UCSF has been awarded a five-year cooperative agreement from the Centers for Disease Control and Prevention as one of the nation’s 10 regional centers for Public Health Preparedness and Response (PHPR), an effort to ensure the country is ready to meet any future health threats, from pandemics to extreme weather events.
Public health emergencies such as COVID-19, hurricanes and extreme heat have underscored the critical need for a more robust and resilient U.S. public health system, the CDC said.
UCSF was awarded the cooperative agreement to serve as the lead institution for the newly established Region 9 Pacific Southwest Center for Emergency Public Health, which covers California, Arizona, Nevada, Hawaii, and U.S.-affiliated Pacific islands (USAPI). The USAPI include American Samoa, the Commonwealth of the Northern Marianas, the Federated State of Micronesia, Guam, the Republic of the Marshall Islands and the Republic of Palau.
“The Regional Centers will play a vital role in advancing the development and implementation of evidence-based strategies and interventions across communities, enhancing their ability to prepare for and respond to public health threats,” Lisa C. Barrios, DrPH, director of the Division of Readiness and Response Science at the CDC, said in a letter announcing the cooperative agreements.
Other institutions named as regional centers include Harvard University, Columbia University, Johns Hopkins University, Tulane University, and the Universities of Minnesota, Nebraska, North Carolina, Utah and Washington.
In addition, UCSF was one of four universities—along with Columbia, Utah and Washington—to receive specific support to work with tribal, rural and frontier communities. UCSF will focus on mitigating disparities in resources and risks in the USAPI.
George Rutherford, MD, MA, director of the Center for Global Strategic Information and Public Health Practice at UCSF’s Institute for Global Health Sciences, will serve as principal investigator of the new regional center. Karen Horn MBA, MPH, will serve as the center’s program director.
UCSF will receive about $1 million for the first year of the grant. UCSF will distribute that money to other partners across the region, including the Public Health Institute, UCLA, the University of Nevada, Reno, the University of Hawaii, Manoa and other tribal and USAPI partners.
An Emerging Discipline
After the terrorist attacks of Sept. 11, 2001, Horn said, the CDC started thinking about what it means for public health professionals to be prepared for a disaster.
“Public health emergency preparedness and response is a relatively new discipline,” Horn said. As such, she said, “there are not that many evidence-based strategies and interventions to bring to bear.”
Events from the COVID-19 pandemic to the thermometer topping 100 degrees for more than 100 consecutive days in Phoenix this summer have stressed the importance of developing, implementing and evaluating public health strategies.
UCSF spent a year working with the Public Health Institute and UCLA planning for the center. Its mandate includes three focus areas:
- Capacity. The region needs its workforce to be able to handle short-term and long-term needs when a public health emergency strikes, Horn said. It will need the ability to effectively activate a surge workforce in a moment of crisis, but also a resilience, as underscored by the fatigue that afflicted health workers after months of treating patients with COVID-19.
- Coordination and communication. UCSF is looking to build what Horn called “communities of practice”. One idea is to host tribal emergency preparedness and response personnel around the topic of climate and health. The regional center plans to work with tribal partners to develop and disseminate promising practices in addressing heat emergencies in tribal regions.
- Risk communications. Agencies need to combat “mis- and disinformation,” Horn said. “We need to increase the uptake of public health guidance through improving trust with public health and do this through helping public health officials directly address mis-and disinformation and also find trusted community partners to work with to get the messaging across.”
A Broad Coalition
The Regional Center will work with a wide variety of people and institutions to identify and disseminate effective strategies to further the cause of emergency public health, including governmental agencies, academic institutions, hospitals, primary care associations and nonprofit agencies.
Strategies for public health emergencies have evolved over the years. For the most part, the field rested on the shoulders of police and fire departments, emergency medical technicians, and offices of emergency services. Some academic centers have studied the issue. Events from the AIDS epidemic to the 1989 San Francisco earthquake showed the importance of preparedness and coordination.
But, Horn said, “COVID demonstrated that we needed to get more organized.”
With the cooperative agreements, the CDC is focusing on developing the evidence base around public health preparedness and response interventions.
Climate change is adding another layer to the need. “A lot of these disasters come out of climate change,” Horn said. “The heat emergencies, the hurricanes, the fires, the rising sea level on the islands—climate change is a huge driver of these public health disasters.”