First Quarter 2009

Welcome to 2009’s first quarter E-Brief, 

designed to inform readers about key 

global health activities at the Centers for 

Disease Control and Prevention (CDC). 

Our first issue of the year demonstrates 

how the agency has worked with nontraditional public heath partners in the 

private sector to improve the health of 

people around the world. Amidst the 

global economic crisis, public-private 

partnerships have become a vital way to 

leverage increasingly limited resources to 

help respond to country needs, advance 

progress on U.S. Government global 

health initiatives, and achieve the greatest 

possible health impact. 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

Coordinating Office for Global Health

Subscribe to the Global Health E-Brief 

on CDC Washington’s website: 

http://www.cdc.gov/washington/globalhealth_ebrief.html

CDC Foundation Helps CDC Do More, Faster 

Around the World

CDC scientists battle the world’s toughest public 

health challenges, but rarely do they act alone. They rely 

on many vital alliances, including partnerships forged 

through the CDC Foundation, to achieve mutually 

beneficial goals. 

Since 1995, the CDC Foundation has helped CDC 

connect with foundations, corporations, organizations 

and individuals to build programs that improve the 

health and safety of people around the world. A private 

nonprofit organization established by Congress, the 

CDC Foundation currently helps facilitate more than 175 

active CDC programs in the United States and more than 

30 countries.

IN THIS ISSUE

1 CDC Foundation Helps CDC Do More, Faster Around the 

World

2 CDC and Rotary International: Partnering to End 

Polio

3 Innovative New Technology Shows Promise in 

Assessing Populations Affected by Natural, Other 

Disasters

4 Partnership with Merck and GlaxoSmithKline 

Gets Essential Drugs to People at Risk of Tropical 

Diseases

5 Public-Private Partnership Strengthens Laboratory Systems in Fight against AIDS and Tuberculosis

CDC Global Health

E-Brief

Building Public-Private 

Partnerships

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CDC Foundation partnerships sometimes begin with 

CDC scientists who have ideas, but lack resources. At 

other times, organizations recognize that they can 

better accomplish their own public health goals by 

working through the CDC Foundation.

“For CDC, building alliances with private sector 

partners is often critical to moving important work 

forward. That’s why the CDC Foundation exists,” said 

Charles Stokes, president and CEO. “We bring CDC 

together with organizations interested in the same 

public health issues, then facilitate and implement 

meaningful programs to achieve common goals.”

For example, Cargill, an international producer and 

marketer of food, agricultural, financial and industrial 

products and services, works with the CDC Foundation 

to fight micronutrient deficiency in the developing 

world. Cargill provides funding for the Flour Fortification 

Initiative (FFI), a coalition of CDC and partners that 

works to increase the vitamin and mineral content in 

staple foods to prevent anemia and developmental 

disabilities.

CDC Foundation partners often help CDC engage 

in public health efforts that the agency does not have 

the resources to implement on its own. For example, a 

recent grant from the Bill & Melinda Gates Foundation 

will help CDC and the World Health Organization 

(WHO) strengthen disease surveillance and response in 

developing countries in Central Africa, where disease 

outbreaks and new emerging infections pose significant 

health threats. The project will help guide Central 

African health officials as they investigate, verify and 

respond to threats.

As one of a number of partners in the Bloomberg 

Initiative to Reduce Tobacco Use, the CDC Foundation 

works with experts at CDC and WHO to implement the 

Global Adult Tobacco Survey (GATS). GATS monitors 

adult tobacco use and the effectiveness of tobacco 

control measures in 16 countries that are home to 

approximately two-thirds of the world’s smokers. To 

date, the survey has been completed in Brazil and Turkey 

and will be implemented in the remaining countries 

during 2009. A new round of countries will be selected 

in 2010. 

The Central Africa surveillance and global tobacco 

survey projects are just two examples of the diverse 

activities supported by the CDC Foundation. Each 

project offers CDC greater flexibility, accountability and 

speed than might otherwise be possible. 

