building modern disease prevention and control programs that include geographic monitoring, laboratory diagnosis, reference identification, and intervention.

Transformation from an internal to an external orientation could begin with modest investments to update disease surveillance within Russia by improving the equipment and communication capabilities of the five anti-plague institutes and then moving toward international cooperation. It is likely that, if asked, the international community would contribute some of the necessary funds, given the worldwide benefits of such a transformation. The initiation of joint U.S.-Russian epidemiological systems would be a logical early step in this direction.

Upgrading the SSESC system and bringing the anti-plague network more directly into national and international surveillance systems are only two possible initiatives to strengthen Russia’s surveillance and response capabilities. Certainly greater support of agriculture disease surveillance networks with special attention to zoonotic diseases would be highly beneficial as well.

The next chapter addresses the role of research organizations which support surveillance and control activities described in this chapter. Together, these two chapters should provide useful guidance for further Russian efforts to improve the scientific base for combating infectious diseases.