By Tracy Whittington
On Aug. 1, 2018, when the Democratic Republic of Congo (DRC) confirmed its 10th Ebola outbreak since 1976, the Office of International Health and Biodefense (IHB) closely collaborated with the Bureau of African Affairs to lead the Department of State’s response efforts in Washington. IHB is a part of the Science Directorate in the Bureau of Oceans and International Environmental and Science Affairs and staffed with health, science, and policy experts. It coordinated with the interagency to drive policy decisions around U.S. government investment—more than $569 million in humanitarian assistance in DRC and neighboring countries—in vaccine supply, deployment of U.S. experts, and resource mobilization. IHB also coordinated across the Department to address the challenges of placing subject matter experts and delivering vaccines and therapeutics in an active conflict zone.
IHB was established as a general health office in 2000, then its mission shifted in response to numerous events, such as the creation of the President’s Emergency Plan for AIDS Relief and the 2001 anthrax attacks. It then became the primary Department office responsible for infectious disease policy and outbreak response. In this capacity, IHB leads policy discussions across the Department, the interagency, and multilateral organizations; coordinates international and trans-border activities related to infectious diseases in support of U.S. citizens and missions overseas; and provides core staffing for outbreak monitoring and health crisis management within the Department. Additionally, IHB provides information and recommendations for Department leadership, congressional briefings, and the National Security Council. IHB is uniquely positioned to manage a holistic Department response effort touching on multiple policy and operational areas.
Outbreaks are typically complex events requiring multiple lines of effort. Rare occasions lead to the formation of a Department task force or coordination unit, such as with the novel coronavirus (COVID-19). The creation of the Coronavirus Global Response Coordination Unit has allowed IHB to focus on key components of the Department’s health diplomacy efforts to help end the outbreak. Among these is IHB’s work to identify multi-sectoral funding mechanisms for the response, coordinating messaging to international partners, supporting strengthened health systems in partner countries, and facilitating timely, reciprocal information-sharing across the interagency in support of ongoing multilateral discussions, including during the G7 and G20 summits.
IHB also closely collaborates with international and non-governmental stakeholders to ensure that American researchers and innovators have access to the information, tools, and samples (both clinical and pathogen) needed to spur COVID-19 research and development efforts. While responding to this global pandemic, the office also helps ensure continued U.S. access to influenza virus samples, which are fundamental to developing vaccines to protect our national security and lays the groundwork for further information exchange needed to combat future global health security threats.
One of IHB’s most important roles during the COVID-19 outbreak has been working closely with the interagency and Department colleagues, both in Washington, and across the world, to ensure Americans have access to essential medical supplies. In partnership with the Bureau of Economic and Business Affairs, IHB has led initiatives to develop a global export restrictions tracker and to identify opportunities abroad for increased U.S. purchases of personal protective equipment (PPE) and other needed supplies—both of which assisted the Federal Emergency Management Agency in procurements for the domestic response. As of May 9, 124 flights to the United States had delivered COVID-19 diagnostic kits, PPE (including more than 54 million N95 masks and 1 billion gloves), and additional medical supplies from China, Malaysia, Vietnam, and other countries.
IHB doesn’t just respond to outbreaks, however. Having been a lead drafter for the United States Global Health Security Strategy, IHB helps set the overall international posture on global health security. Since 2014, it has also been the leading office for the Department in advancing the United States’ goals for the Global Health Security Agenda (GHSA), which envisions a world safe and secure from global health threats posed by infectious diseases. IHB coordinates interagency implementation of America’s country-level GHSA investments overseas, which among other areas help strengthen technical capacity in disease surveillance, laboratories, emergency management, biosafety and biosecurity, risk communication, and workforce development. In the past five years, the U.S. government has invested more than $1 billion in GHSA partner countries, and this work has led to life-saving outcomes. The infrastructure, networks, and capacity frameworks built with these efforts are now enabling these nations to prepare for and respond to the COVID-19 pandemic in a more responsible manner.
Though IHB’s work is often focused overseas, some of the best public health expertise resides in cities and towns across America. IHB leverages a variety of the Department’s international exchange programs to bring foreign global health security experts to the United States where they meet with representatives from state, local, and tribal governments, as well as academia, NGOs, and the private sector. Exchanges have focused on an array of pressing issues: stopping mosquito-borne diseases (such as dengue and Zika); integrating human, animal, and environmental health data sets to corral zoonotic diseases (such as Ebola and COVID-19); and enhancing action to manage the rise of drug-resistant bacteria that threaten lives and basic health care delivery.
In the wake of the current pandemic, IHB has been a lead for identifying priorities for the joint Department of State/USAID COVID-19 strategy requested by Congress, as well as for the U.S. government’s Action Plan to Support the International Response to COVID-19. As the nation and the world move forward, the office will promote reforms to the international health system and efforts to address the second-order impacts of both the outbreak and foreign governments’ responses to it. Working in unison, IHB’s pandemic response and global health security teams will continue helping to ensure partners recover from the challenges of COVID-19 and will be better prepared for future health threats.
Tracy Whittington is the public diplomacy officer at the Office of International Health and Biodefense.