ABSTRACT
Policy Points The critical task of preparedness is inseparable from the regular work of advancing population health and health equity.
Subject(s)
COVID-19 , Civil Defense , Humans , Public HealthABSTRACT
Early detection and ongoing monitoring of infectious diseases depends on diagnostic testing. The US has a large, diverse system of public, academic, and private laboratories that develop new diagnostic tests; perform routine testing; and conduct specialized reference testing, such as genomic sequencing. These laboratories operate under a complex mix of laws and regulations at the federal, state, and local levels. The COVID-19 pandemic exposed major weaknesses in the nation's laboratory system, some of which were seen again during the global mpox outbreak in 2022. In this article we review how the US laboratory system has been designed to detect and monitor emerging infections, describe what gaps were revealed during COVID-19, and propose specific steps that policy makers can take both to strengthen the current system and to prepare the US for the next pandemic.
Subject(s)
Communicable Diseases, Emerging , Pandemics , Humans , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , COVID-19 , Laboratories , Pandemics/prevention & control , PolicyABSTRACT
The U.S. has the tools to end the HIV epidemic, but progress has stagnated. A major gap in U.S. efforts to address HIV is the under-utilization of medications that can virtually eliminate acquisition of the virus, known as pre-exposure prophylaxis (PrEP). This document proposes a financing and delivery system to unlock broad access to PrEP for those most vulnerable to HIV acquisition and bring an end to the HIV epidemic.
Subject(s)
Epidemics , HIV Infections , Pre-Exposure Prophylaxis , HIV Infections/epidemiology , HIV Infections/prevention & control , HumansABSTRACT
This special edition of JLME centers on a novel proposal for a national PrEP access program with the potential to break through a failed status quo.
Subject(s)
HIV Infections , Pre-Exposure Prophylaxis , HIV Infections/prevention & control , HumansSubject(s)
COVID-19 , Papillomavirus Vaccines , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Humans , VaccinationABSTRACT
Data sharing among regulators must be "business as usual".
Subject(s)
Global Health , Information Dissemination , United States Food and Drug Administration , United StatesABSTRACT
The complexity and inefficiency of the U.S. health care system complicates the distribution of life-saving medical technologies. When the public health is at stake, however, there are alternatives. The proposal for a national PrEP program published in this issue of the Journal applies some of the lessons of the national COVID vaccine campaign to HIV prevention. In doing so, it draws on other examples of public health approaches to the financing of medical technology, from vaccines for children to hepatitis C treatment.
Subject(s)
COVID-19 , HIV Infections , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Child , HIV Infections/prevention & control , Humans , Pharmaceutical PreparationsSubject(s)
Public Health Administration , Public Health Practice , United States Public Health Service/organization & administration , Accreditation , Federal Government , Health Policy , Health Workforce/statistics & numerical data , Local Government , Public Health Administration/standards , State Government , United StatesABSTRACT
Since the first case of COVID-19 was identified in the USA in January, 2020, over 46 million people in the country have tested positive for SARS-CoV-2 infection. Several COVID-19 vaccines have received emergency use authorisations from the US Food and Drug Administration, with the Pfizer-BioNTech vaccine receiving full approval on Aug 23, 2021. When paired with masking, physical distancing, and ventilation, COVID-19 vaccines are the best intervention to sustainably control the pandemic. However, surveys have consistently found that a sizeable minority of US residents do not plan to get a COVID-19 vaccine. The most severe consequence of an inadequate uptake of COVID-19 vaccines has been sustained community transmission (including of the delta [B.1.617.2] variant, a surge of which began in July, 2021). Exacerbating the direct impact of the virus, a low uptake of COVID-19 vaccines will prolong the social and economic repercussions of the pandemic on families and communities, especially low-income and minority ethnic groups, into 2022, or even longer. The scale and challenges of the COVID-19 vaccination campaign are unprecedented. Therefore, through a series of recommendations, we present a coordinated, evidence-based education, communication, and behavioural intervention strategy that is likely to improve the success of COVID-19 vaccine programmes across the USA.