Territorial Advisor’s Strengthening Public Health Emergency Preparedness & Outbreak Response

The National Governors Association's Health and Homeland Security & Cybersecurity teams, in partnership with Johns Hopkins' Center for Outbreak Response and Innovation (CORI), held a 3-day convening on Guam April 28-30. This convening was one of the culminating events connected to the year-long NGA policy academy "Strengthening Outbreak Response through Data, Forecasting, and Analytics Policy Academy" created to support Governors' offices in their efforts related to infectious disease outbreak response, forecasting and disaster response. Participating members of the policy academy include three of the five U.S. territories: American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI) and Guam.

Territories and geographically isolated states bring distinct perspectives to infectious disease preparedness and response. This in-person convening gave participants a forum to discuss shared challenges and exchange best practices for outbreak and disaster response. In addition to policy academy members, representatives from Hawai'i, Puerto Rico and the U.S. Virgin Islands also participated in the convening.

The convening began with remarks from Guam's Lieutenant Governor Josh Tenorio, who shared his appreciation for the work and his thoughts on the future of emergency preparedness efforts. Other convening sessions featured presentations from subject matter experts, an interactive scenario-based workshop and attendee-based roundtable discussions focused on topics identified through policy academy action planning discussions.

During the sessions, attendees heard from subject-matter experts and shared perspectives on pressing outbreaks and disaster response issues. Some of the main themes from these discussions included:

Workforce and Data

Attendees explored challenges around developing and retaining workforce, maintaining epidemiologic and analytic capacity, and communicating regionally to inform coordinated response efforts. There was an emphasis on modernizing public health data systems while maintaining basic, resilient backup systems during emergencies. The importance of operational capacity was also discussed. Themes around functional coordination systems, clear roles and readiness in the event of an emergency were reinforced as key considerations in not only response plans, but also the policies put in place.

Territorial Realities

Attendees explored the nuances of mainland guidance and instances where recommendations cannot be directly translated to territorial/island contexts, including smaller populations, geographic isolation and infrastructure and resource limitations. A key takeaway was evaluating lessons learned from tenured staff, institutionalizing the knowledge and continuing participation in emergency response specific exercises to ensure policies and systems are ready for crises.

Regional and Local Communication

Attendees engaged in peer-to-peer sharing with a specific focus on regional collaboration and communication across the territories to share approaches on data, emergency response procedures and related policies. Discussions dissected communication strategies at local/native/tribal, territorial, national, and international levels. These conversations emphasized the need for building and maintaining strong relationships across agencies, leadership, and communities prior to, during, and after emergencies.

Overall, this convening was an opportunity for territory and state health and emergency preparedness policy experts to come together to discuss shared challenges and the innovative solutions they have developed to strengthen their outbreak and disaster response systems and reflect their respective local contexts. Participants emphasized the importance of sustaining collaborative efforts locally and regionally, continuing to bolster their workforce and data capacities, and relying on effective communication to inform their peers and populations before, during, and after an emergency.

For more information about NGA's Strengthening Outbreak Response through Data, Forecasting, and Analytics Policy Academy, please contact and .