Global Disease Detection Program: Frequently Asked Questions

GDD helps countries build capacity to detect and respond to potential health threats. While CDC remains vigilant and ready to support responses to public health emergencies when they occur, we must also help countries build the systems they need to find and stop outbreaks before they reach our shores.

Another key factor in the program’s work is establishing strong relationships in countries. Building relationships takes time, and our GDD Centers are part of a long-standing partnership with host countries, organized around each country’s priorities and CDC’s technical experience.

Since its beginning in 2004, the program has supported over 50 countries through its 10 centers. Assistance includes outbreak response, laboratory and pathogen discovery, training, surveillance, and networking.

In some ways, the biggest successes and biggest challenges of the GDD program both result from our ability to help countries be better prepared to prevent, detect, and respond to public health threats.

Scarcely a week goes by without a grim reminder in the media of infectious disease emergence or re-emergence in the United States and around the world. As demonstrated with the SARS outbreak in 2003 and the Ebola epidemic in 2014, a disease threat in one country is a threat to all countries, and the world must have effective prevention and control measures. As we look at the history of the GDD Centers, we see examples of new diseases detected before they became significant threats, as well as faster response to many diseases because of the capacity we helped to build in the country. Because of the importance of being able to detect health threats as close to the source as possible, successes come when we have laboratory capacity in place. Countries can test rapidly and feed information into surveillance systems to inform public health leadership on what they need to do to protect their citizens.

The biggest challenge is the unknown. As we are working with countries to prepare for the next public health threat, we don’t know what the disease will be, when it will strike, or where it will happen. That’s what makes our work so important. We need the lab systems in place to discern which pathogens could be emerging as new diseases. We need the surveillance networks in place to know what diseases are naturally occurring and at what levels so we know when there is a new threat. And we need GDD Centers, who can respond quickly to diseases within their region.

As the program moves forward, we plan to:

• Continue to develop core public health capacities in all GDD Centers
• Increase coordinated multicenter scientific collaboration across GDD Centers to strengthen the global network
• Increase the number of public health professionals trained by GDD programs
• Broaden and strengthen global partnerships
• Reduce gaps and build capacity in global preparedness for emerging health threats

CDC has a long and storied history of supporting global health protection, ranging from smallpox eradication, cholera control, and polio elimination, to emergencies including SARS, novel influenza (H5N1 and H1N1), and Ebola. The GDD program was initiated in the early 2000s to promote a broader approach to preparing countries for any infectious disease threat that could occur, regardless of pathogen.

Everything we do through the GDD program helps build country capacity in alignment with the International Health Regulations, which are an international framework agreed on by all WHO member countries to improve global health security. The following chart shows how the GDD program’s activities help meet the requirements of the IHR.

GDD was one of the first ways that CDC systematically approached global health security, and has provided the basis and lessons learned for our work on the Global Health Security Agenda (GHSA). Six of the countries with GDD Centers have also been identified as GHSA countries (Bangladesh, India, Kenya, Kazakhstan, Thailand, Georgia). The countries with GDD Centers have already made great strides in many of the foundational elements of building their public health systems, including:

• Improving laboratory networks
• Strengthening surveillance systems
• Developing the workforce
• Establishing emergency operations centers

All of these elements are accelerated in GDD countries because of the partnerships, science, and infrastructure that have been strengthened through our GDD investments.

Additionally, countries that have been strengthened through GDD Centers are more likely to serve as regional leaders, sharing their technical expertise with other countries as they promote global health security.

The criteria below are used to determine where to put a GDD Center.

• Public health significance: The country has a high population density or history of infectious diseases or expected potential for emerging diseases
• Country commitment: The country supports and values partnership with CDC and will actively engage in collaborative activities and identify new partners
• Established CDC presence: The country has an established, effective working relationship with CDC and supports CDC staff in-country
• Established regional reach: The country has the infrastructure and regional stature to serve as regional resource, or is already acting as a regional leader in other arenas
• International partner presence: The country has other U.S. Government agencies and international partners operating in-country

Established presence of CDC and other U.S. Government agencies in a country has been a helpful factor in deciding where to place a GDD Center. We want to ensure the success of GDD Centers in helping countries improve their capacity to prepare for public health threats. A history of strong relationships with the U.S. government can be a good indicator of a willingness on behalf of the host government to work closely with us.

Beginning in 2006, GDD began routinely monitoring the program’s capabilities and progress using a framework that includes quantitative and qualitative information related to the following five key activities:

• Outbreak Response: Improving the timeliness and reliability of outbreak investigations and responses
• Pathogen Discovery: Advancing public health knowledge through innovative research into the epidemiology and biology of emerging infections and identifying novel threats before they spread
• Training: Building capacity and improving the quality of epidemiology and laboratory science through training
• Surveillance: Strengthening surveillance systems that are capable of detecting, assessing, and monitoring the occurrence and public health significance of infectious disease threats over time
• Networking: Enhancing collaboration through shared resources and synergy