# Presentation: 914933

## Global Earth Observations

**Vice Admiral Conrad C. Lautenbacher, Jr., Ph.D. U.S. Navy (Ret.)**
**Under Secretary of Commerce for Oceans and Atmosphere and**
**Administrator, National Oceanic and Atmospheric Administration (NOAA)**
**November 7, 2006  ****•  American Public Health Association 134****th**** Annual Meeting,  Boston, MA****.**

**Global Earth Observations**
**A New Approach to Prevention, Early Warning and More Rapid Problem-Solving**

**Notes:**
good afternoon

I am Vice Admiral Conrad C. Lautenbacher, Under Secretary of
Commerce for Oceans and Atmosphere and Administrator of
NOAA, the National Oceanic and Atmospheric Administration. 

thank you for joining us 

welcome also to those watching us on the live webcast

for those who may not know, NOAA:

has about 12,500 employees --  focus ranges from the surface of the sun to the bottom of the sea

work dovetails with many global public health concerns -- weather and climate, air quality, disease vectors, heat waves, contaminated water, healthy seafood and marine mammals

as a public trust our bottom-line goal is to put science and service to work for the benefit of society 

efforts involve international and national partners in just every  arena

## Slide 2

**Notes:**
am not a health professional, as so many of you are, but I believe we share the perspective that the health of the human species depends directly on the health and condition of our planet

a global context frames many 21st-century  human health issues

as Dr. Gro Harlem Brundtland,  former director of the World Health Organization said,  “In the modern world, bacteria and viruses travel almost as fast as money.  With globalization, a single microbial sea washes all of humankind.  There are no health sanctuaries.”

am here today because I believe that one of the most pressing needs for improving human health and well-being is to bring together -- in one system -- the many disparate entities that include health and environmental data and observations

we must connect the scientific dots to better understand the link between our environment and public health, and other major sectors such as weather and climate, agriculture and energy

for science to be sound and valuable for public health, we need more than snapshot assessments -- we must incorporate observations into models that can be used to forecast and prevent or mitigate health concerns before they become a crisis

## WHO reports that about 25% of the total burden of disease can be attributed to environmental and occupational factors.

-  **Neonatal**
** ****causes**
** ****37%**

-  **Acute **
** ****respiratory**
** ****infections**
** ****19%**

**Diarrheal **
** ****diseases**
** ****(post-neonatal)**
**         ****17%**

**Injuries 3%**

**Other **
** ****10%**

**Main Causes of Death Among Children Under Five**

- World Health Report 2005

**Malaria**
**   ****8%**

**HIV/AIDS 3%**

**Measles  4%**

**2000 - 2003**

**Notes:**
in short, to best meet 21st-century concerns, 21st-century approaches and technology must be as integrated as the planet they aim to observe, predict and protect 

there is no question about the need

around the world one person in five does not have access to good quality drinking water

in 2003, malaria and cholera killed nearly 3 million people, many of them children

as these World Health Organization figures show, acute respiratory infections, malaria, and diarrheal disease account for nearly half of the causes of death of children under five

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WHO also reports that about one quarter of the total burden of disease can be attributed to environmental and occupational factors

## Outbreak Detection and Response

**DAY**

**CASES**

**- 120**

- Adapted from J. Davis, Climate Adaptation
- Workshop, Nov. 2003

**Outbreak Detection and Response**

**Notes:**
our shared goal is to get ahead of the curve and reduce morbidity and mortality

this slide shows a typical epidemic scenario --  the first step is to detect the first case, then to report it, then to gain laboratory confirmation whenever possible, and finally to respond

the goal of reducing morbidity and mortality is reflected by the total area under the curve

red area under the curve indicates normal morbidity and mortality -- with the yellow area reflecting the only opportunity to mount a response and reduce health impact   

response is mounted only after the epidemic has peaked and is on its natural path out of a population

the key point is that the opportunity to control the epidemic in such a scenario is relatively small

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## Effective Health Early Warning

