Since it is hard to predict those diseases that may have future significance, worldwide and in the United States, CDC emphasizes preparedness. The CDC strategy for addressing emerging infectious diseases derives from recommendations in the 1992 IOM report and is structured around four goals:

Goal 1: To improve surveillance and response capacity.

Goal 2: To address applied research needs.

Goal 3: To strengthen prevention and control programs.

Goal 4: To repair public health infrastructure at local, state, national, and international levels.

• CDC's extramural research program, halted in 1973, was reinstated at a level of $800,000 for FY97. Funding priority is assigned to research projects focused on:
• • antimicrobial resistance (including mechanisms of resistance, development of better diagnostics, and strategies to improve prescribing practices); and
  • tickborne disease (Ehrlichia and Babesia).
• Founding role in development and implementation of the CISET report.
• Organization and implementation of three sentinel networks: a physician network in collaboration with the Infectious Disease Society of America; one with the International Society of Travel Medicine; and one with a network of 11 academically based emergency departments in the United States, each focused on diseases and syndromes identified in their particular environment.

The CISET report represents collaborative thinking by 17 different federal agencies about how to work more effectively, together and with the private sector, toward implementing the CISET plan without duplicating efforts. At the operational level, interactions between CDC, NIH, FDA, and DOD are good.