only benefits its northern participants, but also helps build a sustainable public health capacity in the developing world. Historically, the goal of many tropical disease training programs was to strengthen the northern country’s capacity for tropical disease diagnosis and treatment. The trend toward a bidirectional, more egalitarian approach that benefits the developing-country partner as much as its northern collaborator reflects a growing awareness that a sustainable global public health capacity can be achieved only with the full and equal participation of the developing world. Thus, not only are the Gorgas Course and other, similar programs becoming more popular, both politically and among students, but their nature is also changing in significant and telling ways. The shifting focus of many of the international training programs of the Fogarty International Center (FIC) within the National Institutes of Health (NIH) further reflects the increased awareness, funding, and efforts needed to strengthen bidirectional international training in epidemiology, public health, and tropical medicine in particular.

Are there enough of these programs to go around, however? In addition, despite the clear and growing need and interest, are U.S. medical and veterinary students receiving enough training in public health, let alone in tropical infectious diseases? The Gorgas Course, FIC programs, and other, similar initiatives are summarized here. The chapter also addresses the need to better incorporate public health training into U.S. medical and veterinary school curricula and ways in which Russian scientists could contribute to a transnational public health education program.

Workshop participants identified other opportunities for progress as well. These include worldwide access to antiretroviral agents and vaccines; an increased capacity for global and regional surveillance; and technological advances in information and communications technology, namely, the Internet.

Rather than focusing on specific opportunities, several of the presentations and discussions revolved around the various ways in which certain organizations and regions are capitalizing on such opportunities. The Pan American Health Organization (PAHO), for example, is relying on the development of regional political networks to aid in the construction of regional surveillance networks and to facilitate the sharing of diagnostic and treatment techniques across borders. Despite these promising developments, many obstacles impeding regional efforts to strengthen infectious disease control capacity remain.

Another regional example is Russia, which, despite its current general state of public health as described in the previous chapter, has experienced some recent achievements and taken advantage of opportunities for the development of international collaborations in infectious disease control. The State Research Center of Virology and Biotechnology (VECTOR) plays a leading role in these efforts, which are summarized here.



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