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Emerging Infections: Microbial Threats to Health in the United States
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. The implementation of such a program should also encompass 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 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, to protect the health of their citizens who were sent to settle or administer recently acquired territory. After World War II, there was a second blossoming of such surveillance activities. The Fogarty International Center was established, as were several overseas laboratories staffed by Department of Defense personnel. Privately funded activities, like those of the Rockefeller Foundation Virus Program, were also important contributors to infectious disease surveillance at the international level.
Over the past two decades, a number of these facilities have been closed or are no longer operating with U.S. oversight. Nevertheless, although its efforts are substantially reduced from previous levels, the United States still maintains an international presence in infectious disease surveillance and research. As is the case in related domestic efforts, however, international infectious disease surveillance activities undertaken by U.S. government agencies remain largely uncoordinated and in need of a strategy to focus them in appropriate areas, such as emerging diseases.
The committee recommends that international infectious disease surveillance activities of U.S. government agencies be coordinated by the Centers for Disease Control (CDC). To provide the necessary link between U.S. domestic and international surveillance efforts, the body that is established for this purpose should be the same as that suggested earlier in the recommendation on domestic surveillance. Alternatively, a federal coordinating body (e.g., a subcommittee of the Federal Coordinating Council for Science, Engineering, and Technology's [FCCSET] Committee on Life Sciences and Health, specifically constituted to address this issue) could be assigned the coordinating function. Implementation of surveillance activities, however, should remain with the appropriate federal agencies (e.g., the CDC, Department of Defense, National Institutes of Health, U.S. Department of Agriculture).
The efforts of multilateral international organizations, such as the World Health Organization (WHO), are critical in coordinating infectious disease