**DAY**

**CASES**

**Effective Health Early Warning**

**- 120**

- Adapted from J. Davis, Climate Adaptation
- Workshop, Nov. 2003

**Outreach and stakeholder involvement**

**Notes:**
dramatic difference in this slide

Earth observations and monitoring provide the opportunity to shift the whole scenario forward

red area under the curve is much smaller than in the previous slide, indicating a reduction in morbidity and mortality 

shifting the process forward provides the opportunity to better control an epidemic, allowing public health measures to reach a much greater number of people in a more timely, efficient way as reflected by the large yellow area under the curve
a key element on this slide is the yellow box on the left indicating Earth observations and monitoring information 

if you start with some early indicators about environmental conditions conducive to an outbreak, you have a chance to shift the curve toward a healthier outcome

## Slide 6

**Notes:**
malaria, for example, is a complex system of interactions between humans and mosquitoes 

unfortunately it remains one of the world’s most significant public health issues 

orange area shows limited risk; red areas indicate where transmission occurs 
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we have learned that El Niño, by altering the range and amount of rainfall and related changes in ecosystems, can have a striking effect on the incidence of malaria -- extending the range of mosquitoes and possibly the virulence of malaria

## Rainfall and Malaria

**Weekly Cases in Niger from 2001 to 2003**

-  Thiaw, W. – NOAA/OHHI

**Notes:**
in Niger, there is a clear correlation between rainfall and malaria

the vertical lines indicate rainfall levels -- malaria outbreaks begin to increase in the middle of the rainy season in late July and peak toward the end of the rainy season during the first week of October 

red dots show weekly malaria cases in 2001; green dots show cases in 2002; blue dots indicate cases in 2003 

working closely with local communities, the Massachusetts Institute of Technology, and the Niger Ministry of Health, NOAA is helping to develop a suite of actions to help villagers get ahead of the curve -- information about climate and other environmental factors will contribute to more effective vector control and better use of bednets and anti-malaria medication   

similarly, in South Africa, malaria control districts regularly use seasonal climate predictions to manage their vector control and malaria intervention strategies 

from prevention to response, I realize many of you are  challenged to target your resources as effectively as possible -- Earth observations can help you to do this  

in this case and others, international partners are using Earth observations to put environmental and health indicators to good use -- lives are being saved as a result 

## Slide 8

**Notes:**
as a water-borne disease, cholera also has clear environmental links, in this case to the ocean environment

in 2002, WHO reported more than 120,000 cases of cholera and over 3,700 deaths

in 2005, 7 of the 11 U.S. cholera cases reported by the CDC occurred after Hurricanes Katrina and Rita

improvements in prevention and treatment require solid scientific understanding of the scope of interactions between the pathogens, hosts and their shared environment  

## El Niño:  Early Warning for Cholera

**El Ni****ñ****o:  Early Warning for Cholera**

**Notes:**
this slide is based on work conducted over several decades by Dr. Rita Colwell, a Distinguished Scholar in Oceans and Human Health at NOAA and former director of the National Science Foundation

her work led to our current understanding that water is not just a carrier for cholera but an actual reservoir -- and that environmental factors can both trigger epidemics and determine their severity 

water temperature, rainfall, water depth and living marine organisms, in this case microscopic animals called copepods, all have a direct impact on cholera outbreaks -- and El Niño, pictured here, brings new cholera outbreaks each warm water cycle

understanding the complex life cycle among these elements and El Niño events can sound an alarm for cholera outbreaks

because of greater understanding -- NOAA provided a six-months heads-up for the last El Niño event -- the world health community has a much better shot at getting ahead of the curve  

