tion and control strategies, therefore, the factors influencing the emergence of infectious disease must be recognized and addressed at a global level.

Disease burdens—such as those incurred as a result of HIV, tuberculosis, and malaria—can contribute to the destabilization of nations, damaging their social and political infrastructures (National Intelligence Council, 2000; Denver Summit of the Eight, 1997). The past decade has seen the HIV epidemic besieged but entrenched in the United States, and spread globally with a catastrophic social and economic impact on many developing countries. Affecting adults in their productive years disproportionately, HIV has led to a grievous decrease in per capita gross domestic product (GDP) across Africa, resulting in a vicious spiral of decreased investment in public health and worsening of the epidemic. The resurgence of tuberculosis is devastating many countries, particularly Russia and other former Soviet republics, where tuberculosis rates have increased an astounding 70 percent in less than a decade. Antimicrobial resistance has become a major barrier to treatment of tuberculosis and malaria worldwide, threatens the effectiveness of antiretroviral therapy in persons with AIDS, and has made treatment of common bacterial infections more difficult in the United States and elsewhere. Infectious diseases are appearing abruptly in new locations and claiming hundreds of lives; a case in point is West Nile encephalitis, which spread to most parts of the United States within 3 years following its sudden appearance in the Northeast. Certain risks to health, such as contamination of food products, have resulted in enormous economic consequences, along with implications for human disease. Infectious diseases have even been used to intentionally terrorize populations, further dramatizing the need for a comprehensive assessment of and response to microbial threats.

Amelioration of major health risks and problems in any country, therefore, is a global good that may indirectly benefit the United States. Moreover, in an era of heightened concern regarding international networks of terrorism and nations with weapons of mass destruction, leadership in addressing the infectious disease problems of other countries can build trust and goodwill toward the United States. Repeatedly, U.S. efforts to monitor and address infectious disease threats in other countries have been welcomed and have increased understanding and improved relationships between countries. The need for an adequate global response to infectious disease threats, therefore, derives from the United States’ humanitarian, economic, and national security interests.

According to a recent analysis by the National Intelligence Council (2000), newly emerging infectious diseases, including the intentional use of a biological agent, will pose an increasing global health threat and will complicate U.S. and global security over the next 20 years. As outlined in that report, the future impact of infectious diseases will be heavily influ-



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