No abstract

The first Ebola cases in West Africa were reported by the Guinea Ministry of Health on March 23, 2014, and by June it became the largest recorded Ebola outbreak. Centers for Disease Control and Prevention field teams were deployed to West Africa, including in-country logistics staff who were critical for ensuring the movement of staff, equipment, and supplies to locations where public health knowledge and experience were applied to meet mission-related requirements. The logistics role was critical to creating the support for epidemiologists, medical doctors, laboratory staff, and health communicators involved in health promotion activities to successfully respond to the epidemic, both in the capital cities and in remote villages. Logistics personnel worked to procure equipment, such as portable video projectors, and have health promotion materials printed. Logistics staff also coordinated delivery of communication and health promotion materials to the embassy and provided assistance with distribution to various partners.

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

A critical component of successful public health emergency responses is the availability of appropriate numbers of personnel with emergency response expertise. To achieve this, the United States Centers for Disease Control and Prevention (CDC) focused on strengthening training, personnel database systems, and responder outreach. To ensure availability of well-trained public health emergency responders, CDC and external partners coordinated training, planning, exercise, and evaluation activities; established the School of Preparedness and Emergency Response; and implemented Responder Training Tiers for response roles with defined functional competencies. For personnel information, CDC developed interoperable databases to streamline the search for specific staff expertise for a response. To improve responder outreach, CDC developed various mechanisms to efficiently identify and assign potential responders to responses. These measures work together to sustain a qualified workforce for public health emergencies, and may be helpful to other public health agencies for staffing and training of their response workforce.