## Sea Surface Temperature

**Linked to Cholera**

**Bay of Bengal**

- Lobitz et al. 2000 PNAS 97:1430

**Notes:**
here’s how understanding the environmental links can be applied to intervention

this slide depicts the clear connection between sea surface temperature, sea surface height and the predictable lag in cholera cases

the blue line reflects sea surface temperature, which is predictable based upon El Niño events; the red line reflects cholera cases

using remotely-sensed technology to monitor sea surface temperature and height, and other elements of marine life, such as phytoplankton blooms, the Earth science community can now develop a global warming system for cholera

in the Bay of Bengal in Bangladesh, there is the capability to predict outbreaks locally so that public health interventions can be directed to where they are most needed, a preemptive rather than a reactive approach

the goal is to prevent outbreaks in other vulnerable parts of the globe      

## Thinking Globally, Acting Locally 

**Thinking Globally, Acting Locally**

**Notes:**
using Earth observations, we can see the geography and topography of an area in Bangladesh at risk for cholera

satellite imagery and GIS tools provide this imagery of the environmental context in which the disease is transmitted

animation shows the low-lying Ganges Delta that is highly vulnerable to sea surface temperature and height -- two factors directly related to cholera risk

you’ll see blue areas representing water and red spots reflecting population clusters

Earth observations allow for El Niño forecasts and, therefore, prediction of cholera risk

monitoring sea level rise in low-lying regions allows for targeted public health intervention -- it is an important factor in managing and mitigating cholera outbreaks and also permits flood warnings when people are at risk 

## Thinking Globally, Acting Locally 

**Sari Cloth Filtration Reduces**
** ****Cholera Cases****Fall, 2000**

- Dr. Rita Colwell

**Thinking Globally, Acting Locally**

**Notes:**
the value of earth observations and research is apparent on the community level where knowledge gained leads to the predictability required to more effectively manage public health interventions

in many areas of rural Bangladesh, women now filter drinking water through a simple, folded sari cloth

reducing the number of zooplankton in drinking water reduces exposure to attached bacteria

in studies from 1999 to 2002, Dr. Colwell found that folding the traditional sari cloth to filter water reduced the incidence of cholera by more than a factor of two -- and also that older sari cloths worked more effectively than newer, more expensive ones

apparently the more these cloths are washed, the tighter the weave becomes

## Lyme Disease:  Predicting the Risk

**Lyme Disease:  Predicting the Risk**

**Larvae develop**

**Larvae feed on infected host and becomes infected**

**Larvae dormant over winter**

**In spring, larvae molt into a nymph that transmits disease to a person or animal**

**Nymph grows to adult tick**

**Adult tick drops off host, lays eggs on the ground**

**Notes:**
lyme disease is another complex system linked to the environment changes in habitat -- because of climate and weather, urban development or natural progression -- affect the distribution and transmission of lyme diseasechanges in rainfall can alter the dynamics of the system -- mice willmove to where the food is, deer ticks will follow, deer populationschange, and humans are an endpoint 
more precise understanding of the environmental link also will open the door to understanding how changes in biodiversity will affect future transmission of the disease -- disruption of habitat could either increase or decrease risk, depending on the nature of the change and on the associated human behavioral changes again, use of Earth observations can be critical in more effectivelytargeting intervention strategies -- earth observations can help in understanding both the connections between the environment and risk of lyme disease and in anticipating changes in risk from year to year and decade to decade  

with good lead time, the public health community can more effectively target outreach to individuals each season, and participate in longer-term urban development and planning activities to reduce future risk  

## Biodiversity • Ecosystem Health • Human Health

**Biodiversity ****•**** Ecosystem Health ****• Human Health**

**Pharmaceutical promise**

**Major source of protein... over a billion people rely on reef-related fisheries**

**Natural barrier to storm surges and other natural events**

**Notes:**
coral reefs offer an excellent example of the link between biodiversity, ecosystem health and human health -- they offer many vital benefits and a large percentage of fish depend on coral reefs at some point in their life cycles  
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worldwide over a billion people depend on the reefs for all or part of their nutrition and livelihoods 

this fisherman is from a traditional reef fishing community in Sebesi [seh-beh-si], a round island about 90 minutes from Jakarta in Indonesia -- over 100 of the roughly 600 households there depend directly on fishing for their livelihoods 
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reefs also are natural barriers to hazardous storm surges and other severe events  
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they offer tremendous pharmaceutical promise -- this rich and still largely undiscovered biodiversity is sometimes called the medicine cabinet of the 21st century, holding out strong hope for medicines for several types of cancer, heart disease, HIV, arthritis, and other serious diseases
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bleached corals rob us of this promise -- when stressed by high water temperatures and other factors, corals lose the algae that gives them color  

this brings human as well as environmental consequences

NOAA and other organizations are working hard to better understand how we can proactively manage these ecosystems to maintain biological diversity and prevent loss and protect health

