First national health security strategy released by HHS

The intent of the four-year plan is to bolster response systems for widespread health emergencies.

By — Posted Feb. 1, 2010

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The far-reaching impact of the influenza A(H1N1) epidemic illustrated the nation's need for a comprehensive plan to respond to health emergencies, federal officials say. The Dept. of Health and Human Services has issued its first National Health Security Strategy to meet that need.

The plan, released Jan. 7, sets priorities for government and nongovernment activities for the next four years. The intent is to bolster community resilience to health emergencies, strengthen and sustain health emergency response systems, and reduce existing gaps.

The health security strategy also will create a framework outlining what physicians can do to prepare themselves, their practices and families for a health emergency.

"For the first time, we have the federal government saying, 'Building a health system is essential, and doing it in a comprehensive way is essential for homeland security,' " said internist Georges Benjamin, MD, executive director of the American Public Health Assn. "Whether it be infectious disease, or a natural disaster, or a terrorist event, it's important we have comprehensive public health infrastructure to deal with it."

HHS was directed by the Pandemic and All-Hazards Preparedness Act to develop the strategy and an accompanying implementation plan by 2009. While the act called for updates every four years, HHS intends to update the plan every two years to reflect advances in public health and medicine.

The strategy and its Interim Implementation Guide were developed collaboratively by HHS, state and federal officials, medical organizations and others.

Priorities detailed in the interim guide include identifying ways to enhance capabilities and suggesting steps for filling work force shortages in specialties that play a key role in health security. Work on this structural frame was set to begin in January, with the more comprehensive Implementation Plan scheduled for release in September.

Public health needs

Improving surge capacity and replenishing the depleted work force are among the public health system's greatest needs, Dr. Benjamin said.

"What's happened over the last few years is we've added funding for preparedness, but the funding has been cut in some of these other areas that we have to use every day," he said. "Having properly trained bodies and enough of them to do the jobs in public health remains a vulnerability for us."

The federal government has cut core funding for public health preparedness by 27% (adjusted for inflation) since fiscal 2005, according to a December 2009 report on emergency health preparedness issued by Trust for America's Health and the Robert Wood Johnson Foundation.

The health security strategy acknowledges the funding problem, stating "stable funding is a prerequisite to attract and retain high-quality staff for public health, health care delivery, and emergency management."

The release of the national strategy comes amid recent concerns about America's emergency preparedness.

On Dec. 1, 2009, HHS Secretary Kathleen Sebelius requested a review of the government's system for handling public health emergencies. Two weeks later, Trust for America's Health and the Robert Wood Johnson Foundation issued their report detailing the nation's problems with public health emergency response. And on Dec. 18, 2009, the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report indicated that the number of state health department epidemiologists had decreased since 2006.

The Sebelius-requested review is part of the new health security strategy, which asks all levels of government to strengthen their health and emergency response systems, said Gretchen Michael, spokesperson for the HHS Office of the Assistant Secretary for Preparedness and Response.

"The whole point is everybody has to look inward and outward to see" what can be done, Michael said.

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U.S. strategy for health security

The Dept. of Health and Human Services' National Health Security Strategy includes an Interim Implementation Guide detailing actions to be implemented before the more comprehensive Implementation Plan is enacted. Here are steps intended to be put in place by September:

  • Identify and prioritize a list of efforts to enhance the capabilities required to achieve national health security.
  • Conduct a work force gap analysis and develop work force competencies for all sectors involved in national health security.
  • Coordinate HHS efforts to improve national health security with all federal agencies involved in national health security and national security.
  • Begin to identify and develop methods for risk analysis appropriate to the broad range of risks to the public's health.
  • Develop an evaluation framework, including plans for performance monitoring and evaluating the impact of initiatives.
  • Promote and implement quality improvement methods for health security on a broader scale.
  • Propose an agenda for research to enhance national health security.
  • Conduct an assessment of the countermeasures enterprise with the aim of identifying how to develop, manufacture and ensure availability and delivery of countermeasures faster and more efficiently.

Sources: Interim Implementation Guide for The National health Security Strategy of the United States of America, Dept. of Health and Human Services, (link)

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External links

"National Health Security Strategy of the United States of America" Dept. of Health and Human Services, December 2009 (link)

"Interim Implementation Guide for the National Health Security Strategy of the United States of America" Dept. of Health and Human Services, December 2009 (link)

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