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U.S. Department of Health and Human Services

ASPR International Capacity Building Programs

Since its establishment in 2006, ASPR has actively collaborated with partner countries and international organizations to strengthen core public health emergency preparedness and response capacities. Those relationships have grown to include many countries in Africa, Southeast Asia, the Caribbean, and Central and South America, and a number of cooperative agreements have allowed ASPR to fund several projects that target key gaps and challenges in pandemic influenza and emerging infectious disease preparedness.  Capacity building activities have focused on assisting partners to build national core capacities in their countries to fulfill their obligations under the International Health Regulations (IHR 2005).

These collaborations are supported through a combination of programmatic and policy activities, grants, and cooperative agreements.  Under these arrangements, DIHS has initiated and overseen:

  • National assessments and planning for pandemic influenza and other emerging (and re-emerging) infectious diseases
  • Assessing, organizing, and strengthening IHR National Focal Points (NFP) operations
  • Enhancing laboratory-based and syndromic infectious disease surveillance systems
  • Preparing for and responding to specific public health threats
  • Developing, strengthening, and exercising preparedness and medical countermeasure plans
  • Improving screening, detection, and response to health threats at designated points of entry
  • Developing and implementing laboratory biosafety and biosecurity programs

Pasteur Institute

DIHS has supported multiple projects aimed at strengthening national public health systems through both financial and technical assistance, together with the Pasteur Institute and the Institute Pasteur International Network (IPIN)-affiliated laboratories. Through IPIN, DIHS is primarily supporting strengthening these systems in Cambodia, Cameroon, the Central African Republic, Ivory Coast, Madagascar, and Senegal with the anticipated addition of Guinea in 2018. In the past, some assistance has also been provided to the Pasteur laboratories in Vietnam and Laos.

Capacity building and sustainment focus on pandemic influenza and other emerging infectious disease surveillance and response systems. DIHS currently supports the WHO-certified National Influenza Centers in Cameroon, Central African Republic, and Senegal, as well as the Southeast Asia Regional H5N1 Reference Center in Cambodia.  Surveillance and response for other emerging and re-emerging infectious diseases, such as viral hemorrhagic fevers and poliovirus, and outbreak early-warning surveillance systems are being supported in Cameroon, Ivory Coast, Madagascar, and Senegal.  In several countries, the DIHS cooperative agreement funds are used to support national epidemiology training programs and public health emergency planning with the Ministries of Health and Agriculture. Funds also and help the national laboratory professionals to reach out and support neighboring y countries who do not have an affiliated IPIN laboratory.

In 2017, the cooperative agreement was leveraged to facilitate work by the Centers for Disease Control and Prevention’s (CDC) under the Global Health Security Agenda (GHSA).  DIHS, CDC, and IPIN collaborated to develop a new training program for non-influenza respiratory disease surveillance for the GHSA Phase I francophone countries in West and Central Africa that will be adaptable to their unique local laboratory systems. The training will focus on using single- and multiplex polymerase chain reaction methods for identifying viral and bacterial causes of influenza-like illness and severe acute respiratory illness.

Core objectives with priority countries include:

  • Building surveillance networks to detect novel influenza viruses
  • Strengthening laboratory diagnostic and surveillance capacity
  • Training personnel to enhance workforce capability and capacities
  • Strengthening IHR NFP communication capacities
  • Strengthening national pandemic influenza and public health emergency plans

Major Accomplishments:

  • Assistance in establishing National Influenza Centers in , Cambodia, Cameroon, Central African Republic, Madagascar, Laos, and Senegal
  • Establishment of the biosafety level 3 (BSL-3) laboratory in Cambodia, which is now the WHO Collaborating Center for H5N1 in the region
  • Development of regional outbreak preparedness and response through workshops in Cambodia, Cameroon, and Senegal.
  • Expanding influenza surveillance networks to include other respiratory viruses and supporting national outbreak investigations
  • Support for Ebola outbreak response activities in Guinea and Senegal by the laboratory staff from Senegal
  • NFP training workshops in Cameroon that included representatives from Cameroon, Central African Republic, Senegal, and Togo

Dr. Maria Julia Marinissen, DIHS Director, and DIHS staff visits the Centre Hospitalier D’Essos, a sentinel surveillance site for influenza in Cameroon in June 2012. 
Dr. Maria Julia Marinissen, DIHS Director, and DIHS staff visits the Centre Hospitalier D’Essos, a sentinel surveillance site for influenza in Cameroon in June 2012.

