Timely and informed public health responses rely on accurate and accessible data no matter where in the world they occur. As the US Data Modernization Initiative (DMI) gets underway, APHL is also helping guide parallel efforts in several countries around the world.
The Global Public Health Data Innovation (GPHDI) project, supported by funding from the American Rescue Plan through the US Centers for Disease Control and Prevention’s (CDC’s) Global Health Center, aims to improve public health data collection, automation, integration and exchange to support global health decision making and outbreak responses. Over three years, the project will target 10 countries across four continents: Kenya, Sierra Leone, Uganda and Zambia in Africa; Colombia, Honduras and Paraguay in the Americas; Georgia and Ukraine in Europe; and Thailand in Asia.
APHL is a key laboratory partner in the initiative and brings a unique mix of domestic and global expertise to the project. “We can build on lessons learned from DMI and apply that experience to a global health context,” said Reshma Kakkar, MA, APHL’s informatics manager for the Global Health program.
The Global Health team is working closely with APHL’s domestic Informatics team, using the evolution of public health laboratory informatics in the United States over the last 20 years as a roadmap to chart possible paths for other countries, said Paul Jankauskas, MS, MPA, APHL informatics manager. “We can use our progress here as a potential model to help other countries determine where they are now, where they want to be and what types of solutions might they want or be able to implement to get there.”
First-year efforts are underway in Kenya, Zambia, Georgia and Thailand. APHL has been able to spend time on the ground in all four countries, building on existing relationships and working with in-country staff to understand each country’s needs and challenges and to determine where APHL can best assist.
Because innovation is a focus of the initiative, the team is exploring new ways to span traditionally siloed systems, disease-specific efforts, and even international borders with the goal of building stronger regional public health networks. “One of the areas that I’m really excited about is a new cross-country approach,” Kakkar said. “Somewhat like the technical assistance teams APHL has created in the US, we’re creating thematic teams—focused on data integration or visualization, for example—comprising people in different countries but all working together to solve a common problem.”
Empowering people to think about problems and solutions in a multi-country context has been both challenging and rewarding, she said. They are also helping establish in-country leadership for local projects.
“A lot of the capacity and skills are already in place in these countries,” Kakkar said. “It’s a privilege for APHL to be able to work with the local staff and give just that extra support to enable them to move forward.”
At the same time, APHL’s Food Safety team is bolstering global data collection for antimicrobial resistance surveillance using next-generation sequencing technologies on enteric bacteria isolates through PulseNet International. With CDC support, the team is working to stand up PulseNet Asia Pacific in Thailand, Malaysia, the Philippines, Taiwan and New Zealand.
A feasibility pilot study is training staff in the five countries to use whole-genome sequencing protocols and a bioinformatics platform to analyze bacterial isolates for antimicrobial resistance circulating in the region.
“Right now, we don’t really have good systematic approaches for surveillance,” said Kristy Kubota, APHL’s PulseNet manager. By engaging the food, animal and clinical sectors, “we are working toward getting international laboratories to use a One Health approach to fight antimicrobial resistance in a public health-focused way.”