Epidemiology and Laboratory Capacity for Infectious Diseases
The Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement was initiated in 1995. It was one of the first key activities under CDC's infectious disease strategy developed in response to the Institute of Medicine's landmark report, Emerging Infections: Microbial Threats to Health in the United States. The goal of the ELC Cooperative Agreement is to protect the public health and safety of the American people. It does this by enhancing the capacity of state, local, and territorial health departments to effectively detect, respond, prevent, and control known and emerging (or re-emerging) infectious diseases.
ELC provides state, local, and territorial health department grantees with the financial and technical resources to strengthen essential epidemiologic, laboratory, and health information systems to detect, prevent, and control infectious diseases. This enhanced capacity leads to better e.g., quicker, more targeted) disease outbreak response and improved development, implementation and evaluation of public health interventions that protect the public health and safety of the American people.
ELC's ultimate beneficiary is the American public. They benefit from the actions that state, local, and territorial grantees take in using ELC resources to prevent and control infectious disease outbreaks.
State, local, and territorial health departments are the direct target of ELC. There are currently 64 grantees, including all 50 state health departments, the six largest local health departments (Chicago, the District of Columbia, Houston, Los Angeles County, New York City, and Philadelphia), and eight territories or U.S. affiliates (American Samoa, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Puerto Rico, the Republic of Palau and U.S. Virgin Islands).
Public Health Impact
ELC benefits public health departments by:
- Enhancing the nation's capacity to respond to complex infectious disease threats in the United States through the following:
- Strengthening epidemiology capacity.
- Enhancing laboratory capacity.
- Improving health information systems.
- Enhancing collaboration.
- Developing, implementing, and evaluating public health interventions.
- Providing a platform for networks to be created and managed on a variety of infectious disease issues (e.g., FoodNet, CaliciNet, PulseNet, ArboNet) to ensure prompt identification of emerging infectious diseases.
- Better integration of epidemiology, laboratory, and health information systems.
- Promoting early detection methods that will facilitate the timely implementation of control measures and minimize transmission of infectious diseases.
The ELC Cooperative Agreement provides funding for general, flexible, and cross-cutting epidemiology, laboratory, and health information systems support for state, local, and territorial public health entities. ELC funding also allows specific CDC infectious diseases programs to invest in capacity development in their subject matter areas of pathogen-specific laboratory detection and epidemiologic investigation. This approach helps target resources for capacity building toward infectious diseases and other public health threats of current relevance and importance to CDC.
The focus of the state, local, and territorial activities is primarily on naturally occurring infectious diseases, drug-resistant infections, and health information systems capacity. There are two primary classes of ELC activities: (1) categorical (disease-specific) activities where various CDC programs provide funding and technical resources for specific activities, and (2) flexible activities where grantees use funds to address remaining high-priority needs and respond to unexpected infectious disease issues.
- National Electronic Disease Surveillance System
- Foodborne diseases
- Antimicrobial resistance and healthcare-associated infections
- Vectorborne diseases
- Parasitic diseases
- Respiratory diseases, including vaccine preventable diseases
- Prion disease
- Border infectious diseases surveillance
- Capacity for other emerging or re-emerging infectious diseases
Flexible (Non-Disease-Specific) Activities
In 2010, the Affordable Care Act (ACA) was signed into law and established the Prevention and Public Health Fund (PPHF) to "provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs." ELC is among a number of programs at CDC that have received this funding aimed at building state, local, and territorial public health infrastructure. ELC receives half of its funding from the PPHF to support state, local, and territorial health department activities that address their program needs and do not clearly fall under specific disease components and/or are cross-cutting.