At the outset, we commend the Department of Defense (DOD), and particularly DTRA, for launching the TADR network. This initiative has considerable potential for enhancing DOD’s nonproliferation objectives while improving disease surveillance in Central Asia and the Caucasus, and indeed in other regions of the world as well. Disease surveillance capabilities of the countries where DTRA is concentrating its efforts have declined considerably since the fragmentation of the Soviet Union. At the same time, the capabilities of the scientific personnel for working with dangerous pathogens are significant, and directing these capabilities toward public health and animal health challenges is important.
Meanwhile, the threats of endemic and emerging diseases in the regions of interest remain substantial. The spread of diseases of regional and/or global significance such as Severe Acute Respiratory Syndrome (SARS) and avian influenza increases the importance of effective national surveillance networks linked to global surveillance systems. In this regard, the TADR network can play a critical role in many technical areas, such as upgrading laboratory and epidemiological capabilities, improving awareness and understanding of animal-to-human transmission of diseases, and providing important incidence data and analyses of trends in the region.
Of course, if the potential of the network is to be realized, the disease agents of interest must also include many agents that are of significant public health and animal health concern within the countries where the network is implemented. One pathogen of great concern is multi-drug resistant tuberculosis. Strains of tuberculosis that are resistant to all known drugs have been found in Kazakhstan. In addition, the network should have the capability to detect syndromes that might not be easily associated with specific pathogens but could lead to investigations that uncover pathogens of concern.
We appreciate the opportunity to contribute to the further development of the TADR network by focusing our attention on data system components of the network. We consider this letter report an important interim step in our continuing efforts to assist in upgrading disease surveillance capabilities in countries of the former Soviet Union. We are prepared to provide additional views on the TADR network and on related research issues in response to future requests from DTRA.
In addition to the focus on the GDR, a few observations on development of the overall network are offered. Only if the network provides information that is of considerable interest to U.S. government organizations and American specialists will the GDR be persuasive in seeking resources for investment in the program over the long term. This report suggests several steps to help ensure that the information that is obtained will indeed be of interest.
Furthermore, we have not examined the cost aspects of the TADR network in general or the data system in particular. We recognize the difficulty in balancing financial investments in public and veterinary health infrastructures with payoffs measured in terms of prevention of diseases in humans or livestock, pathogen containment, achievement of nonproliferation