Global Health Partnerships

The scope and intensity of global health challenges ensures that no single country or agency can work alone to meet them. To contribute to shared global health objectives, CDC works in close partnership with a wide array of international agencies and institutions to shape global health policies and to fund, implement, and evaluate programs. CDC's partnerships with international and multinational organizations include the World Health Organization and its regional offices, other United Nations agencies (such as UNICEF) and affiliated agencies (such as the United Nations Foundation), the World Bank, other federal agencies within the U.S. Government, private foundations, universities, and global health organizations. Each is described briefly below.

Like others involved in these efforts, CDC staff hope to improve public health outcomes by providing technical expertise and learning new methods to improve the constantly evolving practice of public health. Another important aspect of sharing global health knowledge is the standardization of data collected– critical to the ongoing challenge of detecting and comparing trends around the world. CDC representatives also participate in policy discussions that explore the many options for devoting scarce resources to long-standing as well as emerging public health crises. These discussions offer opportunities for bringing U.S. perspectives to multilateral settings, along with the equally important goal of bringing the perspectives and insights of other countries and partners to the United States.

CDC's global health partners include the following:

• The World Health Organization (WHO) is the leading United Nations (UN) institution charged with determining global health policy. CDC contributes to WHO's efforts through the secondment of CDC staff to strategic posts within the WHO structure, with special attention to the WHO Regional Offices (e.g. PAHO, AFRO), and through grants to support specific programs of global importance, such as polio eradication and surveillance for emerging diseases. In addition, a number of WHO Collaborative Centers are based within CDC, sharing staff, research initiatives, and publications for use by the global health community. (See Appendix C for a list of WHO Collaborating Centers at CDC.)
  
  
• The World Bank is the leading institution for investments in health and development and thus plays a critical role in shaping global health policy. Other regional development banks may provide new opportunities to address specific global health issues in the future. CDC has had assignees at the Bank since 1997.
  
  
• The United Nations Foundation (UNF), with an annual endowment of $100 million, provides financial support to United Nations agencies for projects in the areas of child health, population, women's health, and the environment. CDC collaborates on policy and technical issues, helping to shape the UNF's health agenda in the developing world. (A CDC staff member is assigned to UNF.)
  
  
• UNICEF, a key partner in child health initiatives, has been a particularly critical ally in CDC's global immunization activities. As the final phase of the global campaign against polio approaches, UNICEF collaboration will continue to be a critical element as CDC and its partners achieve the goal of eradication.
  
  
• Within the U.S. government, the United States Agency for International Development (USAID) has had a longstanding relationship with CDC to support common global health objectives. The Department of Health and Human Services' Office of Global Health Affairs coordinates global health policy for the Department, providing opportunities to CDC, as well as relying on its technical resources. Several CDC staff members are assigned to USAID to work on these collaborative initiatives. The Fogarty International Center at the National Institutes of Health (NIH) serves as the locus for inter-agency collaborations in global health. The U.S. Department of State (DOS) is a crucial partner in carrying out CDC's overseas programs and activities. DOS is responsible for assuring that all U.S. Government overseas programs and activities are consistent with the overall goals and objectives of U.S. foreign policy. Through its embassies and diplomatic corps around the world, the Department offers protection and support for agency personnel on long- and short-term assignments.
  
  
• In the private sector, several U.S. foundations demonstrate an interest in global health issues and projects by supporting programming in areas important to CDC. For example, the Rockefeller Foundation has actively supported the development of “Public Health Schools Without Walls,” which in turn work closely with CDC's Field Epidemiology Training Programs (FETPs). The Bill and Melinda Gates Foundation recently has given high priority to its global health programs. Its areas of emphasis, including vaccine delivery, maternal mortality reduction, malaria, and TB are aligned with CDC's interests, leading to many collaborative efforts. Rotary International supports the efforts of CDC and other global partners to add polio to the list of diseases eradicated from the world - a goal that is within reach.
  
  
• Many U.S.-based international non-governmental organizations (NGOs) are actively engaged in international health projects. The relief agency CARE, for example, participates in a joint CARE-CDC Health Initiative (CCHI), which makes best use of CDC's technical and scientific expertise and CARE's on-the-ground capabilities to address critical health issues in countries around the world. The eradication of Guinea worm and the prevention of river blindness throughout the world tops the Atlanta-based Carter Center's list of global health concerns. Through The Carter Center's efforts, community-based intervention programs primarily in Africa have greatly reduced the burden of these diseases among some of the world's poorest people. Combining forces with the CDC, WHO, UNICEF, and others, The Carter Center helps make the idea of public-private partnership in global health a reality.

Like the country-specific activities described throughout this report, CDC's collaborative work with international and multilateral agencies supports the agency's five strategic global health goals:

Public Health Surveillance and Response

One of the important functions of surveillance systems is the ability to detect emerging health threats, ideally before they have spread. In a world compressed by the rapid movement of goods and people, a strong network of global surveillance systems offers the best chance of early warning and thus early response.

CDC and its global health partners have consistently invested in the development and upgrading of surveillance systems around the world. Strong individual systems are important, but so is comparability and consistency across systems. The International Collaborative Effort (ICE) on Automating Mortality Statistics, initiated by CDC's National Center for Health Statistics (NCHS), is one example of a global standardization effort. Working with USAID, WHO, and representatives from 26 countries, NCHS staff have helped improve the international comparability of mortality statistics by developing standards for automation. Because of this effort, data can be collected, analyzed, and compared in consistent – and thus more useful – ways.

