The United States faces many potential threats to human health, including natural disease outbreaks, environmental exposures, and acts of terrorism. In today’s modern world of high- density population centers and global mass transit such threats and hazards can significantly impact human health. These potential threats speak to the need for an integrated all-hazards approach to health security by all sectors of society. At the same time, the broader and more sophisticated use of information technology, new information sources, and analytic techniques holds the potential to accelerate recognition of health threats and improve the accuracy of assessments. With greater availability and real-time delivery of health information it may be possible to maintain a comprehensive picture of the nation’s health and detect aberrations in illness patterns faster and more accurately.

These new opportunities and increasing threats demand a national vision for biosurveillance that builds on existing capabilities and relationships while investing in innovative and science-driven tools and methods. Effective biosurveillance embraces a complementary “system of systems” that leverages the data collection and analyses performed at the local level while incorporating broader national perspectives.

Biosurveillance in the context of human health is a new term for the science and practice of managing health-related data and information for early warning of threats and hazards, early detection of events, and rapid characterization of the event so that effective actions can be taken to mitigate adverse health effects. It represents a new health information paradigm that seeks to integrate and efficiently manage health-related data and information across a range of information systems toward timely and accurate population health situation awareness.

The National Biosurveillance Strategy for Human Health (hereafter The Strategy) articulates a vision for enhanced biosurveillance and is intended to guide national interests to:

• Implement a national enterprise of complementary biosurveillance systems that provides relevant, accurate and timely information for government, healthcare, business, and personal decision-making for planning and responding to population health emergencies;

• Coordinate health-related information sharing, according to defined data sharing policies, both vertically and horizontally across all levels of government, jurisdictions, and health- related disciplines to improve the effectiveness of disease monitoring and response;

• Prioritize improvements to existing biosurveillance efforts and infrastructures;

• Ensure biosurveillance data is available for local use, where it is best understood and managed;

• Develop new relationships while continuing to leverage and maintain existing ties between local public health professionals and data providers;

• Engage a diverse consortium of governmental, non-governmental, academic, and business sector stakeholders in the complex and distributed national enterprise of biosurveillance for human health;

• Optimize resources to support biosurveillance and broader public health needs; and

• Address all hazards while assuring flexibility and specificity of biosurveillance methods as required to monitor and investigate cases at the local level.

The Strategy provides the foundation for a long-term effort to improve a nationwide capability to manage health-related data and information. It is grounded in U.S. laws and Presidential Directives, including Homeland Security Presidential Directive-21 (HSPD-21), “Public Health and Medical Preparedness”, which names biosurveillance as one of four critical priorities for improving public health preparedness. HSPD-21 also mandates the development of a nationwide integrated biosurveillance capability, as well as the establishment of a federal advisory committee. As a result, the National Biosurveillance Advisory Subcommittee (NBAS), which includes private sector representatives, and state and local government public health authorities, was established to help carry out these mandates. This subcommittee to the Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS), produced their first report which includes recommendations to strengthen the nation’s biosurveillance capability and provides counsel to the federal government regarding a broad range of issues affecting a nationwide biosurveillance strategy for human health. That report has helped shape The Strategy document.

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