The PHEMCE is an interagency coordinating body led by the HHS Assistant Secretary for Preparedness and Response, comprising the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, and interagency partners at the Departments of Defense, Veterans Affairs, Homeland Security, and Agriculture. It coordinates the development, acquisition, stockpiling, and recommendations for use of medical products that we need to effectively respond to a variety of high consequence public health emergencies, whether naturally occurring or intentional.

EXECUTIVE SUMMARY

The 2017-2018 Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Strategy and Implementation Plan (SIP) describes the priorities that the U.S. Department of Health and Human Services (HHS), in collaboration with its interagency partners, will implement over the next five years. This strategy updates the 2016 PHEMCE SIP and fulfills the annual requirement established by Section 2811(d) of the Public Health Service (PHS) Act, as amended by the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA). The annual PHEMCE SIP provides the blueprint the Enterprise will use to enhance national health security through the procurement and effective use of medical countermeasures (MCM). Starting with this iteration of the SIP, the PHEMCE is retitling its SIP to reflect a more forward-focused strategic document by referring to the year the PHEMCE developed it as well as the following year. For example, the PHEMCE developed this SIP in 2017; therefore, it is the 2017-2018 PHEMCE SIP. The PHEMCE examines the SIP goals and objectives annually by taking into consideration the progress achieved and the remaining strategic gaps in MCM preparedness. During the development of the 20172018 PHEMCE SIP, the PHEMCE examined the goals and objectives articulated in the 2016 PHEMCE SIP and determined that no changes were necessary at this time.

The streamlined 2017-2018 PHEMCE SIP provides:

1) a summary of the major recent accomplishments;

2) new activities;

3) updates to the activities from the 2016 PHEMCE SIP; and

4) specific information required annually under PAHPRA reporting mandates.

The 2016 PHEMCE SIP identified priority activities in the near-term (fiscal year (FY) 20172018), mid-term (FY 2019-2020), and long-term (FY 2021 and beyond) timeframes. The PHEMCE maintained these timeframes in the 2017-2018 PHEMCE SIP. The PHEMCE is still pursuing activities detailed in the 2016 PHEMCE SIP unless otherwise noted in this document. All activities described are contingent on available appropriations.

PHEMC

Public Health Emergency Medical Countermeasures Enterprise

The Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) coordinates Federal efforts to enhance chemical, biological, radiological and nuclear threats (CBRN) and emerging infectious diseases (EID) preparedness from a medical countermeasure (MCM) perspective. The PHEMCE is led by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) and includes three primary HHS internal agency partners: the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the National Institutes of Health (NIH), as well as several interagency partners: the Department of Defense (DoD), the U.S. Department of Veterans Affairs (VA), the Department of Homeland Security (DHS) and the U.S. Department of Agriculture (USDA).

	PHEMCE Strategy and Implementation Plans The HHS PHEMCE Strategy articulates the strategic direction and will guide policies and decisions for the end-to-end mission of the PHEMCE.  The HHS PHEMCE Implementation Plan identifies priorities across the PHEMCE mission areas.   Learn More >>
	​PHEMCE Multiyear Budget The multiyear budget highlights spending plans for the various HHS agencies within the PHEMCE and provides Congress and our external stakeholders with information on funds that have been invested in specific threat areas and future plans for investments in specific threat areas, based on availability of funds.​​ Learn More >>
	2010 PHEMCE Review The vision to combat emerging infectious diseases, pandemics, and bioterrorism is simple: our nation must have the nimble, flexible capability to produce MCMs rapidly in the face of any attack or threat, whether known or unknown, novel or reemerging, natural or intentional.    Learn More >>
	PHEMCE Mission Components The PHEMCE coordinates medical countermeasure-related efforts within HHS and in cooperation with PHEMCE interagency partners.  This is a complex mission space and many Federal agencies have responsibilities that are critical to its success.  Learn More >>
	PHEMCE Governance The PHEMCE evolved to address a wider array of challenges, including CBRN threats, pandemic influenza, and emerging infectious diseases.  Under this new paradigm, the PHEMCE is better positioned to address the range of cross-cutting activities that comprise the MCM development process. Learn More >>

CDC

Malaria can be a severe, potentially fatal disease (especially when caused by Plasmodium falciparum) and treatment should be initiated as soon as possible.

