The workforce necessary to accomplish the needed improvement in the national capacity to respond to microbial threats must be supported with strong training programs in the applied epidemiology of infectious disease prevention and control. As a vital component of this workforce, the knowledge and skills needed to confront microbial threats must be better integrated into the training of all health care professionals to ensure a prompt and effective response to any and all infectious disease threats, whether naturally occurring or maliciously introduced.
CDC, DOD, and NIH should develop new and expand upon current intramural and extramural programs that train health professionals in applied epidemiology and field-based research and training in the United States and abroad. Research and training should combine field and laboratory approaches to infectious disease prevention and control. Federal agencies should develop these programs in close collaboration with academic centers or other potential training sites. Domestic training programs should include an educational, hands-on experience at state and local public health departments to expose future and current health professionals to new career options, such as public health.
Our nation—and the world—faces a serious crisis with respect to vaccine development, production, and deployment. Concern has increased over the inadequacy of vaccine research and development efforts, periodic shortages of existing vaccines, and the lack of vaccines to prevent diseases that affect persons in developing countries disproportionately. Yet, too little has been done to resolve these issues. The evolving threat of intentional biological attacks makes the need for focused attention and action even more critical.
The challenges associated with vaccine innovation, production, and deployment are many and complex. Solutions will require a novel, coordinated approach among government agencies, academia, and industry. Issues that must be examined and addressed in a more meaningful and systematic fashion include the identification of priorities for research, the determination of effective incentive strategies for developers and manufacturers, liability concerns, and streamlining of the regulatory process. Currently, the federal government is neither addressing all of these challenges at a sufficiently high level nor providing adequate resources. Leadership, empowerment, and accountability are urgently needed at the cabinet level to