The Integrated Disease Surveillance (IDS) project is another example of a collaborative project seeking greater standardization across surveillance systems. Supported by CDC's Epidemiology Program Office (EPO) and National Center for Infectious Diseases (NCID), along with WHO-AFRO, USAID, and the UN Foundation, the IDS project is designed to improve infectious disease surveillance, epidemic preparedeness, and response in 46 African countries. A similar project, coordinated by CDC's National Center for HIV, STD, and TB Prevention (NCHSTP) with support from USAID, UNAIDS, and WHO, led to the development of a series of monographs on specific aspects of HIV biological surveillance in developing countries.

CDC's National Center for Injury Prevention and Control (NCIPC) has participated in the International Classification of External Causes of Injury, a classification scheme that will help standardize international injury surveillance. At the request of WHO, the Center's staff have developed a manual on injury surveillance in less-resourced environments that will allow countries with minimal staff and material resources to collect comparable injury data, especially data on violent injury.

Public Health Infrastructure and Capacity-Building

CDC is an active participant in public health training programs around the world, contributing faculty, curricula, and specific techniques and tools – such as EpiInfo software – that strengthen public health capacity at all levels. One of many examples is TEPHINET – Training Programs in Epidemiology and Public Health Interventions NETworks. TEPHINET was created with support from WHO, CDC, and the Fondation Merieux. The program is designed to initiate and link a network of field-based training programs that emphasize epidemiology and public health interventions. CDC's National Institute for Occupational Safety and Health (NIOSH) supports training of researchers around the world in disciplines key to occupational safety and health, such as epidemiology, occupational medicine, industrial hygiene, safety engineering, and toxicology.

Training is a critical tool for enhancing public health capacity, but in order to be deployed effectively, training must respond to specific and measurable needs or performance gaps. Developing a tool to assess public health performance in international settings has been an ongoing effort of CDC's Public Health Practice Program Office (PHPPO). Working with PAHO through its “Public Health in the Americas” initiative, PHPPO staff have helped design an instrument that measures the degree to which essential public health services are provided throughout the Americas. This tool will provide each country with a guide for developing and investing in optimal public health practice standards.

Disease and Injury Prevention and Control

Eliminating or eradicating a disease from the face of the earth is one of the most compelling of public health achievements, averting not only needless suffering and death but also the enormous expense of continuing prevention and treatment programs. Today, polio and measles seem destined to follow smallpox into this roster of public health achievements. The CDC's National Immunization Program (NIP) has been a partner alongside WHO, PAHO, UNICEF, and Rotary International in the global efforts to eradicate polio and accelerate measles elimination and control. NIP staff provide epidemiologic, programmatic, and operational technical assistance to measles- and polio-endemic countries. CDC also contributes research on injection safety technology, laboratory assistance, training of thousands of health care workers, and short-term technical consultations from its epidemiologists, virologists, and managers. CDC's National Center for Infectious Diseases (NCID) contributes to The Carter Center's lead effort to eradicate Guinea worm disease by serving as a source of technical and scientific assistance.

Applied Research for Effective Health Policies

Partnerships among multilateral and global health agencies often help launch and sustain research projects by pooling funding and drawing needed technical and other resources to a particular initiative. Examples include a collaboration between CDC and UNICEF to develop a case control study that will help identify risk factors for arsenicosis. Arsenic contamination of ground water is a serious problem in many countries, and the study results will help scientists around the world use laboratory and epidemiologic methods to identify high-risk groups and intervene.

Multinational organizations also serve as a forum for disseminating research findings quickly to public health organizations around the world. For example, CDC's National Center for Infectious Diseases collected and analyzed pneumococcal vaccine evaluation data from a multi-laboratory study. The study results led to guidelines designed to assist regulatory agencies in evaluating a laboratory's ability to measure antibody concentrations, which were later disseminated by WHO.

Exchange of Information and Lessons Learned

Through conferences, meetings, and published reports and guidelines, global health agencies play a critical role in the exchange of public health information and of lessons learned. These communications not only ensure the efficient spread of useful strategies and data, but also foster the personal and institutional links that lead to collaboration and cooperation on global initiatives.

Beyond disseminating information, an important role for multinational coalitions is the setting and endorsement of accurate information and standards. NIOSH staff have contributed to many such efforts, including participation in WHO's International Programme for Chemical Safety (IPCS) – a project involving 14 other institutions from 10 countries. A specific initiative involved developing chemical assessment documents known as International Chemical Safety Cards (ICSC). The cards communicate highly technical hazard data by translating material safety data sheets into concise, accurate, and accessible information for workers and managers in both small and large businesses. Over 1,250 cards have been developed on chemicals found in different workplaces; these have been translated into more than 20 languages and are available on NIOSH's web site.

A prime example of concerted action against a global health threat is the ongoing joint effort for tobacco control, which brings together CDC, WHO, the American Cancer Society, other U.S. federal agencies, and the World Bank – among others. Through meetings, conferences, and published reports, CDC and its partners have been able to present a united front and support science-based policy positions on economic issues, treaties (such as the WHO-sponsored Framework Convention for Tobacco Control), environmental tobacco smoke (ETS), mass media campaigns, and regulatory initiatives.

Top of page | Back | Home | Contact Us

Accessibility | Privacy Policy

CDC Home | Search | Health Topics A-Z

This page last reviewed April 15, 2003

Centers for Disease Control and Prevention
The Office of Global Health