“An important part of the Foundation’s role in 

building partnerships is providing accountability and 

ensuring the successful implementation of programs,” 

said Stokes. “CDC Foundation staff members are directly 

involved in negotiating project details, hiring people, 

writing contracts and managing budgets. We offer our 

partners unparalleled opportunities to join with CDC to 

fight some of the world’s most complex public health 

problems.” 

Learn more about CDC Foundation partnership 

opportunities at www.cdcfoundation.org.

CDC and Rotary International: Partnering to End 

Polio

For only the second time, since smallpox was 

successfully eradicated in 1977, the world has the 

chance to eradicate a deadly virus and bring an end to 

the suffering and deaths associated with it. Today, polio 

is on the cusp of similar success.

One of the most successful public-private 

partnerships in history, the global polio eradication 

initiative was launched in 1988 by CDC, Rotary 

International, the United Nations Children’s Fund 

(UNICEF), and the World Health Organization (WHO). In 

the 20 years since then, the number of polio cases has 

been reduced by more than 99%, from 350,000 cases per 

year to fewer than 1,700 in 2008. In 2009, the number 

of polio-endemic countries has fallen from 125 to only 

four—Afghanistan, India, Nigeria, and Pakistan. 

The CDC Foundation connects CDC with private sector partners to improve 

the health and safety of people around the world. As a partner in the 

Bloomberg Global Initiative to Reduce Tobacco Use, CDC Foundation works 

with experts at CDC and the World Health Organization (WHO) to implement 

the Global Adult Tobacco Survey (GATS) in 16 countries that account for 

approximately two-thirds of the world’s smokers, including Bangladesh.
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Through a combination of fund-raising, advocacy, and 

volunteerism, Rotary, the private partner among the 

founding organizations of the partnership, has played a 

critical role in the extraordinary progress towards polio 

eradication. Rotary is the world’s largest humanitarian 

service organization, with 1.2 million business and 

professional leaders in a global network of 33,000 clubs. 

Rotary members have contributed nearly $800 million 

for purchase of polio vaccine, operational costs for 

large-scale vaccination campaigns, medical personnel, 

surveillance, and lab equipment. Rotary has also helped 

influence donor governments to contribute more than 

$3 billion to the initiative. The United States is the largest 

government donor, providing more than $1.5 billion.

In January 2009, the Bill & Melinda Gates Foundation 

awarded to Rotary a $255 million challenge grant to fight 

polio, which Rotary will match with $100 million raised by 

its members over the next three years. Announcing the 

award, Bill Gates said, “Rotary in particular has inspired 

my own personal commitment to get deeply involved in 

achieving eradication.”

CDC and WHO are lead technical partners in the 

initiative. CDC assigns public health experts to WHO and 

UNICEF regional and country offices, where they hold 

leadership positions in polio and immunization programs. 

CDC also provides funds for oral polio vaccine required 

for large-scale vaccination campaigns, and serves as the 

“viral detective” among the partners—CDC scientists use 

their expertise to identify the strain of poliovirus involved 

in a case and pinpoint its exact geographical origin, 

providing essential information about actions to take to 

stop the virus’ spread. 

Rotary International complements CDC and WHO 

technical expertise through its huge network of 

volunteers working hand-in-hand with CDC and WHO. 

With the motto “Service Above Self,” more than 1 million 

Rotary International members worldwide have rolled up 

their sleeves as volunteers in the fight against polio. The 

volunteers pay their own travel expenses on such trips; 

they return with first-hand experience of the program 

and share their stories with their home Rotary clubs. In 

January 2009, a marketing and management consultant 

from south Florida led a team of 42 Rotary volunteers to 

India to help vaccinate children against polio—her third 

such trip. An insurance agent in Seattle has led Rotary 

volunteer teams to his native Ethiopia to immunize 

children with the oral polio vaccine.

Rotary and CDC are very much partners on the ground, 

collaborating closely on several specific projects to 

support the initiative. 

