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HHS FACT SHEET
December 2, 1998
Contacts:  CDC Press Office (404) 639-3286
                 NIH Press Office  (301) 496-5787

HHS INITIATIVES TO COMBAT EMERGING INFECTIOUS DISEASES

Overview: Emerging infectious diseases present one of the most significant health challenges facing the global public health community today. Infectious diseases -- those caused by microscopic organisms and spread from person to person -- are the leading cause of death worldwide. Efforts to control them in the United States have led to important achievements in public health. But infectious diseases not only continue to occur, they are growing in number, type and importance to the health of the population globally. Examples include the outbreak of avian flu in Hong Kong in 1997, as well as outbreaks of Ebola hemorrhagic fever, hantavirus pulmonary syndrome, drug-resistant infectious diseases, HIV/AIDS, and foodborne diseases. The direct costs of infectious diseases in the United States alone are estimated to be more than $30 billion a year.

Since 1993, HHS health agencies have worked to strengthen our nation's defense against emerging infectious diseases. The Centers for Disease Control and Prevention (CDC) has primary responsibility for disease surveillance and prevention in the U.S., and it has developed a comprehensive strategy to improve the nation's methods for combating the threats posed by new and reemerging infectious diseases.

As part of its comprehensive strategy, CDC is working with states and international organizations to improve early disease detection and outbreak containment. The National Institutes of Health (NIH) is supporting research on detecting and controlling emerging infectious diseases and on the biology and pathology of infectious agents. Other HHS agencies such as the Food and Drug Administration (FDA) work to assure that the American public is protected from infectious diseases potentially spread by the food supply and other sources.

In June 1996, President Clinton issued a Presidential Decision Directive on Emerging Infectious Diseases. The directive sets policy and provides for coordination across the federal government in improving domestic and international disease surveillance, prevention, and the response measures.

HHS funding to combat emerging infectious diseases includes $79 million in FY 1999. A complementary joint effort in CDC and FDA is an initiative to counter food borne diseases totals $68.5 million in HHS funding in FY 1999.

BACKGROUND

In the years following World War II, it was widely believed that humans were winning the war against infectious disease. Life-threatening bacterial diseases such as tuberculosis and typhoid fever could be treated by antibiotics, and childhood diseases such as polio and whooping cough could be conquered through vaccination. The incidence of infectious diseases had been reduced dramatically.

But in the 1950s, penicillin began to lose its power to cure infections cause by Staphylococcus aureus, a common bacterium that can cause serious illness. In 1957 and 1968, new strains of influenza emerged in China and spread rapidly around the globe, and in the 1970s there was a resurgence of sexually transmitted diseases. Also during the 1970s, several new diseases were identified, including Legionnaires' disease, Lyme disease, toxic shock syndrome, and Ebola hemorrhagic fever. During the 1980s, as state and local support for infectious disease surveillance declined, acquired immune deficiency syndrome (AIDS) appeared and tuberculosis reemerged, spreading quickly through U.S. cities.

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)

By the early 1990s, health experts no longer believed that infectious diseases were receding in the U.S. or elsewhere. In 1994, CDC launched a national effort to revitalize the U.S. capacity to protect the public from infectious diseases. CDC released an updated plan in November 1998. The strategy includes:

Already, CDC's comprehensive plan has produced results. CDC has identified quick and accurate methods for diagnosing Cyclospora, improved its mechanism for identifying and controlling Ebola outbreaks, improved global influenza surveillance, and implemented a rapid response and outreach system for E.coli outbreaks.

Key elements of CDC's strategy that have already been implemented include:

NATIONAL INSTITUTES OF HEALTH (NIH)

NIH is responsible for research and training aimed at the development of vaccines, therapies, and diagnostics for emerging and reemerging infections. In 1996, the National Institute of Allergy and Infectious Diseases (NIAID) at NIH developed "A Research Agenda for Emerging Infectious Diseases," which identified three goals. These include research on environmental factors that influence disease emergence and create resistance to antibiotics, development of vaccines and medications, and education and training, both nationally and internationally, to help control future emergence of infectious diseases.

To put these goals into practice, NIH institutes have undertaken numerous research activities.

FOOD AND DRUG ADMINISTRATION (FDA)

The FDA has developed working groups to address antibiotic resistance as it relates to new drug approvals. One group, the Antibiotic Resistance Coordinating Committee, educates health care professionals on antibiotic resistance and the appropriate use of antibiotics. It also reviews consumer ads and television commercials intended to market antibiotics to the public.

Another working group convened a workshop with industry representatives in July 1998 to discuss potential development of treatments due to antibiotic-resistant organisms. The committee also discussed the definition of antibiotic resistance, clinical trial design, and methods to encourage prudent use of antibiotics.

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