Developing a strategic plan for public health preparedness at CDC

The Centers for Disease Control and Prevention (CDC) plays a critical role in ensuring the public health system is cable of responding to public health events, including natural disasters, emerging infectious diseases, and chemical, biological, radiological, nuclear, and explosive events. Annually, CDC administers more than 600 million dollars for state, territorial, and local preparedness infrastructure and response through the Public Health Emergency Preparedness Cooperative Agreement. During the 2009-2010 H1N1 Response, CDC administered over 2 billion dollars in H1N1 response funding through Public Health Emergency Response grants. Within CDC, the preparedness and response budget supports more than 200 projects and activities across the agency. However, a number of factors, including a rapidly changing policy environment, have prevented the development of a unified strategic direction for CDC's preparedness efforts. To address this gap, during the winter of 2009-2010, a modified-Delphi approach was used to gather input from subject matter experts across the agency in five domains—1) health monitoring and surveillance; 2) epidemiology and other assessment sciences, 3) laboratory sciences and services; 4) response and recovery operations; and 5) public health systems support. Through a series of questionnaires and teleconferences, the experts developed objectives as well as associated sub-objectives, strategies, and activities and prioritized their outputs. This is presentation will describe these methods, the resulting strategic plan for CDC's preparedness work, and uses of the plan, including the allocation of CDC's discretionary preparedness dollars and the development of a model for measuring progress toward public health preparedness.