For example, during the first campaigns against polio 

in war-torn southern Sudan, Rotary started an emergency 

response initiative that allowed funds to be raised rapidly 

in times of outbreaks or other program emergencies. CDC 

has helped advise Rotary about public health priorities 

and technical issues for the use of these funds. Another 

example is the initiation by CDC staff, in cooperation with 

the CDC Foundation, of the Polio Eradication Heroes Fund 

to provide recognition and a stipend to surviving family 

members when volunteers in polio-endemic countries 

were killed while conducting eradication activities. Rotary 

is the single largest donor to this fund and advises the 

CDC Foundation about deserving volunteers who should 

be considered for this award. Through 2008, 74 awards 

totaling $73,800 have been given to surviving families 

through the Heroes Fund.

“The impact of the CDC-Rotary partnership has been 

demonstrated in hundreds of ways—from supporting 

short-term technical experts to implement the Global 

Polio Eradication Initiative in dozens of countries to 

recognizing those who have been injured or lost their 

lives carrying out polio immunization activities,” says 

Carol Pandak, manager of the PolioPlus program at 

Rotary International.

While work remains until polio is completely 

eradicated, the public-private partnership to end polio 

has directly affected the lives of many in developing 

countries. The cumulative efforts of all the partners 

have meant that more than 250,000 deaths have 

been prevented and 5 million children are walking 

today who otherwise would have been paralyzed.  

Since 1988, when CDC joined forces with the World Health Organization, 

UNICEF, and Rotary International, the number of cases around the world 

has dropped dramatically. All four partners were recently inducted into the 

Polio Hall of Fame. Shown here (Left to Right) are Carol Pandak, PolioPlus 

program manager, Rotary International; Werner Obermeyer, deputy director, 

WHO UN Headquarters; Anne Schuchat, Interim Deputy Director for Science 

and Program, CDC; and Ahmed Magan, senior health advisor & chief of 

Immunization, UNICEF.
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Innovative New Technology Shows Promise in 

Assessing Populations Affected by Natural, Other 

Disasters

 It’s a bird, It’s a plane. It’s a kite. It’s a blimp. It’s a 

helicopter. 

When you take away the bird you have four examples 

of flying objects that have all been used to test an 

exciting new surveillance platform in the works at CDC.

Since 2006, CDC has worked with the Georgia Institute 

of Technology to develop a low-cost, high-resolution 

device that produces images for population assessment 

in disasters. The idea is to develop a convenient and easy 

way to get near real-time aerial photos during complex 

humanitarian emergencies. 

The Modular Photographic Observational Device, or 

“ModPod,” idea grew out of a need to conduct rapid 

assessments after disasters so that responders can plan 

an effective response. 

“You could apply the surveillance platform to 

just about anything,” says CDC’s Steve Bullard, an 

environmental health scientist. “In addition to refugee 

data, it can be used to rapidly collect images of chemical 

spills, terrorist events, or other events for which photos of 

what has happened on the ground are needed.”

Following a natural or man-made disaster, hundreds 

of thousands of people can be dislocated. For example, 

when the category 3 cyclone, Nargis, made landfall in 

Burma it caused more than 85,000 deaths and displaced 

more than 800,000 people. When events like this occur, 

public health responders need a good estimate of the 

population size in the affected area to plan rations, 

shelter, water, and the provision of healthcare services. 

The ModPod could have been used to photograph 

the affected area to determine the magnitude of the 

devastation and assist in establishing the needs of the 

people. Population estimates are also essential when 

conducting surveys and outbreak investigations. 

Initially, the CDC team that developed the ModPod 

tried using satellite imagery to gather data on refugee 

camps, but quickly ran into obstacles. Satellite imagery is 

expensive. Coverage over remote areas can be infrequent. 

Clouds limit visibility. And, a significant time lag often 

occurs between the collection of a satellite image and 

its release to non-US government partners and disaster 

responders. CDC recognized that these challenges could 

largely be overcome by using an inexpensive aerial 

camera and a system to link the resulting photos.