Patients who have severe P. falciparum malaria or who cannot take oral medications should be given the treatment by continuous intravenous infusion.

Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:

• chloroquine
• atovaquone-proguanil (Malarone®)
• artemether-lumefantrine (Coartem®)
• mefloquine (Lariam®)
• quinine
• quinidine
• doxycycline (used in combination with quinine)
• clindamycin (used in combination with quinine)
• artesunate (not licensed for use in the United States, but available through the CDC malaria hotline)

In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.

How to treat a patient with malaria depends on:

• The type (species) of the infecting parasite
• The area where the infection was acquired and its drug-resistance status
• The clinical status of the patient
• Any accompanying illness or condition
• Pregnancy
• Drug allergies, or other medications taken by the patient

Report a serious drug side effect

If you have had a serious side effect while taking a drug, you or your health care provider can report that side effect to the federal Food and Drug Administration (FDA). MedWatch is the FDA Safety Information and Adverse Event Reporting Program. You are encouraged to take the reporting form to your health care provider.

Alternatively, health care providers can report to the FDA.

• online www.accessdata.fda.gov/scripts/medwatch/
• by phone (1-800-FDA-1088)
• or fax (1-800-FDA-0178)

The advantage to having your health care provider file the report is that he/she can provide clinical information based on your medical record that can help the FDA evaluate the report.

However, for a variety of reasons, you may not wish to have the form completed by your provider, or the provider may not wish to complete the form. Your health care provider is not required to report to the FDA. In this case, you may complete the online reporting form at www.fda.gov/medwatch/report/consumer/consumer.htm yourself via the Internet.

Bloomberg

“…..FEMA was running low on food rations. In the previous four weeks, the agency had supplied millions of meals to the Texans and South Floridians displaced by hurricanes Harvey and Irma. Maria had created a third disaster zone with more complex logistics, having knocked out Puerto Rico’s electricity, gutted its roads, and destroyed its markets and ports. Restoring food security on the island could take months. Lee had to procure millions of servings of just-add-water meals to sustain the victims. Could Jackson provide at least 2 million and begin deliveries immediately?….”

• Mylar pouches of freeze-dried meals such as Savory Stroganoff and Loaded Baked Potato Casserole
• Designed to remain edible on shelves for a quarter century.

Wise Company

WHO

Sweetened beverage tax will help beat NCDs in the Philippines

19 December 2017

The World Health Organization (WHO) commends the Philippines as it passes a landmark law today with new tax provisions for sugar-sweetened beverages (SSB). The Tax Reform for Acceleration and Inclusion (TRAIN) Act provides a Php6 per litre tax (approximately 14% increase in price) for caloric and non-caloric sweetened beverages. The initiative makes Philippines among the first countries in Asia to introduce SSB tax in their national agenda.

Evidence has shown that SSB tax can reduce consumption of sugars and help prevent overweight, obesity, and noncommunicable diseases (NCDs) such as diabetes and cardiovascular disease. In the Philippines, overweight and obesity rates have been steadily increasing and diabetes and cardiovascular disease now cause 4 out of every 10 deaths among Filipinos. With 87% of Filipinos suffering from tooth decay, the reduction of sugars intake will also reduce this risk. The revenue to be generated from the SSB taxation also has the potential to be utilized for health-promoting purposes.

Taxation of SSBs is a great step forward in protecting the health of Filipinos. Experience in other countries has shown positive results. Mexico, for instance, implemented 10% excise tax on SSBs in 2014 and demonstrated an average reduction of 7.6% in purchases of taxed beverages in its first two years of implementation. The reduction in consumption is predicted to have positive impacts on health outcomes and reductions in health care expenses in Mexico.

We congratulate the legislators and health advocates who together have worked hard during the past years to push the inclusion of SSB tax into law. This tax will save many lives over the next years.

NY Times

• Jakartans are digging illegal wells, drip by drip draining the underground aquifers on which the city rests — like deflating a giant cushion underneath it.
• About 40 percent of Jakarta now lies below sea level.

BBC