Public Health Division

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


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


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


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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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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CASES

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Case

Detection/

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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


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


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


• 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


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


QUESTIONS

CDR Franca Jones, PhD Tel: 301-319-3268

E-mail: [email protected]

mailto:[email protected]

Public Health Division

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