Slide1 l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 15

Workshop: The State of National Governance Relative to the International Health Regulations (2005) Ottawa, Canada, 20-21 September 2006 PowerPoint PPT Presentation


  • 121 Views
  • Uploaded on
  • Presentation posted in: General

Workshop: The State of National Governance Relative to the International Health Regulations (2005) Ottawa, Canada, 20-21 September 2006 Overview: United States of America Anthony A. Marfin Centers for Disease Control and Prevention. Goal.

Download Presentation

Workshop: The State of National Governance Relative to the International Health Regulations (2005) Ottawa, Canada, 20-21 September 2006

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Slide1 l.jpg

Workshop: The State of National Governance Relative to the International Health Regulations (2005)

Ottawa, Canada, 20-21 September 2006

Overview: United States of America

Anthony A. Marfin

Centers for Disease Control and Prevention


Slide2 l.jpg

Goal

Describe the extent to which United States has a system of governance that will enable effective implementation of the revised International Health Regulations 2005


Background political structure l.jpg

Background: Political Structure

  • Federal system of government

  • States independent sovereign governments

  • States retain powers not expressly delegated to Federal government

  • Full presidential system


Who does public health l.jpg

Who does public health?

  • Concurrent jurisdiction

  • U.S. Constitution division of jurisdiction:

  • “[P]owers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States, respectively, or to the people.”

  • Federal government given power “to regulate commerce with foreign nations, among the several States (interstate)” Movement of disease affects commerce


Slide5 l.jpg

Who does public health?

  • Responsibility for public health is shared but most functions are decentralized

    • Within a single state: All aspects of surveillance, reporting, & public health clearly belong to state/local HDs

    • International and interstate events: Jurisdiction of federal government

  • Federal public health entities DONOT have direct authority over state/local public health entities


National core capacities where public health activities are performed l.jpg

National Core CapacitiesWhere public health activities are performed

ActivityNationalStateLocal

Case detection/notificationNo Yes Yes

Collection of case dataNo Yes Yes

Analysis & interpretationYesYesYes

Investigation of cases & confirmation of diagnosis:

  • Epidemiologist*YesYes

  • Clinician No*Yes

  • Laboratory **Yes

    DisseminationYesYesYes

    Response/Intervention*YesYes

* Upon request


Notifiable diseases l.jpg

Notifiable Diseases

  • “Notifiable diseases” vary between counties & states

  • Federal government, only 9 quarantinable diseases

  • Harmonization through consensus with professional organizations of state/local public health officers

  • Example (CSTE): “…by supporting the use of effective public health surveillance and good epidemiologic practice through training, capacity development, and peer consultation, developing standards for practice …”


Ihr negotiation approval l.jpg

IHR negotiation & approval

USG will implement IHRs in a manner consistent with our fundamental principles of federalism

IHRs will be implemented by the Federal Government to the extent that the implementation of the Regulations comes under the legal jurisdiction of the Federal Government

To the extent that IHR obligations come under the legal jurisdiction of the state/local governments, the USG will bring these obligations with a favorable recommendation to the notice of the appropriate state authorities


Development of surveillance systems l.jpg

Development of surveillance systems

  • Work with professional groups representing state and local health officers and epidemiologists to adopt the IHR 2005 requirements as a standard

  • As necessary, provide financial and technical support to states to adopt a new standard


Surveillance detection notification verification reporting l.jpg

Surveillance: Detection, notification, verification & reporting

  • Performed by state/local government; technical / lab assistance from federal government (upon request)

  • Federal government has constitutional authority to ensure that these processes meet IHR 2005 requirements in interstate or international settings

    • No authority over events that occur within a state (without an interstate or commerce connection)

    • Mechanisms to ensure that these processes meet IHR 2005 requirements are being discussed

  • Currently, USG works with professional groups representing state/local government to adopt requirements as their standard


Surveillance detection notification verification reporting11 l.jpg

Surveillance: Detection, notification, verification & reporting

  • Communication:

    • CDC’s Epi-X – Rapid, firewall-protected privileged information sharing system between federal, state, and local health officials

    • Health Alert Networks

    • CDC forward-deployed field stations (Quarantine Stations)


Jurisdictional authority for pheics l.jpg

Jurisdictional authority for PHEICs

  • Federal government will express authority over PHEICs within specific jurisdictions (i.e., international and interstate events)

  • Otherwise, U.S. state/local governments will have such authority (intrastate events involving non-Federal assets or resources)

  • Regarding PHEICs in intrastate settings, USG will take appropriate measures to facilitate the implementation of IHRs at the local level


Potential obstacles l.jpg

Potential Obstacles

  • Potential obstacles to communication/collaboration

    • Dual reporting system

    • Variation in technologic capacity amongst states/counties

    • Need for rapid movement of information

    • Establishing and using a National IHR Focal Point for all international communications


Overcoming these obstacles l.jpg

Overcoming these obstacles

  • How to overcome these obstacles

    • Standardize data collection based on scientific principles

    • Simplify data transfer (“NECESSARY not desirable”)

    • Web-based data systems (“workspaces”) that are jointly accessible and maintained by 3 levels of government

    • XML file transfers between data systems

    • Dedicated communication system for public health practitioners

    • Communication protocols between 3 levels of government

    • Communication protocols within federal government for sending/receiving international communications

  • Methods to overcome obstacles will require:

    • Agreements regarding data sharing

    • Development and access to secured electronic communication systems


Summary conclusions l.jpg

Summary & conclusions

  • Obstacles to implementation include:

    • Decentralized public health delivery system

    • Implementing in a manner consistent with fundamental U.S. principles of federalism.

    • Full implementation relies cooperation from state and local governments

    • Rapid communication between 3 levels of government

    • Technical support for state/local HDs

  • No expectations of outside agencies for any assistance with implementation


  • Login