Gorgas Memorial Institute for Health Studies (GMI), Panama

DIHS is supporting with Panama’s Gorgas Memorial Institute for Health Studies (GMI) to enhance regional public health emergency preparedness and response capabilities in laboratories, international points of entry, and IHR NFPs. 

Core objectives include:

  • Conducting IHR NFP assessment, developing standard operating procedures, and enhancing communications
  • Evaluating existing plans, conducting exercises, and communicating results
  • Continuing capacity building and biosafety/security systems in Central America’s first and only BSL-3 laboratory
  • Moving towards real-time surveillance and notifications using existing electronic systems
  • Facilitating memoranda of understanding with Colombia and Costa Rica for assessment and capacity building at points of entry
  • Supporting public health emergency preparedness and response capacities at several international points of entry, including air, land, and sea ports
  • Supporting the development of emergency management and communications plans throughout the country and efforts to align those plans with neighboring countries

Major Accomplishments

  • Assisted in the development of the first BSL-3 laboratory in Panama
  • Continued support for maintenance of biosafety certification for the BSL-3 laboratory and training of additional laboratory personnel
  • Enhanced capacity of the BSL-3 virology suite
  • Establishment of the first country-wide sentinel surveillance network for seasonal and pandemic influenza
  • Created Panama’s first ever public health emergency operations
  • Set up a Gorgas Regional Health Care Training Center for health care workers, resulting in training of over 5,000 public health and medical professionals from more than ten Latin American and Caribbean countries, including Belize, Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama
  • Provided direct support to Panama’s Ministry of Health for a number of infectious diseases surveillance and response programs, as well as basic and advanced-level training in field epidemiology methods and rapid outbreak response for Ministry of Health personnel
  • Facilitated memoranda of understanding with Colombia and Costa Rica for assessment and capacity building at points of entry

IHR National Focal Point Capacity Building Missions

Since 2012, the IHR Program has supported WHO/Pan American Health Organization-led missions, in collaboration with regional IHR NFPs, to strengthen the Americas’ IHR NFP capacities. During these missions, the U.S. IHR NFP exchange IHR-relevant operational and procedural knowledge and experiences and share best practices on U.S. IHR NFP operations. Such exchanges include discussing U.S. government reporting procedures and transparent domestic information sharing protocols and templates for adoption and adaptation relevant to respective countries’ IHR NFP operations, as well as support in drafting IHR NFP Standard Operating Procedures.

Core Objectives

  • Understand and ensure that government policy, regulation, law, etc. supports current NFP structure and suggest ways to strengthen IHR and NFP implementation, if needed
  • Guide implementation and/or adaptation of best practices and established NFP structures to match national policy and government structure (e.g. sharing current NFP best practices, models, and NFP manuals/guidance)
  • Share experiences and lessons learned in the management of NFP processes and procedures
  • Directly support the development/revision of NFP SOPs, if needed
  • Discuss opportunities to strengthen IHR NFP capacities and IHR core capacities at national, regional, and global levels
  • Discuss early warning and response systems for unusual and unexpected public health events
  • Share communication and coordination processes to detect, verify, assess, respond, and notify on public health events
  • Discuss and share experiences in coordination and completion of the annual IHR implementation report to the WHO (i.e. monitoring scheme)
  • Discuss activities to increase awareness of the IHR and roles and responsibilities of domestic public health stakeholders

Major Accomplishments

  • Assisted respective countries in revision and/or development of NFP and other IHR relevant Standard Operating Procedures in collaboration with ministerial representatives
  • Defined pathways to enhance communication across ministries and internally within Ministries of Health and leveraging existing authorities for strengthened IHR reporting
  • Trained IHR-relevant stakeholders on use of Annex 2 of the IHR (2005) and event notification to WHO
  • Developed and/or enhanced working relationships between IHR NFP leads in the Americas Region, and the WHO Regional IHR Contact Point

National Center for Disease Prevention and Control Programs and the Directorate for Epidemiology Mexico

Through several cooperative agreements with Mexico’s National Center for Disease Prevention and Control Programs (CENAPRECE) and Directorate for Epidemiology (DGE), DIHS supported the establishment of Mexico’s first federal BSL-3 laboratory, which became a part of the CDC’s Laboratory Response Network in 2012.

