programs, as well as several other efforts in international health under one new initiative, the International Centers for Tropical Disease Research.

The CDC currently supports research and training in the area of infectious diseases through its National Center for Infectious Diseases. Earlier efforts by the agency, however, may have valuable components that deserve revisiting. For example, from the mid-1960s to the early 1970s, the CDC administered an extramural program that awarded grants to academic and other institutions for research in infectious disease prevention and control. The committee has concluded that this now defunct program filled a need for support in a critical area of research.

The committee recommends increased research on surveillance methods and applied control strategies; on the costs and benefits of prevention, control, and treatment of infectious disease; and on the development and evaluation of diagnostic tests for infectious diseases. Reinstating and expanding (both in size and scope) the extramural grant program at the Centers for Disease Control, which ceased in 1973, would be one important step in this direction. Similarly, the Food and Drug Administration's (FDA) extramural grant program should be expanded to place greater emphasis on the development of improved laboratory tests for detecting emerging pathogens in food.

An adequate supply of well-trained, experienced epidemiologists is critical to the nation's surveillance efforts. CDC's Epidemic Intelligence Service (EIS) provides health professionals with two years of training and field experience in public health epidemiology. The EIS is the model as well for another evolving program, the joint CDC/WHO Field Epidemiology Training Program (FETP), which places field-oriented epidemiologists in countries that need to develop and implement disease prevention and control programs. Current and former EIS officers and FETP graduates are important sources of information on emerging diseases and constitute a personnel nucleus for a global surveillance network. The distribution of these epidemiologists, however, is restricted because of the limited number of program graduates each year.

The committee recommends the domestic and global expansion of the Center for Disease Control's (CDC) Epidemic Intelligence Service program and continued support for CDC's role in the Field Epidemiology Training Program.

The seven overseas medical research laboratories maintained by the U.S. Department of Defense are the most broadly based international facilities of their kind supported by the United States. In addition to being well situated



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