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Environmental Factor, November 2012

HHS workshop aims to speed up public health emergency response

By Cindy Loose

Nicole Lurie, M.D., assistant secretary for Preparedness and Response at the U.S. Department of Health and Human Services (HHS)

HHS created Lurie’s office in the aftermath of Hurricane Katrina. (Photo by Chris Smith courtesy of HHS)

NIEHS Senior Medical Advisor Aubrey Miller, M.D.

“This energy, coming in at a very high level, is very important to making needed progress,” Miller said of the meeting. (Photo courtesy of Steve McCaw)

Experts from NIEHS and nearly two dozen other federal agencies gathered Sept. 25 on the NIH campus in Bethesda, Md., to carry out a critical mission — to identify ways that research scientists can be deployed immediately in response to terrorist acts, natural disasters, accidents, and pandemics.

“We are not currently organized to do science in the moment,” said Nicole Lurie, M.D., (http://www.hhs.gov/open/contacts/aspr.html)  assistant secretary for Preparedness and Response at the U.S. Department of Health and Human Services (HHS), which sponsored the workshop, “Scientific Preparedness and Response for Public Health Emergencies.” When a national disaster occurs, she explained, protocols are in place to send first responders rushing to the scene. Research scientists, however, too often must await approvals of data collection protocols, reviews of proposed studies, and funding, before rushing out the door to do critical work.

“The overriding question is, ‘What can we put in place to speed up the response, so that we save as many lives as we can?’” Lurie asked. 

 

Getting scientists to work during emergency response

More than 70 experts from federal agencies, as diverse as HHS and the Government Accounting Office, the U.S. Department of Defense, and the Office of Management and Budget, came together to identify the best means of accomplishing that goal. Participants also included representatives from NIH, as well as 10 NIH institutes and centers (see text box).

“All the right people were in one place focusing on how to further scientific preparedness,” said NIEHS Senior Medical Advisor Aubrey Miller, M.D., who along with NIEHS Worker Education Training Program (WETP) Director Chip Hughes and program analyst Jim Remington, helped organize the conference.

Keynote speaker Harvey Fineberg, M.D., Ph.D., warned, “Catastrophes we know are coming.” He also quoted former President Dwight Eisenhower, saying, “Plans are useless, but planning is essential.” Fineberg, who is president of the Institute of Medicine, argued that, although research during a disaster is challenging, it is as essential as pre-disaster and post-disaster research.

“This is a very exciting time — we are tasked to make a difference,” said speaker Lewis Rubinson, M.D., Ph.D., deputy chief medical officer of the National Disaster Medical System. “Novel collaborations,” he added, “are required.”

“Science during crisis is difficult, but can be done,” said Gary Machlis, Ph.D., science advisor to the director of the U.S. National Park Service. He cited classic examples, including the development of radar during the Battle of Britain, the Manhattan Project in the midst of World War II, and the safe return of Apollo 13 after an explosion crippled the service module.

Areas of concern

In a series of six individual breakout sessions, participants focused on specific areas of concern and then summarized their ideas in a final forum.

Participants from one workshop suggested leveraging existing networks to create a roster of experts to be called upon for various contingencies. Addressing a recurrent theme about the nagging delays involved in getting independent reviews and approvals of research projects during an emergency, another panel suggested the development of a centralized independent human subject review panel at NIH.

Finding quicker funding mechanisms was also considered. Chip Hughes, who led two of the sessions, noted that this meeting dovetails nicely with new NIEHS strategic goals to promote involvement of staff and grantees in the underlying science of emergency responses and emerging threats. A summary of all the recommendations from the workshop are expected to be finished in coming months.

NIEHS continues to be very involved in emergency response efforts through WETP, which has supported the responses to the 2001 World Trade Center attack and the 2010 Gulf oil spill. WETP has trained more than two million workers, nationwide, in emergency response and handling of hazardous materials. Additionally, NIH is involved in important national programs to develop new and improved medical countermeasures designed to prevent, diagnose, and treat biological, chemical, and radiological agents that can pose a public threat, such as anthrax (see text box).

(Cindy Loose is a contract writer with the NIEHS office in Bethesda, Md.)


The NIH presence

Besides hosting the workshop, NIH representatives from NIEHS and nine other NIH institutes and centers (ICs) participated in the discussions.

  • National Human Genome Research Institute
  • National Center for Advancing Translational Sciences
  • Center for Information Technology
  • National Institute of Diabetes and Digestive and Kidney Diseases
  • National Institute of Neurological Disorders and Stroke (NINDS)
  • National Heart, Lung, and Blood Institute
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
  • National Library of Medicine (NLM)
  • National Institute of Mental Health

In addition to programs at NIEHS, NINDS, (http://www.ninds.nih.gov/research/counterterrorism/counterACT_home.htm)  NICHD, and NLM, (http://www.nlm.nih.gov/medlineplus/biodefenseandbioterrorism.html)  programs for developing countermeasures are in place at other ICs, including the National Institute of Allergy and Infectious Diseases, (http://www.niaid.nih.gov/topics/biodefenserelated/Pages/default.aspx)  National Cancer Institute, National Eye Institute, National Institute of Arthritis and Musculoskeletal and Skin Diseases, and National Institute of General Medical Sciences.



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