Because the United Nations frequently flies helicopters 

in areas affected by complex humanitarian emergencies, 

CDC decided to build a modular system that could be 

suspended from helicopter skids. This modular system 

can be configured in different ways, with different lenses 

and capabilities, depending on available resources. For 

example, an “infrared” lens could be added to detect heat 

sources, or a low-cost optical lens can be used to capture 

imagery. The team approached several universities to 

discuss collaboration and ultimately developed a close 

partnership with the Georgia Tech Research Institute, 

which took the lead on technical design, wiring, and 

system integration.

Using an inexpensive camera and a housing unit 

typically used to carry alpine ski equipment, the ModPod 

relies on a geographic positioning system (GPS) to “tell” 

the camera when it is flying over an area of interest. Once 

inside that zone, the camera begins taking overlapping 

pictures. The camera stops when the ModPod leaves 

the area. When the helicopter lands, the pictures are 

downloaded onto a laptop. A composite image of the 

entire zone is created using commercial software. The 

system even allows users to re-create the ModPod flight 

path in GoogleEarth. Using the resulting mosaic image, 

the team is now working to refine methods of conducting 

rapid population estimates. 

In August 2008, the ModPod was flown over 

Oglethorpe University, Atlanta, GA, in one of many 

ongoing system tests. The ModPod successfully took 

pictures of students in the stadium, cars, trees, and even 

backpacks on an open field. The camera resolution is not 

sufficient to capture individual faces.

CDC’s Steve Bullard tests an early version of the ModPod on the CDC remotecontrolled airship. The photo was taken during the 3-day Georgia Breast 

Cancer Walk in 2006.
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What’s next? The group continues to test and improve 

the system so that it can be ready for use in the event of 

a public health emergency. For this new technology, the 

sky’s the limit!

Partnership with Merck and GlaxoSmithKline 

Gets Essential Drugs to People at Risk of Tropical 

Diseases

In a quiet, dusty village in Togo—a resource-poor 

country of some 5 million people in west Africa—lies the 

seed of what for many is only a dream: a chance to break 

the cruel cycle of poverty and disease. 

That seed is a model program that successfully 

integrates public health interventions to control Guinea 

worm disease, malaria, and a group of neglected tropical 

diseases (NTDs): lymphatic filariasis (elephantiasis); 

trachoma (eye infection); soil-transmitted helminths 

(hookworm, roundworm, whipworm); and schistosomiasis 

(snail fever). These NTDs cause substantial disability or 

poor health for hundreds of millions of people around 

the world. In addition to causing physical and emotional 

suffering, these debilitating and disfiguring diseases 

hamper worker productivity, keep children out of school, 

and prevent families and communities from thriving.

The Togo program is simple and community-driven. 

Villagers are given three drugs once a year to prevent 

disease transmission. At the annual visit, pregnant 

women with young children are encouraged to buy bed 

nets at low cost for prevention of malaria and other 

insect-carried diseases such as lymphatic filariasis. The 

women are also reminded to report any case of Guinea 

worm disease, an NTD that has been virtually eliminated 

in Togo. 

What makes this program a success? It is effective, 

inexpensive, and sustainable. 

The low cost of the program ($0.22 per person during 

the first year and $0.10 per person each year after) is 

possible because of a partnership between CDC, Merck, 

and GlaxoSmithKline to eliminate NTDs using a strategy 

of mass drug administration. 

Today, because of the generosity of Merck and 

GlaxoSmithKline, who are providing free drugs “for as 

long as needed” and funding for coalition building, 

increasing numbers of governmental and nongovernmental organizations are joining philanthropic 

groups such as the Gates Foundation to provide a lowcost, rapid impact package of essential NTD drugs to 

the bottom billion of the poorest people—what some 

public health experts consider “the best bargain in public 

health.” 

CDC has long played a critical role in the eradication, 

elimination, or control of these diseases through its 

technical expertise in epidemiology, entomology, 

immunology, and molecular diagnostics. CDC scientists 

have contributed to the mapping of these diseases, 

studied the physical damage they cause, studied ways 

to prevent them and, in the case of lymphatic filariasis, 

studied ways to treat its long-term disabling and 

disfiguring effects. CDC also contributes its expertise in 

monitoring and evaluating the interventions.