## A Global Earth Observation System of SystemsGEOSS

**Notes:**
I began this presentation by saying that we must connect the scientific dots to better understand the crucial links between the environment and global public health,  and that one of the most pressing needs for improving human health and well-being is to bring together-in one system -- the many disparate entities that include health and environmental data and observations

I am pleased to tell you that we are on the brink of developing such a system -- it is called GEOSS, or the Global Earth Observation System of Systems, and over the next decade I believe it will revolutionize our understanding of how Earth works and make 21st-century technology as integrated as our planet   

benefits to the global health community, and to just about every other sector of society, will be profound

rather than the many thousands of individual pieces of  technology now working around the globe, GEOSS will function on the principle of interoperability -- the recognition that no matter how effective and efficient all of our single-purpose systems may be, their value will be much greater when they can work together, as one global system of systems

## From Observation to Action

**Achieving Comprehensive, Coordinated, and Sustained Earth Observations for the Benefit of Humankind**

**Notes:**
GEOSS is emerging as an end-to-end system that will support the sound science on which sound policy must be built 

just about all the benefits dovetail with interests of the global public health community  

## 66 Countries and the European Commission

**Algeria**
**Argentina**
**Australia**
**Bahrain**
**Belgium**
**Belize**
**Brazil**
**Cameroon**
**Canada**
**Central African**
** ****Republic**
**Chile**
**China**
**Croatia**
**Cyprus**
**Denmark**
**Egypt**
**European**
**  ****Commission**
**Finland**
**France**
**Germany**
**Guinea-Bissau**

**Honduras**
**Hungary**
**Iceland**
**India**
**Indonesia**
**Iran**
**Ireland**
**Israel**
**Italy**
**Japan**
**Kazakhstan**
**Latvia**
**Luxembourg**
**Malaysia**
**Mali**
**Mauritius**
**Mexico**
**Moldova**
**Morocco**
**Nepal**
**Netherlands**
**New Zealand**
**Niger**

**Nigeria**
**Norway**
**Paraguay**
**Philippines**
**Portugal**
**Republic of Korea**
**Republic of the**
**   ****Congo**
**Russian Federation**
**Slovak Republic**
**Slovenia**
**South Africa**
**Spain**
**Sudan**
**Sweden**
**Switzerland**
**Thailand**
**Tunisia**
**Uganda**
**Ukraine**
**United Kingdom**
**United States**
**Uzbekistan**

**www.earthobservations.org**

**66 Countries and the European Commission**

**43 Organizations**

**Notes:**
support for GEOSS is growing 

in slightly over three years, 66 countries, the European Commission, and 43 international organizations have committed to making GEOSS operational over the next decade

a 10-year plan is now being implemented

## usgeo.gov

**usgeo.gov**

**U.S. Group on Earth Observations**

**Department of Commerce**
**  ****National Oceanic and Atmospheric**
**   ****Administration**
**  ****National Institute for Standards and**
**   ****Technology**
**Department of Defense**
**  ****U.S. Army Corps of Engineers**
**  ****Navy**
**  ****Air Force**
**  ****National Geospatial-Intelligence**
**   ****Agency**
**Department of Energy**
**Department of Health and Human Services**
**  ****National Institute of Environmental **
**   ****Health Sciences**
**Department of Homeland Security**
**  ****Federal Emergency Management**
**   ****Agency**
**Department of the Interior**
**  ****U.S. Geological Survey**
**Department of State**

