might consolidate information from more specialized sources, such as the National Nosocomial Infections Surveillance System (NNISS), the National Electronic Telecommunications System for Surveillance (NETSS), and the influenze surveillance system; it could also include additional information, such as vaccine and drug availability. As an alternative, expansion of currently available databases and provisions for easy access to these sources should be aggressively pursued. Also included in the implementation of such a program should be expanded efforts to inform physicians, public health workers, clinical laboratories, and other relevant target groups of the availability of this information.


U.S.-supported overseas infectious disease laboratories have played a historic role in the discovery and monitoring of infectious diseases. The United States and other nations first created these disease surveillance posts, many of them in tropical and subtropical countries, in an effort to protect the health of their citizens who were sent to settle or administer recently acquired territory. During and after World War II, there was a second blossoming of U.S. government-supported international disease research and surveillance activities. Several overseas laboratories staffed by Department of Defense (DoD) personnel were established. The Middle America and Pacific Research Units of the National Institutes of Health (NIH) were founded, and later terminated. The Gorgas Memorial Laboratory, in Panama, was until 1991, supported by the United States. Privately funded activities, like those of the Rockefeller Foundation Virus Program, were important contributors to surveillance efforts. Other private foundations and universities also played a role in surveillance overseas.

Over the past two decades, the number of such facilities has declined, largely as a result of shifts in program priorities. This trend is of concern to the committee, particularly in view of the many important achievements of the laboratories that have been closed. The loss of these facilities has left a major gap in U.S. overseas infectious disease surveillance, research, and training capabilities. Brief histories of some U.S.-supported overseas laboratories, several of which no longer operate, appear below. (See also the section on research and training later in this chapter.) Table 3-2 is a list of current U.S. government-supported overseas infectious disease laboratories.

Past Successes

The Gorgas Memorial Laboratory The Gorgas Memorial Laboratory (GML) in Panama, founded by the Gorgas Memorial Institute in 1928, was

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