Dr. Els Mathieu, a CDC scientist who studies NTDs, 

has spent months in Togo with the Ministry of Health 

training, advising, monitoring, and evaluating the 

concept of integrated disease management. With tools 

now available to eliminate and control these diseases, 

she helped shepherd the program into success. She knew 

it could work. “The solutions are here. The partners are on 

board.” 

In fact, evaluation of the model program of integrated 

interventions has shown that 80% of the population in 

the targeted districts has received drug coverage for 

four diseases: onchocerciasis, lymphatic filariasis, soiltransmitted helminths, and schistosomiasis. In addition, 

evidence indicates that Togo may be the first African 

country to interrupt transmission of lymphatic filariasis.

After seeing the initial success, “the Togolese are 

anxious to scale up the program so the entire country can 

benefit,” Mathieu adds. 

It is hoped the program will become a model for the 

entire country of Togo and eventually all of West Africa. 

Dr. Els Mathieu, a CDC scientist, works with community members on integrated 

disease management in Togo.
Public-Private Partnership Strengthens 

Laboratory Systems in Fight against AIDS and 

Tuberculosis 

With more than 33 million people in the world living 

with HIV and 2.7 million new HIV infections each year 

(UNAIDS 2008 Report on the Global AIDS Epidemic),

prevention and control efforts can seem daunting even 

in the best of settings. Yet weaknesses in the health care 

systems in most countries supported by the President’s 

Emergency Plan for AIDS Relief (PEPFAR) are enormous 

and no single entity—governmental, non-governmental 

organization, or industry—can meet these challenges 

alone. 

A partnership between PEPFAR and Becton, Dickinson 

and Company (BD), a leading global medical technology 

company with laboratory expertise, is maximizing limited 

resources and helping to build robust, sustainable 

laboratory facilities. 

In the fight against HIV/AIDS in Africa, a strong 

laboratory system is critical for proper prevention, 

treatment, and care. Laboratory data are essential to 

accurately assess the status of patients’ health, make 

accurate diagnoses, plan a course of treatment, and 

subsequently monitor the effects of treatment. Health care 

workers must be able to trust that laboratory test results 

are accurate, reliable and timely. 

In October 2007, PEPFAR—through CDC and BD—

launched a five-year public-private partnership, the first of 

its kind, to improve overall laboratory systems and services 

in African countries severely affected by HIV/AIDS and 

tuberculosis (TB).

With up to $18 million in funding, the partnership is 

being initiated in eight African countries: Côte d’Ivoire, 

Ethiopia, Kenya, Malawi, Mozambique, South Africa, 

Tanzania, and Uganda. The strategy includes three key 

components: 

 laboratory-strengthening programs built on 

National Laboratory Strategic Plans tailored to 

 meet specific country needs; 

fellowship programs for BD associates to share 

their expertise with implementing partners, and 

short-term technical assistance by both BD and 

PEPFAR partners to provide laboratory training at 

multiple levels within a country. 

The collaboration is greatly leveraging the level of 

assistance offered to all PEPFAR-supported countries 

in Africa, and is preparing more health care workers to 

provide quality HIV testing and improved TB diagnoses. 

In Uganda, for example, CDC and BD are using Global 

Positioning System/Global Information System (GPS/GIS) 

technology to map multiple laboratory sites with the goal 

of developing a transportation network and monitoring 

specific improvements in the identified laboratories. 

According to John Nkengasong, a CDC scientist and cochair of the PEPFAR Laboratory Technical Working group, 

“The PEPFAR-BD partnership has taken the lead in Uganda 

to strengthen laboratory systems by developing quality 

management and specimen transport referral systems. 

These efforts will go a long way to improve the care people 

receive, and ultimately their health.”

The collaboration with BD is one more example of how 

public-private partnerships effectively link resources and 

technology in the private sector with scientific expertise 

in the public health community. These partnerships 

are critical for scaling up what works, building capacity 

of governments and local organizations, and creating 

sustainable programs – all essential steps needed to help 

move the AIDS response forward and enable communities 

and countries to change this epidemic’s deadly course. 

