the application of a wide range of pesticidal chemicals within the habitat of any endangered species. EPA has developed an emergency exemption procedure to allow pesticide use in restricted areas when the possibility of an outbreak of a vector-borne disease is great. This procedure, however, is extremely cumbersome and time-consuming, and the committee believes that it is essentially useless if followed as prescribed, since emergency approval of a pesticide is likely to come after the critical period during which its use could avert an outbreak.

As with vaccines, there is little economic incentive for firms to develop new pesticides for public health use, primarily because such use is a very small fraction of the total pesticide market. Pesticide development is now driven mainly by the demands of agriculture. Moreover, as pesticide development has become more specialized, there are fewer compounds available that have both agricultural and public health uses. The committee feels strongly that pesticide development for public health applications needs to be given some priority.

The committee recommends that additional priority and funding be afforded efforts to develop pesticides (and effective modes of application) and other measures for public health use in suppressing vector-borne infectious diseases.

Public Education and Behavioral Change

Public policy discussions and scientific efforts sometimes focus on vaccine and drug development to the exclusion of education and behavioral change as means for preventing and controlling outbreaks of infectious disease. This is unfortunate, because it is often only by changing patterns of human activity—from travel, personal hygiene, and food handling to sexual behavior and drug abuse—that the spread of disease can be halted.

Even when scientists and public health officials rely on and encourage education and behavioral change to prevent or limit the spread of infectious disease, the public may not be convinced of its necessity. Although scientists may see emerging microbes as a very real threat to public health, the average citizen may be unaware of the potential danger or may consider those dangers to be less important than other health risks, like heart disease and cancer. In such instances, a carefully conceived media campaign may have a beneficial effect on behavior that affects disease transmission.

The committee recommends that the National Institutes of Health give increased priority to research on personal and community health practices relevant to disease transmission. Attention should also be focused on developing more effective ways to use education to enhance the health-promoting behavior of diverse target groups.



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