CDC in Central America
A field researcher from Universidad del Valle-Guatemala (UVG) collects a sample from a participant in an antimicrobial resistance (AMR) research project in Quetzaltenango, Guatemala. Photo by Nicholas Tenorio/CDC
The Centers for Disease Control and Prevention (CDC) has collaborated with public health institutions in Central America since the 1960s. The initial focus on parasitic diseases has expanded to encompass public health programs throughout the region on HIV/TB, global disease detection, emergency response and other areas of global health security. The CDC Central America office, based in Guatemala, houses the multi-country program offices for the Division of Global HIV and TB (DGHT) and the Division of Global Health Protection (DGHP). Together with headquarter-based CDC experts, they support work in the Central American countries of Belize, Costa Rica, El Salvador, Honduras, Guatemala, Nicaragua, and Panama, as well as selected activities in Colombia, the Dominican Republic, and Peru. CDC Central America works in partnership with the Central American and Caribbean Regional Office (CACRO), based in Panama, to strengthen regional health systems and workforce capacities to prevent, detect, and respond to diseases throughout the region.
CDC Central America works collaboratively with Ministries of Health (MOH), Executive Secretariat of the Council of Ministers of Health of Central America and the Dominican Republic (SE-COMISCA), the Pan American Health Organization (PAHO), and other regional and international partners on issues such as COVID-19 and other respiratory diseases, HIV, tuberculosis, vector-borne disease, and antimicrobial resistance.
Global Health Security
Helping countries respond to public health threats quickly and effectively within their borders is critical to preventing the spread of disease regionally and around the world. CDC supports disease outbreak response, surveillance, laboratory systems, and workforce development in coordination with local, regional, and global public health organizations. CDC Central America has partnered with Brigham and Women’s Hospital, Baylor College of Medicine, Washington State University, and Universidad del Valle de Guatemala since 2018 to strengthen epidemiological surveillance for acute febrile illnesses (AFI) and antimicrobial resistance (AMR) in Belize, the Dominican Republic, El Salvador and Guatemala.
CDC’s AFI surveillance network in Central America and the Dominican Republic identifies emerging and re-emerging disease threats, strengthens regional collaborations, and increases capacity for disease surveillance
CDC collaborates with ministries of agriculture, health, environment, and defense across Central America to conduct One Health Zoonotic Disease Prioritization (OHZDP) workshops to increase opportunities for cross-disciplinary surveillance, prevention, and control of zoonotic diseases
Since 2017, CDC has participated in outbreak investigations for measles, rabies, fungal infections, dengue, foodborne diseases, and COVID-19
Since 2022, CDC has collaborated with the Government of El Salvador to pilot the region’s first use of Wolbachia bacteria to control mosquito-borne disease transmission
CDC and SE-COMISCA support strengthened surveillance of healthcare-associated bloodstream infections (candidemia) in eight hospitals in El Salvador, and helped update the national guidelines for candidemia surveillance
CDC partners with the SE-COMISCA to strengthen the National Institute of Health in El Salvador
Field Epidemiology Training Program (FETP)
FETP strengthens the public health workforce capacity to investigate and respond to disease outbreaks. CDC Central America supports three tiers of FETP (Frontline, Intermediate, and Advanced) to train epidemiologists in identifying and containing outbreaks before they become epidemics. COMISCA and MOHs lead FETP activities across the Central America region. Advanced FETP participants earn a master’s degree in epidemiology through Universidad del Valle-Guatemala (UVG).
Since 2000, when the program started in the region, 4,929 residents have graduated from FETPs in Central America across all three tiers
Since 2012, over 122 Central America FETP residents have presented their work at international scientific conferences
Surveillance and Immunization Support
Previous collaborations between CDC and MOHs to expand regional laboratory capacities and surveillance were critical to the region’s COVID-19 response. FETP graduates were instrumental to the response. Together with CDC’s implementing partners, FETP graduates led efforts to increase vaccination rates and provide epidemiological support to MOHs.
Within the framework of the One Health project, implemented by COMISCA, with the collaboration of the Regional International Organization for Agriculture Health (OIRSA) and the Central American Commission for Environment and Development (CCAD), Honduras, and El Salvador have been supported the development of their prioritized lists of zoonotic diseases of greatest concern and to develop next steps to address diseases in collaboration with other partners using the CDC methodology.
A digital tool was developed for the notification of suspected animal cases of avian influenza, which contributed to the identification of index cases in Central America.
