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The U.S. Agency for International Development (USAID) is a major leader in the global response to the dangers posed by emerging pandemic threats. Since 2005, the dual goal of USAID’s Pandemic Influenza and Other Emerging Threats (PIOET) program has been to a) minimize the global impact of existing pandemic influenza threats, particularly from the H5N1 highly pathogenic avian flu; and b) pre-empt the spillover, amplification and spread of future pandemic threats.
Since mid-2005, USAID, in partnership with the United Nations’ Food and Agricultural Organization (FAO), the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC) and national government and non-government counterparts, has strengthened the capacities of more than 50 countries for monitoring the spread of H5N1 avian influenza among wild bird populations, domestic poultry and humans, to mount a rapid and effective containment of the virus when it is found and to assist countries prepare operational capacities to mount a comprehensive response in the event that a pandemic-capable virus emerges.
In response to a growing concern about the possibility of an influenza pandemic and its potential to cause tens of millions of deaths, particularly in developing countries, USAID launched a series of efforts beginning with the Humanitarian Pandemic Preparedness Initiative (H2P) in 2007, a partnership with the U.S. Department of Defense’s Pacific and Africa Combatant Commands (PACOM and AFRICOM) in 2008 and in 2009, the PREPARE project to support national capacities (civilian and military) to prepare for and respond to the worst consequences of a pandemic. USAID focused its assistance to support national authorities to put in place pandemic preparedness plans that addressed five distinct areas:
- supportive care and treatment for those with influenza
- limiting transmission from patients with influenza to others in their households and communities
- provision of preventive and/or curative care for those ill with potentially fatal diseases other than influenza, e.g., malaria, diarrhea, bacterial pneumonia, other vaccine-preventable diseases, HIV and AIDS, tuberculosis
- ensuring ready access to food
- rapid resumption of income-generating activities following a pandemic
Pandemic Preparedness activities were completed in 2012.
In 2009, recognizing the threat of new infectious diseases extended beyond the risks posed by avian influenza, USAID launched the Emerging Pandemic Threats (EPT-1) program. EPT-1 was designed to give earlier insight into the emergence of new public health threats (in addition to influenzas) and enhance country-level capacities to mitigate their potential impact. The EPT-1 portfolio initially drew heavily from the experiences and lessons acquired from efforts to address the threats posed by H5N1 – and as such reflects a strategic approach that (1) builds on the understanding that the future well-being of humans, animals and the environment are inextricably linked; (2) promotes a One Health approach that spans the animal health, public health, conservations communities and the environment; (3) targets promotion of those policies and the strengthening of those skills and capacities critical for both minimizing the risk of viral spillover, amplification and spread and the ability to limit their social, economic and public health impact; and (4) uses a “risk”-based approach to target investments where the likelihood of viral spillover, amplification and spread is greatest.
EPT-1’s strategic approach provided a framework for USAID investments intended to reduce the risk of spillover, amplification and spread of new viruses of animal origin and their potential economic and human toll. At the heart of EPT-1’s approach has been the recognition that to be effective USAID cannot be successful on its own and must partner with a range of other U.S. Government agencies and multilateral, bilateral, national, non-governmental and private sector players. EPT-1 ends on September 2014.
Moving Forward … Beginning in October 2014
Like its predecessors, the Emerging Pandemic Threats Program-2 (EPT-2) has three overarching purposes: the prevention of new zoonotic disease emergence, the early detection of new threats when they do emerge and their timely and effective control. EPT-2 will build on the lessons and knowledge from its predecessors and bring heightened focus to those “places and practices” that enable not just “spill-over” of new microbial threats, but also potentiate their “amplification and spread.” It will also invest in the One Health policies and capacities needed for their prevention and control. At the core of EPT-2 are seven new areas of strategic focus:
- Developing longitudinal data sets for understanding the biological drivers of disease emergence
- Understanding the human behaviors and practices that underlie the risk of “spill-over, amplification and spread” of new viral threats
- Promoting policies and practices that reduce the risk of disease emergence
- Supporting national One Health platforms
- Investing in the One Health workforce
- Strengthening national preparedness to respond to events of public health significance
- Strengthening global networks for real-time bio-surveillance
Last updated: April 25, 2014