Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement

CDC’s national funding strategy helps state, local, and territorial health departments battle infectious disease threats in the U.S.

Over $300 million in fiscal year 2017 awarded to strengthen U.S. public health infrastructure

CDC awarded over $300 million in federal fiscal year 2017 to strengthen the ability of domestic health departments to respond to infectious disease threats. This crucial CDC investment, provided through the Epidemiology and Laboratory Capacity (ELC) for Infectious Diseases Cooperative Agreement, helps local, state, and territorial health departments continue to:

• Build and maintain effective public health workforce for rapid response to infectious disease outbreaks
• Strengthen cross-cutting national surveillance systems
• Boost laboratory infrastructure with the latest diagnostic technologies
• Improve health information systems to efficiently transmit, receive, and analyze infectious disease-related data electronically

The 5-year funding cycle for ELC’s Cooperative Agreement began August 1, 2014 and runs through July 31, 2019. In its fourth year of this funding cycle, ELC disbursed the largest amount of awards to local, state, and territorial health departments since the Cooperative Agreement started in 1995.

Grantees

Grantees representing these jurisdictions serve as the foundation for our national public health infrastructure and are integral to the nation’s ability to tackle infectious disease threats. Each of ELC’s 64 jurisdictions has an ELC program advisor assigned to them to provide technical assistance, advice, and strategies to maximize use of their cooperative agreement.  ELC program advisors also strategize on how to mitigate grantee-specific challenges to ensure program goals and objectives are met in a resource-limited environment.

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Grantee Activities

State, local, and territorial public health agencies each have unique needs and priorities because of the diverse infectious disease challenges they face, their organizational capacity, geography, and populations. Often, there are unanticipated events that may require the diversion of resources to a specific emerging or re-emerging disease. To better meet essential needs and reduce delays in responsiveness, ELC resources are designed to address planned-for and unanticipated infectious disease threats.

The ELC covers an array of projects that bolster the ability of public health agencies to detect, prevent, respond to, and control infectious disease threats. These projects include activities to fight specific infectious disease as well as multifaceted threats of public health importance. The ELC is a complex program with many different funding streams and discrete projects. Two primary classes of ELC funding are Flexible or Non-disease-specific Funding and Disease-specific Funding:

Flexible or Non-disease-specific funding

tackles high-priority needs that are NOT disease-specific. Funding in this category addresses integrated, cross-cutting activities related to epidemiology, laboratory, and health information systems. Resources are awarded so grantees can:

Disease-specific or Categorical funding

targets specific infectious diseases and other public health threats of importance. Examples include:

• Antimicrobial-resistant bacteria
• Waterborne diseases
• Zika virus
• Influenza (Flu)
• Healthcare-associated infections
• Fungal (mycotic) diseases
• Capacity for other emerging or re-emerging infectious diseases
• Foodborne germs and illnesses
• National Electronic Disease Surveillance System (NEDSS)
• Disease-specific laboratory detection and epidemiologic investigation
• Respiratory diseases, including vaccine-preventable diseases
• Tickborne diseases(Lyme, Rocky Mountain spotted fever, tularemia )
• Mosquito-borne diseases (West Nile, dengue fever, chikungunya virus)
• Flea-borne diseases (plague)
• Parasitic diseases
• Prion diseases (a group of conditions that affect the nervous system in humans and animals)

Public Health Impact

As Americans are increasingly affected by infections emerging anywhere in the world, finding and stopping infectious disease health threats is essential to protecting public health and saving lives. Communities across the nation benefit from the actions taken by state, local, and territorial public health departments to detect, respond, prevent, and control known and emerging (or re-emerging) infectious diseases. Examples of other benefits:

• Preventing future outbreaks.
• Responding more quickly to occurrences of infectious diseases.
• Executing science-based prevention and control strategies leading to decreased infectious diseases deaths and illnesses.
• Improving health outcomes, health care quality, and health equity.

History of ELC

In 1995, the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement was established to distribute resources to domestic public health departments to strengthen the nation’s infectious disease infrastructure. In response to the Institute of Medicine’s landmark report, Emerging Infections: Microbial Threats to Health in the United States, CDC created ELC as a key component of its national prevention strategy. In ELC’s early years, the focus was on helping to build general infectious disease surveillance capacity.

As the program became more established, it expanded to include specific pathogens. In 2010, the program reached an important milestone with the passage of the Affordable Care Act that established the Prevention and Public Health Fund (PPHF). This provided the first mandatory funding dedicated to improving the nation’s public health system. The PPHF expanded national investment in prevention and public health programs to improve health and help restrain increasing private and public sector health care costs.

Since ELC’s inception, CDC’s national funding strategy has grown from assisting eight grantees with $2 million dollars to providing $90-300 million annually (2011 – 2017) to all 50 states, 8 U.S. territories, and 6 cities with the largest local health departments.