FY 2019 Annual Performance Plan and Report - Goal 2 Objective 2

Topics on this page: Goal 2. Objective 2 | Objective 2.2 Table of Related Performance Measures

Goal 2. Objective 2: Prevent, treat, and control communicable diseases and chronic conditions

Communicable diseases and chronic conditions affect the lives of millions of Americans every day. The emergence and spread of infectious diseases—such as HIV/AIDS, hepatitis, tuberculosis, measles, and human papillomavirus (HPV)—can quickly threaten the stability of public health for communities and place whole populations at risk.  The rise of globalization and ease of travel also has made it easier for domestic and international outbreaks—such as recent outbreaks of measles, pandemic influenza A (H1N1), Ebola, Zika, and chikungunya—to create public health challenges. Moreover, the prevalence of chronic conditions—such as diabetes, heart disease, stroke, and cancer—in the United States continues to contribute to the daily struggles of Americans.  The occurrence of multiple chronic conditions also exacerbates the adverse health impacts and health care costs associated with chronic conditions and their associated health risks.

The prevention and management of communicable diseases require strategic coordination, collaboration, and mobilization of resources among governmental and nongovernmental partners within and outside of the United States.  Similarly, managing chronic conditions requires support for affected individuals, families, caregivers, health professionals, and service providers.  HHS programs and initiatives focus on promoting partnerships, educating the public, improving vaccine development and uptake, advancing early detection and prevention methods, and enhancing surveillance and response capacity.

The Office of the Secretary leads this objective.  The following divisions are responsible for implementing programs under this strategic objective: ACL, ASPA, ASPR, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OGA, and SAMHSA.

Objective 2.2 Table of Related Performance Measures

Increase the percentage of Ryan White HIV/AIDS Program clients receiving HIV medical care and have had at least one viral load test demonstrating suppression of the virus (Lead Agency - HRSA; Measure ID - 16.III.A.4)¹³

The Ryan White HIV/AIDS Program (RWHAP) works to improve health outcomes by preventing disease transmission or slowing disease progression for disproportionately impacted communities. One way RWHAP accomplishes this is through the provision of medications that help patients reach HIV viral suppression. People living with HIV who use medications designed to virally suppress the disease are less infectious, reducing the risk of transmitting HIV to others. In FY 2018 and 2019, RWHAP will continue to play a central role in ending the HIV epidemic by ensuring that persons living with HIV have access to regular care, receive antiretroviral medications, and adhere to a regular schedule for taking their medications.

Increase the percentage of adults aged 18 years and older who are vaccinated annually against seasonal influenza (Lead Agency - CDC; Measure ID - 1.3.3a)

In the United States, on average 5-20 percent of the population contracts the flu, more than 200,000 people are hospitalized from seasonal flu-related complications, and approximately 36,000 people die from seasonal flu-related causes.  This measure reflects the universal influenza vaccination recommendation and aligns with the Advisory Committee on Immunization Practices’ (ACIP) updated recommendation (as of 2010) for the seasonal influenza vaccine.  Seasonal influenza vaccinations increased slightly by two percentage points from FY 2013 (42%) to FY 2014 (44%), then varied from 42% in FY 2015 to 43% in FY 2016. CDC's efforts to improve adult vaccination coverage rates include:

• Increasing patient and provider education to improve demand and implement system changes in practitioner office settings to reduce missed opportunities for vaccinations
• Funding 10 state and local health departments to implement the Standards for Adult Immunization Practice in large health systems, community health centers, and pharmacies.
• Enhancing evidence-based communication campaigns to increase public awareness about adult vaccines and recommendations.  CDC routinely conducts literature reviews and surveys of the general public and health care providers to provide a deeper understanding of the target audiences for development of adult immunization communication messages and campaigns.
• Expanding the reach of vaccination programs including new venues such as pharmacies and other retail clinics.  CDC has existing partnerships to implement adult immunization practice standards, HPV vaccination, and pandemic vaccine program planning efforts to expand access to pandemic vaccine.  As of 2016-2017 influenza season, nearly 1 in 4 adults who got an influenza vaccine were vaccinated in a pharmacy or retail setting.

In FY 2018 and 2019, CDC will continue to monitor the percentage of adults aged 18 and older who are vaccinated annually against seasonal influenza to inform its strategies for improving adult vaccination coverage rates.

Continue advanced research and development initiatives for more effective influenza vaccines and the development of safe and broad-spectrum therapeutics for use in seriously ill and/or hospitalized patients, including pediatric patients (Lead Agency - ASPR; Measure ID - 2.4.15b)

The mission of ASPR is to lead the country in preparing for, responding to, and recovering from the adverse health effects of emergencies and disasters by supporting our communities’ ability to withstand adversity, strengthening our health and response systems, and enhancing national health security. The Biomedical Advanced Research and Development Authority (BARDA), within the Office of the Assistant Secretary for Preparedness and Response, provides an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies. This performance measure monitors the number of programs supported through ASPR’s advanced research and development initiatives as they pursue more effective influenza vaccines and the development of safe and broad-spectrum therapeutics for use in seriously ill and/or hospitalized patients, including pediatric patients. In FY 2017, the FDA approved the use of Rapivab (manufactured by BioCryst) to treat acute uncomplicated influenza in pediatric patients two years and older. The FY 2017 result is 2 programs. The data supports the goal to develop more effective influenza vaccines and to develop novel antivirals that have the potential to overcome resistance mechanisms. Resistance is a critical concern related to the emergence of H7N9 in Asia. The initial baseline is now set at 2 programs. Two is also the target for FY 2018 and FY 2019. The targets were set based on resource expectations and overall priorities. In FY 2018 and 2019, ASPR will continue to monitor progress towards an agile, robust and sustainable U.S. infrastructure capable of rapidly producing influenza vaccines against pandemic flu.