**Department of Transportation**
**Environmental Protection**
**Agency**
**National Aeronautics and**
**Space Administration**
**National Science Foundation**
**Smithsonian Institution**
**Tennessee Valley Authority**
**U.S. Agency for International**
**Development**
**U.S. Department of Agriculture**
**  ****Agriculture Research Service**
**  ****U.S. Forest Service**
**White House Council on**
**Environmental Quality**
**White House Office of**
**Management and Budget**
**White House Office of**
**Science and Technology Policy**

**Notes:**
the multi-year U.S. plan will be a valuable contributor to the global plan

## Slide 19

**Notes:**
bringing many different types of data and other information together can be quite a challenge 

in NOAA alone, we currently have about 92 observing systems and over 50 information management systems -- and our scientists measure over 500 unique environmental parameters 

that's why one of the real strengths of GEOSS will be its infrastructure for data management, sharing and access -- I am pleased that HHS participated in developing the GEOSS strategic plan

in some of the research I mentioned earlier, it was important that soil moisture, rainfall, humidity, and other environmental factors were collected along with data on mosquitoes, water quality or air quality 

to be useful for prediction and prevention, Earth science and health science data often must be collected in the same time and space -- key elements to developing early health warning systems and producing useful Earth science tools for the health community are temporally- and spatially-compatible data sets

with not only an increase in Earth observation data but the integration of this data, we will be able to answer many more questions -- and improve our ability to make sound decisions to protect human health and the environment

## GEOSS Operating Principles

**Open and Transparent Process**
**Standardized Practices and Protocols**
**User-friendly Formats**
**Interoperable Components**

## 

**Mosquito Surveillance**

**Social Factors**

**Demographics**

**Climate**

**Global Observations**

**Sea Surface Temperature**

**Land Cover**

**Land Use**

**Other observations**

**Local/Regional Observations**

**Weather**

**Disease Surveillance**

**GEONETCast**** **

**Malaria Case Example**

**Notes:**
a new GEOSS product called GEONETCast is now in development 

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via satellite, physical, biological and public health and other data, it will bring vital information to the global public health and many other communities in user-friendly form 

as a near real-time global data dissemination system, GEONETCast will support a range of societal benefits and be one of the key data dissemination systems within GEOSS
decision-makers and others will have timely access to urgently needed, improved information products that are produced, at least in part, through the use of Earth observations 
GEONETCast will include relevant environmental and biological data that can be crucial to your work -- biological data about disease vectors and pollutants, not just physical data about rainfall, temperature, mudslides, and tsunamis 

in order to understand the critical connection between our environment and our health, information now on thousands of disparate databases around the globe might be incorporated, and we hope you will join us in identifying them

it is essential that public health data be part of  the system -- without it,  we will continue to have a lack of temporally and spatially compatible health and environmental data, a major drawback in developing predictive capability                                               
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here is how GEONETCast might work in addressing malaria

## GEONETCast 

**Malaria Case Example**

**GEONETCast**** **

**Notes:**
given how strapped many health professionals are for a wide range of resources, think how useful it will be for you to be able to tap deeply into the power of the Information Age, and to use GEONETCast to retrieve consistent, validated, compatible data sets quickly and easily

whenever you need it, information vital to your work can be right at your fingertips -- but we need your engagement to make that happen

## www.earthobservations.org

**The goal is to access the right information,****in the right format, at the right time, ****for the right people, to make the right decisions.**

**www.earthobservations.org**

**Notes:**
this is the vision for a world with GEOSS 

there are many questions to answer:

  How can improved global monitoring of viruses in wildlife help
   prevent epidemics of avian flu?

  How can data on the transport of air pollution be factored into
   early warnings for cardiovascular and respiratory responses?

  How can data on weather and stream flow be factored into the
   management of drinking water?

 How can data on ecosystem diversity be a factor in detecting the
  next emerging diseases?
there is contact information on the website, and we encourage you to write and let us know where and how GEOSS can be most useful to you building GEOSS is a pioneering effort that will fulfill many global critical needs and we encourage you to be part of it

thank you
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there is time to answer a few questions and then you will hear about another pioneering and exciting effort related to biodiversity and global public health and GEOSS