Interdisciplinary infectious disease centers should be developed to promote a multidisciplinary approach to addressing microbial threats to health. These centers should be based within academic institutions and link (both physically and virtually) the relevant disciplines necessary to support such an approach. They would collaborate with the larger network of public agencies addressing emerging infectious diseases (e.g., local and state health agencies, CDC, DOD, the U.S. Department of Energy, FDA, the Food Safety and Inspection Service, NIH, the National Science Foundation, USAID, USDA), interested foundations, private organizations, and industry. The training, education, and research that these centers would provide are a much-needed resource not only for the United States, but also for the entire world.

CONCLUSION

Today’s world is truly a global village, characterized by growing concentrations of people in huge cities, increasing global commerce and travel, progressive damage to natural ecosystems, poverty, famine, and social disruption. One can safely predict that infectious diseases will continue to emerge, and that we will encounter unpleasant surprises, as well as increases in already worrisome trends. Depending on present policies and actions, this situation could lead to a catastrophic storm of microbial threats.

Thus while dramatic advances in science and medicine have enabled us to make great strides in our struggle to prevent and control infectious diseases, we cannot fall prey to an illusory complacency. We must understand that pathogens—old and new—have ingenious ways of adapting to and breaching our armamentarium of defenses. We must also understand that factors in society, the environment, and our global interconnectedness actually increase the likelihood of the ongoing emergence and spread of infectious diseases. It is a sad irony that today we must also grapple with the intentional use of biological agents to do harm, human against human.

No responsible assessment of microbial threats to health in the twenty-first century, then, could end without a call to action. The magnitude and urgency of the problem demand renewed concern and commitment. We have not done enough—in our own defense or in the defense of others. As we take stock of our prospects with respect to microbial threats in the years ahead, we must recognize the need for a new level of attention, dedication, and sustained resources to ensure the health and safety of this nation—and of the world.



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