DIHS has also overseen activities aimed at strengthening Mexico’s IHR NFP operations, rapid public health event reporting and response, training for national public health emergency managers, coordination of international health security strategy, development of secure sample sharing protocols for the Institute for National Institute for Diagnostics and Epidemiological Reference (InDRE), and support for multisectoral planning and policy development aligned with North American Plan for Animal and Pandemic Influenza (NAPAPI).  

National Institute for Diagnostics and Epidemiological Reference (InDRE)

ASPR-CDC Public Health Emergency Management Fellowship

Hosted each spring and fall, this weeklong ASPR-CDC Public Health Emergency Management Fellowship (PHEMF) allows foreign fellows the opportunity to learn about public health preparedness, emergency response, emergency operations centers (EOCs), and the WHO IHR (2005) through briefings and field visits by U.S. government and Pan American Health Organization officials and experts. PHEMFs will ideally take these U.S. best practices and operationalize this knowledge to fit the public health needs of their respective countries. Previous PHEMF cohorts have consisted of leading public health emergency and response experts and physicians from Japan, Jordan, and throughout West Africa.

WHO Emergency Operations Centres Network (EOC NET), Switzerland

A DIHS grant for the WHO Emergency Operations Centre Network (EOC NET) in 2016 supported the annual global symposium of EOC NET members and technical experts who are preparing global standards and guidelines of EOC capacity building and operations. The WHO EOC NET is an extension of the WHO’s Health Emergencies Programme that aims at establishing functioning public health EOCs in every country. ASPR is considering a cooperative agreement with WHO EOC NET to further refine and align the global systems.

Previous International Capacity Building Engagements

U.S. Border States Early Warning Infectious Disease Surveillance (EWIDS Project)

In 2003, HHS created the U.S. Border State Early Warning Infectious Disease Surveillance (EWIDS) Project to enhance the ability of Border States and border jurisdictions (including tribes) straddling the borders to rapidly detect infectious disease outbreaks along the border. The U.S. Border States EWIDS Project was designed to build the capacity of public health systems of all 20 U.S. border states (including Alaska), to establish or improve their cross-border early warning of infectious diseases, either naturally occurring, or of a bioterrorist nature.

Under this unique collaboration with HHS-CDC, border states that received EWIDS funding submitted project proposals designed to improve the ability to rapidly detect, identify, and report outbreaks of infectious disease associated with potential bio-terror agents or other major threats to public health along the border. These proposals included projects that improve surveillance, epidemiological investigation, laboratory diagnostics, and/or health alert messaging capacities and capabilities, and have included workforce development and training. EWIDS projects also developed and improved border-wide and state-to-state and state-to-province mechanisms for effective cross-border exchange of surveillance findings among neighboring border jurisdictions and the three Federal governments.

Before the EWDIS projects ended in 2013, DIHS worked with CDC’s Division of State and Local Readiness to ensure the Public Health Emergency Preparedness funding would be able to support state and local awardees.

Early Warning Infectious Disease Surveillance in México (EWIDS-México Project)

From 2006 through 2013, a special companion project along the U.S.-México border region, the EWIDS- México Project, has been designed with similar goals and objectives to assist the six Mexican Border States and México’s Federal Secretariat of Health in strengthening the same capacities and capabilities along México’s northern border. In addition to the investments being made in México’s six northern Border States, this project focused on improving the laboratory capacity of the México’s national institute for diagnostic and epidemiological reference in México City, along with the functional capabilities of its national network of laboratories. DIHS also supported the establishment of Mexico’s first federal BSL-3 laboratory, which became a part of the CDC’s Laboratory Response Network in 2012.


  • This page last reviewed: February 15, 2017