Initiative
will be extended to the Democratic Republic of the Congo, Nigeria, Senegal,
and Uganda.
- Assist ministries of health in malaria control efforts and in the
monitoring and evaluation of antimalarial drug efficacy. CDC is currently
working on national malaria control programs in Kenya, Tanzania, Peru,
and Nepal.
Strengthen the Stop TB Program
- Contribute to Stop
TB
by
- Assigning an epidemiologist to WHO’s Stop TB secretariat
- Providing technical assistance to facilitate the use of the directly
observed therapy short-course strategy (DOTS) for TB. (See also
Priority Area 4)
- Strengthening TB treatment programs in LIFE Initiative/Global
AIDS Program countries (see below)
- Supporting demonstration projects on the medical management of
drug-resistant TB
- Providing technical assistance to improve hospital TB control
and detect hospital and community outbreaks in communities with
high HIV prevalence
- Assigning a medical officer to the International Union Against
TB and Lung Diseases (IUATLD) to train a cadre of international
TB experts, as a joint effort with USAID and WHO
- Providing technical assistance and laboratory support to implement
global antituberculosis drug resistance surveys
- Consult with ministries of health in Russia, Vietnam, and other countries
on training issues related to TB diagnosis and treatment.
- Conduct operations research on
- TB surveillance, program management, and program evaluation strategies
- Multidrug-resistant TB treatment approaches and evaluation strategies
- Treatment strategies for latent TB among persons with HIV infection
- Factors that improve adherence to antituberculosis therapy
- New diagnostic methods, drugs, and vaccine for TB
Expand the LIFE Initiative and Other International
Efforts To Address HIV/AIDS
CDC will work with foreign ministries of health and public and private
sector partners in countries targeted by the LIFE
Initiative/Global AIDS Program (Boxes 6 and 21) to
- Prevent primary transmission of HIV by
- Expanding voluntary counseling and testing programs for youth
and other vulnerable populations
- Building large-scale programs to reduce mother-to-child transmission
- Strengthening programs to reduce bloodborne HIV transmission
- Strengthening medical management of sexually transmitted infections
(STIs)
- Supporting and strengthening national education and mobilization
efforts for disease prevention
- Improve community and homebased care and treatment by
- Expanding and strengthening TB prevention and care
- Enhancing care and treatment of HIV/AIDS and AIDS-related opportunistic
infections
- Exploring the innovative use of antiretroviral therapy
- Build public health and medical infrastructure by
- Expanding and strengthening surveillance for HIV, STIs, and TB
- Providing laboratory support for diagnosis and surveillance of
HIV, STIs, TB, and opportunistic infections, as well as for HIV
screening of blood supplies
- Expanding and strengthening public health information systems
- Providing training in managing and implementing HIV treatment
and prevention programs (see Objectives
for Priority Area 6).
- Enhancing evaluation of HIV/AIDS prevention and care programs.
Support Global Vaccine Initiatives
- Help GAVI
partners develop and implement strategies to strengthen routine immunization
services and monitor their effectiveness.
- Provide assistance to GAVI in assessing the burden of hepatitis B,
yellow fever, Haemophilus influenzae type b, pneumococcus, rotavirus,
meningococcus A, measles, and congenital rubella syndrome in developing
countries and use this information to design, implement, and evaluate
immunization programs against these infections.
- Support efforts by GAVI partners—including pharmaceutical companies,
foundations and development banks—to develop and evaluate new vaccines
that are needed in developing countries, and to promote their availability.
(See also Priority 3.)
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