The University of Nebraska Medical Center is transforming and centralizing infectious disease response and biodefense research with the creation of the Global Center for Health Security.
Such efforts are part of the brave new world of public health which, for years, has been plagued with concerns of viral outbreaks, infectious diseases and, in an environment increasingly stressed by the possibility of terrorism, a biological attack.
“It gives UNMC and Nebraska Medicine a centralized structure that allows us to integrate several health initiatives,” Dr. Chris Kratochvil, vice chancellor for clinical research for UNMC, said in an interview with Homeland Preparedness News. “Over the past several years, we’ve been focused on developing resources in the health security domain.”
In 2016 alone, the university received a $19.8 million award from the U.S. Department of Health and Human Services to develop a training and simulation center while also opening a monitoring facility for those exposed to infectious diseases. That center is scheduled to come online in December 2018.
Meanwhile, the university has focused on a mix of basic research, clinical research and clinical care. At the same time, scientists have been developing new products, diagnostics, surveillance and disease response preparations. They are also beginning to develop international training programs to establish a network focused on training and education for disease response and laboratory observation of pathogens, according to John Lowe, assistant vice chancellor for interprofessional health security training and education for UNMC.
“We’ve gotten to a point where we’re at a critical mass of initiatives,” Kratochvil said. “We have a biocontainment unit. We have the national strategic research institute — that’s a university affiliated research center. We’re associated with United States Strategic Command. All of this is playing a big part in the center we’re developing. By bringing them together, we realized we could be much more efficient and effective.”
The UNMC has been working for years to develop the nation’s biodefense infrastructure and response capabilities, but at a certain point, with a myriad of hospitals, government agencies and academic interests involved, the process can become weighted down in bureaucracy. That, in turn, could mean slower response times at a moment when response is critical.
The Global Center for Health Security seeks to change that. The council in charge of managing it will be Lowe, Kratochvil and Ken Bayles, associate vice chancellor for basic research.
The new center has formed a partnership with Emory University and the New York City Health and Hospitals Corp. to establish a network aimed at advancing emergency medical trials.
“One of the major hurdles in the Ebola outbreak was the requirements just to get a clinical trial in place,” Lowe said. “They were time consuming. While that works for typical drug development, we’re doing the work now to put in place a national clinical trials network to address this.”
Under the new umbrella, all of these efforts will be focused on emerging pathogens, such as Ebola, MERS, the SARs virus or influenza epidemics, as well as medical issues which compound them.
One highlight of the center is a national quarantine unit, complete with the only national training center to utilize virtual reality and advanced clinical simulation to train health care providers, first responders and government employees deployed in an outbreak.
“We will do training of federal employees for management of highly infectious diseases in a biocontainment setting,” Kratochvil said. “We will also be providing a physical quarantine space for the federal government with a 20-bed containment unit that will be operational in two years. We will continue doing training for universities and hospital systems throughout the U.S., developing the infrastructure and capabilities nationally, including development of a network of the 10 regional centers to explore experimental options quickly.”
While the process for the center gets underway, however, UNMC’s experts agree that the nation is, at least, in better shape for responding to outbreaks than it was as recently as three years ago.
“We are greatly more prepared than we were in 2014,” Lowe told Homeland Preparedness News. “We learned a lot from the two cases of Ebola that presented in the U.S. in New York and Dallas. Through our work trying to train workers, we’re still seeing gaps exist — but the level of readiness has vastly improved. There are hospitals that are prepared, but our capacity as a nation still needs to increase.”
Cooperation on the ground is one thing, of course – but continued funding is another.
Funding Crisis?
As Congress continues to hammer out the details of the upcoming budget for the government, the public security of the United States is in the balance. Already, the White House has signalled a shift from biological threat preparedness as a funding priority, including the proposed closure of the Department of Homeland Security’s National Biodefense Analysis and Countermeasures Center.
While such things don’t immediately affect the Global Center for Health Security and UNMC’s operations, they do raise a series of concerns for future preparedness.
“Any cuts to biodefense or health security programs, initiatives, research stand to undermine … the advances that have been made in preparedness domestically,” Lowe said. “They still haven’t reached the point where the country as a whole is ready, and cuts would impact the speed of progress we’ve seen since 2014,” he added.
“All of those facilities that have made huge strides are simultaneously concerned in a health care market where cost and profits are already an issue,” Lowe said. “If federal support for preparedness shrinks, we may see efforts stopped. In others, it may just slow the pace.”