Participants from Nigeria and Ethiopia watch as specimens are logged in before 

processing for TB cultures during the lab strengthening training.

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Update: Child Violence Survey in

Swaziland Spurs Government to

Establish the Sexual Offenses 

Unit

The third quarter 2007 Global 

Health E-Brief featured an article 

on a United Nations Children’s 

Fund (UNICEF) and CDC survey to 

determine the rates of violence 

against young people in Swaziland. The results of this survey 

revealed alarming rates of violence against children, including 

one in three females between the 

ages of 13 and 24 suffering from 

some form of sexual violence during childhood. As a result of this 

survey a new Sexual Offenses Unit 

for children and young people has 

been established. The launch of 

this unit is the first step towards 

developing comprehensive care 

for victims of sexual exploitation, 

violence, and abuse in Swaziland. 

For more information please visit: 

http://www.unicef.org/protection/

swaziland_46978.html

Update: Cholera Outbreak in 

Zimbabwe

As of March 12, 2009, the World 

Health Organization (WHO) Office 

in Zimbabwe and the Ministry of 

Health report that there are 89,930 

suspected cases of cholera with 

4,049 deaths. This is an increase 

of 56,351 cases and 2,378 deaths 

since the report in the last Global 

Health E-Brief (Fourth Quarter, 

2008). CDC deployed a health 

communicator in December 2008 

to assist with informational/educational messages, and in March 

2009 is deploying a medical epidemiologist based in Kenya, as part 

of a WHO Global Outbreak and 

Alert Response Network (GOARN) 

team, to provide further technical 

assistance in the outbreak. CDC 

remains in contact with its staff in 

the region in Mozambique, South 

Africa, Zambia, and Zimbabwe, and 

is working with WHO and other 

global health partners to further 

monitor this situation and assist 

when possible. 

“A Lion in Our Village - The 

Unconscionable Tragedy of 

Cholera in Africa” 

“A Lion in Our Village - The Unconscionable Tragedy of Cholera 

in Africa”, published in the March 

12th edition of the New England 

Journal of Medicine, details the 

burden of cholera in Zimbabwe 

and other surrounding African 

countries in the past year. Rarely 

seen in the United States, cholera 

used to be endemic in South Asia 

before oral rehydration therapy 

was introduced and reduced the 

fatality rate from 30 percent to less 

than 1 percent. After a centurylong absence, a cholera epidemic 

in Latin America in the 1990s was 

met with swift investment in drinking water, sanitation and health 

care.

The sanitation and treatment revolutions have not made the same 

progress in Africa, where there 

have been more than 92,000 cases 

and 4,000 deaths due to cholera 

since November 2008 in Zimbabwe alone. The epidemic shows no 

signs of slowing and has spread to 

other countries.

Dr. Eric Mintz, a CDC scientist with 

expertise in diarrheal diseases, and 

Dr. Richard L. Guerrant, Director 

of the Center for Global Health at 

the University of Virginia, School 

of Medicine, point to a lack of safe 

drinking water, sanitation, and 

hygiene facilities as the underlying 

causes of spread of the epidemic, 

and inadequate access to basic 

health care services and supplies 

as the cause of the high mortality rate. A waterborne disease, 

cholera is the result of inadequate 

treatment of sewage or drinking 

water. The article can be accessed 

at http://content.nejm.org/cgi/

content/full/360/11/1060

Rabies Partnership Expands 

Education Efforts with Help of 

Google

Since 2006, CDC has partnered 

with the Alliance for Rabies 

Control (ARC) to help promote 

rabies education worldwide. As 

part of the collaboration, CDC has 

assisted with the development of 

public health education materials 

for rabies education campaigns in 

Latin America, Africa, and Asia. The 

ARC recently received a grant from 

Google to expand its marketing 

campaign around human rabies 

prevention and animal rabies 

control, and in particular, its 

efforts focused around World 

Rabies Day which occurs this 

year on September 28. Currently, 

it is estimated the Alliance is 

communicating prevention 

messages into 190 countries. For 

information about ARC, please visit 

http://www.rabiescontrol.net/

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