IANPHI and National Public Health Institutes

by

Ellen Whitney, Katherine Seib, Jessica Blackburn, Jacob Clemente, Courtenay M. Dusenbury, Jeffrey P. Koplan

• LAST REVIEWED: 10 February 2023
• LAST MODIFIED: 22 April 2020
• DOI: 10.1093/obo/9780199756797-0197

Introduction

More than one hundred countries around the world have established national public health institutes (NPHIs) to coordinate and lead their public health systems. Some NPHIs, such as the US Centers for Disease Control and Prevention (CDC), South African National Institute for Communicable Diseases (NICD), Brazilian Oswaldo Cruz Foundation (FIOCRUZ), and Chinese Center for Disease Control and Prevention, have developed over time. Others, such as the Public Health Agency of Canada (PHAC), emanated in response to more recent global public health threats like severe acute respiratory syndrome (SARS). NPHI functionalities range from combatting primarily infectious diseases to comprehensive mandates to lead national efforts for prevention and control of both infectious and noncommunicable disease threats. The International Association of National Public Health Institutes (IANPHI), envisioned in 2001 and chartered in 2006, serves to link and catalyze the capacity of NPHIs around the world through a robust international professional and scientific network. IANPHI works closely with the World Health Organization (WHO) through a formal partnership agreement. The Bill & Melinda Gates Foundation, the Rockefeller Foundation, member dues and peer assistance, bilateral cooperative agreements, and private-sector partnerships support its activities. IANPHI’s members encompass more than five billion people across six continents. IANPHI is the only organization whose mission is to strengthen national public health institutes. To do this, IANPHI’s work focuses on (a) supporting a robust scientific community of NPHI directors through an annual meeting, a listserv, and collaborative activities; (b) developing and distributing guidelines and tools that strengthen NPHIs’ abilities to conduct and evaluate public health programs and efforts, including the IANPHI NPHI development framework, the Staged Development Tool, NPHI-to-NPHI evaluation guidance, and a best practices series; and (c) investing in projects designed to create NPHIs and strengthen public health systems in low-resource countries. IANPHI helps NPHIs by advocating for strong and well-supported NPHIs and providing timely information and insights for public health programs and actions.

Introductory Works

NPHIs vary in scope and size, from fledgling institutes focusing only on infectious diseases to those with comprehensive responsibility for laboratory, research, and workforce development; surveillance programs; emergency preparedness and response; and policy for most public health issues. In its 2007 Framework for the Creation and Development of National Public Health Institutes (International Association of National Public Health Institutes 2007, cited under Best Practice Guidelines), IANPHI defined the scope and functions of NPHIs. NPHIs have national influence and recognition, focusing on the major public health issues affecting a country. NPHIs are accountable to national governments and their public and use scientific evidence as the basis for policy implementation and resource allocation. Their key functions—including disease surveillance, detection, and monitoring; outbreak investigation and control; policy development; health promotion and education; and laboratory science—are particularly critical in low-resource nations. Frieden and Koplan 2010 outlines the importance of creating NPHIs to give countries (a) a focal point for strengthening public health systems; (b) increased technical capacity to better respond to major causes of disease, death, and disability; and (c) skills to deliver public health programs for infectious diseases and chronic conditions. European NPHI leaders discuss the functions, scope, and importance of their NPHIs in International Association of National Public Health Institutes/Europe 2011. Frenk and Gonzalez-Block 2008 notes that NPHIs can foster national long-term strategic plans for an evidence-based, sustainable system that addresses major public health challenges, as well as better use of existing resources, including leveraging vertical resources from the donor community around a central national strategy. Rodier, et al. 2007 asserts that NPHIs provide a strategic approach toward meeting the International Health Regulations and responding decisively to public health threats (e.g., avian influenza, SARS). Koplan, et al. 2005 and Jousilahti 2006 outline the important functions of NPHIs and their key role in public health workforce training. Committee on the US Commitment to Global Health 2009 outlines the importance of NPHIs and their role in evidence-informed policy development and public health program execution. Pierre-Louis, et al. 2012 calls NPHIs a key component of global health strategies, stating that the World Bank will make NPHI creation a pillar of its global development efforts. World Health Organization’s Global Action Plan calls for the establishment of NPHIs to strengthen public health systems (WHO 2013). Pekka and Koplan 2017 discusses the impacts that IANPHI has had across its global network of partners during its first ten years of existence.

• Committee on the US Commitment to Global Health. 2009. Invest in people, institutions, and capacity building with global partners. In The U.S. commitment to global health: Recommendations for the new administration. By the Committee on the US Commitment to Global Health, 107–129. Washington, DC: National Academies Press.