To support Central American countries’ COVID-19 response, CDC leveraged existing surveillance platforms to test for SARS-CoV-2 (the virus that causes COVID-19). In Guatemala, CDC also supports the strengthening of the laboratory surveillance electronic system to streamline detection, notification and reporting of notifiable diseases
CDC and PAHO worked together to increase the region’s genomic sequencing capacity for SARS-CoV-2. As a result, national laboratories in Costa Rica, Guatemala and Panama were better able to analyze samples referred from throughout Central America
CDC and partners implemented serological surveys to understand trends in COVID-19 infection within communities and healthcare, agriculture, hospitality, and market workers in Belize, the Dominican Republic, El Salvador, and Guatemala
Since 2021, CDC has supported COVID-19 vaccination activities in Belize, El Salvador, Guatemala, and Honduras. CDC assisted with vaccination program management and operations, dissemination of key messages in local languages, identification of vaccination barriers in priority populations, outreach to pregnant women, and scale-up for other vaccine preventable diseases
CDC donated laboratory equipment, reagents and supplies, antigen tests, personal protective equipment, and other supplies in the region
CDC boosted rapid response teams’ skills in community testing, vaccination promotion campaigns, and home-based care, and collaborated to investigate COVID-related fungal infections (mucormycosis)
HIV and Tuberculosis (TB)
Since 2003, CDC has collaborated with MOHs, community-based organizations, and international partners to respond to the HIV epidemic in Central America by scaling up evidence-based programs that close gaps in HIV prevention, case finding, early antiretroviral treatment (ART) initiation, optimized treatment, and viral load suppression. CDC Central America supports countries to achieve UNAIDS 95-95-95 goals by 2030 by:
- Preventing new infections among populations at substantial risk of infection through HIV combination prevention strategies, including the scale up of pre-exposure prophylaxis (PrEP)
- Increasing HIV testing access and knowledge of HIV status through active case-finding, including outreach among key populations, index testing services, optimized provider-initiated testing, and community testing
- Improving health outcomes among people living with HIV by supporting active linkage to treatment, early treatment initiation, management of opportunistic infections, and promoting optimized treatment regimens and differentiated service delivery models
- Strengthening treatment retention and sustainable viral load suppression among people living with HIV
- Enhancing local capacity for laboratory quality assurance and supporting national efforts to improve the quality of rapid HIV testing
- Strengthening laboratory capacity and network for HIV testing and viral load monitoring
- Increasing workforce capacity through the Extension for Community Healthcare Outcomes (ECHO) model to mentor and create communities of HIV practice among healthcare workers across the region
- Developing local capacities to collect, analyze, and use HIV surveillance and strategic information for public health impact, including HIV recent infection surveillance
- Addressing stigma and discrimination against key populations and people living with HIV
In FY23, CDC supported the provision of HIV prevention services to over 56,000 people, HIV testing for over 123,000 people and HIV treatment for over 31,000 people in Central America, Colombia, and Peru
Laboratory Systems Strengthening
For the past 20 years, CDC Central America has supported laboratory-based disease surveillance and detection of novel strains and pathogens. The agency also supports the Regional Network of National Laboratories (REDLAB) strategic plan. Activities include:
- Since 2019, training more than 4,000 laboratory staff personnel through virtual and in person webinars and workshops
- Strengthening the resources and training to conduct genomic surveillance in Guatemala, Costa Rica and Panama
- Strengthening capacities of national laboratories in Belize and El Salvador to diagnose fungal (mycotic) diseases
- Enhancing laboratory-based surveillance of norovirus and rotavirus (viruses that cause vomiting and diarrhea) in Costa Rica
- CDC works closely with the REDLAB network that works to facilitate collaboration and strategic planning for the national laboratory leadership from throughout Central America
CDC supports laboratory biosafety across the region, such as hosting regional biosafety and biosecurity workshops, supporting the accreditation of local laboratory staff for the certification of Biosafety cabinets
Migration and Border Health
Global migration and border health systems impact the health of migrants and potential cross-border movement of pathogens. CDC engages with national governments, U.S. Embassies, COMISCA, and other partners to improve HIV services for Venezuelan migrants, enhance border health processes, and understand health-related reasons for migration. CDC activities include/have included:
- Implementation of a survey and virtual regional workshop to identify challenges in border health systems and points of entry
- Integration of border health topics into FETP-Frontline
- Engagement in technical collaboration to enhance HIV prevention, care, and treatment services for migrants throughout Central America. For example, CDC and local partners support increased access to HIV prevention, testing, treatment, and laboratory services for Venezuelan migrants in Colombia and Peru
- Support of COVID-19 testing and vaccination for migrants returning to Central America from the U.S. and Mexico
- Combined training initiatives in Honduras, Costa Rica, Guatemala, and the Dominican Republic, surveillance, public health policy, and preventing and responding to potential health emergencies at land entry points
- Prioritizing public health emergency plans for the International Airport San Óscar Arnulfo Romero y Galdámez in El Salvador
- Fostered Costa Rica-Panama collaboration for coordinated health surveillance and binational communication
- Sponsored a Facebook health education campaign emphasizing COVID-19 prevention for travelers
- A mobility survey captured diverse profiles of individuals crossing land borders into Guatemala, providing better understanding of their health risks, needs, and behaviors
- Assessments were conducted in Guatemala and Honduras to document existing public health and mobility data, sourcing information from governmental and non-governmental organizations. The data will highlight priority areas for enhancement
- Bringing COVID-19 Vaccines to Guatemala’s Most Remote Communities | Global Health | CDC
- Motivating More People in Honduras to Get the COVID-19 Vaccine | Global Health | CDC
- U.S. CDC and Partners Collaborate to Vaccinate More Pregnant Women in El Salvador Against COVID-19 | Global Health | CDC
- CDC Leverages Acute Febrile Illness Surveillance System to Respond to COVID-19
- Colombia Increases Surveillance to Protect Pregnant Women Against COVID-19
Photos:
CDC in Central America | Flickr
Videos:
Central America Region Overview
Health Impact in Central America Region
COVID-19 Preparedness in Central America Region
CDC and the Universidad del Valle-Guatemala (UVG)
Value of the Field Epidemiology Training Program (FETP) in Central America
Guatemala Veterinarians FETP
Guatemala FETP
Treating HIV in Honduras
