Some of the MARU field studies were collaborations with the Gorgas Memorial Laboratory. MARU researchers conducted definitive studies on Bolivian hemorrhagic fever, Venezuelan equine encephalitis in Central America, and several viral infections that are transmitted by tropical sandflies. In the mid-1970s, as a harbinger of decreasing U.S. government commitment to international health research, MARU left the NIH to become part of the Gorgas Laboratory.

In 1960, the National Institute of Allergy and Infectious Diseases (NIAID) established the International Centers for Medical Research and Training (ICMRT) program to further support tropical disease research of benefit to U.S. citizens. In collaboration with foreign universities and government agencies, the program provided long-term overseas research training for U.S. scientists. ICMRT grants resulted in broadly productive research programs that studied a wide variety of infectious and noninfectious diseases. In 1979, as part of an overall plan to scale back its involvement in research training activities, the NIAID discontinued the ICMRT program.

Loss of Capacity

The establishment of a new laboratory (particularly on foreign soil), its staffing, and the development of a reputation for carefully conducted, rigorous scientific work are tasks that cannot be accomplished overnight. It is unfortunate that the U.S.-supported overseas laboratories discussed above were, for varying reasons, either discontinued or forced to scale back their efforts. Their achievements had a profound impact on the level of scientific knowledge of many previously known and newly recognized infectious diseases and their causative agents. A further loss is the many opportunities they provided for U.S. scientists to develop overseas field experience and to collaborate with foreign scientists and institutions, thereby acquiring infectious disease surveillance information of importance to U.S. monitoring activities.

Current Efforts

The purposes and entities discussed briefly below constitute current U.S. efforts in international infectious disease surveillance, most of which is conducted through passive monitoring.

  • The NIAID's International Centers for Tropical Disease Research (ICTDR) program. Established as a means to provide more cohesion to existing and newly initiated programs in tropical infectious disease research, the ICTDR program laboratories, because of their geographic distribution (see Table 3-2 above), are well situated to conduct surveillance for new and



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