Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement
CDC’s national funding strategy strengthens capacity to respond to domestic infectious disease threats
Since ELC’s inception, CDC’s national funding strategy has grown from assisting eight grantees with $2 million dollars to providing $90-240 million annually (2011 – 2016) to all 50 states, 8 U.S. territories, and 6 cities with the largest local health departments. In fact, the award distributed in August 2016 is the largest amount dispersed since the ELC Cooperative Agreement started. The ELC program currently covers more than 20 specific infectious disease areas and approximately 45 discrete projects. This crucial CDC investment helps strengthen an effective public health workforce, nimble surveillance systems, modern and efficient laboratory facilities, and more integrated information networks.
CDC’s Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (ELC) funds all 50 state health departments, six of the nation’s 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, including U.S. Virgin Islands, Puerto Rico and Guam. There are 64 grantees.
Public Health Impact
As Americans are increasingly affected by infections emerging anywhere in the world, finding and stopping infectious disease health threats is essential to protecting public health and saving lives. Communities across the nation benefit from the actions taken by state, local, and territorial public health departments to detect, respond, prevent, and control known and emerging (or re-emerging) infectious diseases. Examples of other benefits:
- Preventing future outbreaks.
- Responding more quickly to occurrences of infectious diseases.
- Executing science-based prevention and control strategies leading to decreased infectious diseases deaths and illnesses.
- Improving health outcomes, health care quality, and health equity.
State, local, and territorial public health agencies each have unique needs and priorities because of the diverse infectious disease challenges they face, their organizational capacity, geography, and populations. Often, there are unanticipated events that may require the diversion of resources to a specific emerging or re-emerging disease. To better meet essential needs and reduce delays in responsiveness, cross-cutting ELC resources are designed to address planned-for and unanticipated infectious disease threats.
The ELC oversees an array of projects that strengthen the ability of public health agencies to respond to, prevent, and control known and emerging (or re-emerging) infectious diseases. These include the growing threat of drug-resistant infections , foodborne disease prevention and tracking , vaccine-preventable diseases , as well as activities to reduce healthcare-associated infections.Two primary classes of ELC funding include:
Flexible or Non-disease-specific funding
tackles high-priority needs that are NOT disease-specific. Funding in this category addresses integrated, cross-cutting activities related to epidemiology, laboratory, and health information systems. Resources are awarded so grantees can:
- Strengthen epidemiological capacity:
- Ensure health departments are well-equipped with staff, surveillance systems and other tools to identify, characterize, and provide rapid, effective, and flexible response to infectious disease threats.
- Develop, execute, and evaluate public health interventions to promote early detection methods that will facilitate the timely implementation of control measures and minimize transmission of infectious diseases.
- Support a variety of epidemiological activities.
- Enhance laboratory capacity:
- Develop modern and well-equipped public health laboratories, with well-trained staff, employing high quality laboratory processes and systems that foster communication and appropriate integration between laboratory and epidemiology functions.
- Support a variety of laboratory activities
- Improve health information systems:
- Develop and enhance health information systems infrastructure in public health agencies, including public health laboratories, focusing on standards-based electronic data exchange, information systems interoperability, and enhancing and sustaining integrated surveillance information systems.
- Enhance the electronic exchange of data between public health agencies and clinical care entities, focusing on electronic laboratory reporting (ELR) and electronic case reporting (eCR)
- Increase informatics/IT capacity in public health agencies through staff, contracts, and training.
Disease-specific or Categorical funding
targets specific infectious diseases and other public health threats of importance. Examples include:
- Antimicrobial-resistant bacteria
- Waterborne diseases
- Zika virus
- Influenza (Flu)
- Healthcare-associated infections
- Fungal (mycotic) diseases
- Capacity for other emerging or re-emerging infectious diseases
- Foodborne germs and illnesses
- National Electronic Disease Surveillance System (NEDSS)
- Disease-specific laboratory detection and epidemiologic investigation
- Respiratory diseases, including vaccine-preventable diseases
- Tickborne diseases ( Lyme , Rocky Mountain spotted fever , tularemia )
- Mosquito-borne diseases ( West Nile , dengue fever , chikungunya virus )
- Flea-borne diseases ( plague )
- Parasitic diseases
- Prion diseases (a group of conditions that affect the nervous system in humans and animals)
In 1995, the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement was established to distribute resources to domestic public health departments to strengthen the nation’s infectious disease infrastructure.
In response to the Institute of Medicine's landmark report, Emerging Infections: Microbial Threats to Health in the United States, CDC created ELC as a key component of its national prevention strategy. In ELC’s early years, the focus was on helping to build general infectious disease surveillance capacity.
As the program became more established, it expanded to include specific pathogens. In 2010, the program reached an important milestone with the passage of the Affordable Care Act that established the Prevention and Public Health Fund (PPHF). This provided the first mandatory funding dedicated to improving the nation's public health system. The PPHF expanded national investment in prevention and public health programs to improve health and help restrain increasing private and public sector health care costs.