  This report cites the importance of NPHIs to creating strong national public health capacity, noting that “[c]oordinating core public health functions through an NPHI can result in a more efficient use of resources, improved delivery of public health services, and increased capacity to respond decisively to public health threats and opportunities” (p. 112).

• Frenk, J., and M. A. Gonzalez-Block. 2008. Institutional development for public health: Learning the lessons, renewing the commitment. Journal of Public Health Policy 29:449–458.

  DOI: 10.1057/jphp.2008.35

  Using the development of Mexico’s National Institute of Public Health as an example, the authors discuss the importance of NPHIs in solving complex public health challenges and boosting national capacity in resource allocation and policy development. NPHIs strengthen national research capacity in low-resource nations and counter the silos of vertical programs. IANPHI and Mexico’s National Institute of Public Health have worked to build capacity in Mesoamerica.

• Frieden, T., and J. Koplan. 2010. Stronger national public health institutes for global health. Lancet 376:1721–1722.

  DOI: 10.1016/S0140-6736(10)62007-7

  This commentary describes the core functions of NPHIs, based on the IANPHI Framework (see International Association of National Public Health Institutes 2007, cited under Best Practice Guidelines) and notes that effective public health response requires a multidisciplinary effort (encouraged by NPHIs), with scientific credibility and independence from political interference. The authors call on developing countries to increase the resources to and authority of NPHIs.

• Heymann, D. L. 2008. NPHIs as focal points for leadership in prevention and control of infectious diseases. Journal of Public Health Policy 29:374–376.

  DOI: 10.1057/jphp.2008.19

  Former WHO Assistant Director-General for Health Security and Environment, David Heymann, outlines the role of NPHIs as governmental focal points for science-based public health policy and resource allocation. Citing efforts to combat specific infectious diseases such as SARS, HIV-AIDS, malaria, and tuberculosis, he posits that the infrastructure from these disease-specific investments can become the keystone of the national, coordinated public health infrastructure necessary to comply with the International Health Regulations.

• International Association of National Public Health Institutes/Europe. 2011. National public health institutes: European perspective. Report 40/2011. Helsinki: National Institute for Health and Welfare.

  Directors of NPHIs from European countries share their perspectives on the functions, scope, and importance of NPHIs. The leaders discuss the roles of NPHIs in the context of the European Union’s health policy and the challenges in the creation and sustainability of their institutes.

• Jousilahti, P. 2006. Improving the world’s health: The role of national public health institutes. Central European Journal of Public Health 14:3–5.

  DOI: 10.21101/cejph.b0052

  This article summarizes the importance of NPHIs in fostering and sustaining a competent public health workforce. NPHIs, because they are primarily scientific organizations, are not subject to political changes and can provide a stable base for national expertise. They also encourage collaboration within and between nations on public health challenges.

• Koplan, J. P., P. Puska, P. Jousilahti, K. Cahill, J. Huttunen, and NPHI partners. 2005. Improving the world’s health through national public health institutes. Bulletin of the World Health Organization 83.2: 154–157.

  This article lays out the functions of NPHIs, including research, monitoring and surveillance, infectious disease control, noncommunicable disease control, emergency preparedness, diagnostic services, health promotion and health education, and training. It further outlines the main activities of IANPHI, which include training, collaborative research, and benchmarking.

• Pekka, P., and J. P. Koplan. 2017. IANPHI—10 years of collaboration for institutional public health. European Journal of Public Health 27.2: 192–193.

  DOI: 10.1093/eurpub/ckw241

  The cofounders of IANPHI reflect on the impact of IANPHI on the global network of NPHIs.

• Pierre-Louis, A. M., S. el-Saharty, A. Stanciole, et al. 2012. Connecting sectors and systems for health results. Washington, DC: World Bank.

  The World Bank team notes that “achieving and sustaining positive impact in public health is best served by a national organization which can help ensure a strong and coordinated focus on public health to assist the government in its stewardship role” (p. 21). The Bank will be “supporting client countries’ capacity to perform the essential public health functions, supported in this effort by the establishment of NPHIs” (p. 31).

• Rodier, G., A. L. Greenspan, J. M. Hughes, and D. L. Heymann. 2007. Global public health security. Emerging Infectious Diseases 13:1447–1452.

  DOI: 10.3201/eid1310.070732

  Given the complexity of modern-day disease transmission, including newly emerging infections, the need for cross-border collaboration, strong and well-linked surveillance capacity, and outbreak investigation expertise, NPHIs and IANPHI will play a major role in ensuring that countries are ready for the International Health Regulations.

• World Health Organization. 2013. Global action plan for the prevention and control of NCDs 2013–2020. Geneva, Switzerland: World Health Organization.

  The WHO resolution calls for the strengthening of capacity and innovation through such measures as the establishment of NPHIs (p. 38).