Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement
CDC’s national funding strategy continues to support state, local, and territorial health departments to battle infectious disease threats in the U.S.
The ultimate goal of the Epidemiology and Laboratory Capacity (ELC) Cooperative Agreement is to prevent and control the spread of infectious disease threats to reduce illness and deaths. ELC provides annual funding to domestic public health agencies to support capacity building and infectious disease program delivery. ELC’s current funding cycle (August 1, 2018 through July 31, 2019) is the final year of the current 5-year cooperative agreement.
In federal fiscal year 2018 (FY18), the ELC program awarded over $200 million to 64 domestic public health departments. This crucial investment has grown to become one of CDC’s key nationwide cooperative agreements that supports state and local capacity for:
- Building and maintaining effective public health workforce for rapid response to infectious disease outbreaks
- Strengthening national surveillance systems
- Modernizing public health laboratory capacity
- Improving health information systems to efficiently transmit, receive, and analyze infectious disease-related data electronically
What’s next?
CDC is approaching the launch of a new 5-year ELC Cooperative Agreement, which will begin August 1, 2019 and run through July 31, 2024. Addressing the growth and increasing complexity of the current funding instrument, the ELC took advantage of the opportunity to engage internal and external partners to make strategic improvements to the new 5-year ELC Cooperative Agreement.
Recipients
Recipients 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.
Recipient 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:
- Strengthen epidemiological capacity:
- Ensure health departments are well-equipped with staff, surveillance systems and other tools to identify, characterize, and provide rapid, effective, and flexible response to infectious disease threats.
- Develop, execute, and evaluate public health interventions to promote early detection methods that will facilitate the timely implementation of control measures and minimize transmission of infectious diseases.
- Support a variety of epidemiological activities.
- Enhance laboratory capacity:
- Develop modern and well-equipped public health laboratories, with well-trained staff, employing high quality laboratory processes and systems that foster communication and appropriate integration between laboratory and epidemiology functions.
- Support a variety of laboratory activities
- Improve health information systems:
- Develop and enhance health information systems infrastructure in public health agencies, including public health laboratories, focusing on standards-based electronic data exchange, information systems interoperability, and enhancing and sustaining integrated surveillance information systems.
- Enhance the electronic exchange of data between public health agencies and clinical care entities, focusing on electronic laboratory reporting (ELR) and electronic case reporting (eCR)
- Increase informatics/IT capacity in public health agencies through staff, contracts, and training.
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.