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Protecting Our Nation's Health in an Era of Globalization: CDC's Global Infectious Disease Strategy
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Objectives for Priority Area 5
Establish a Solid Foundation for Global Initiatives
  • Expand the cohort of public health professionals at CDC who have international expertise and can provide support for global initiatives to combat infectious diseases. (See also Priority Area 6.)
  • Help suggest international priorities for current and future global initiatives for disease control. Future initiatives might include antimicrobial resistance monitoring, pandemic influenza preparedness planning, and campaigns to control or eliminate measles, lymphatic filariasis, onchocerchiasis, trachoma, rubella, neonatal tetanus, and hepatitis B.
  • Provide technical assistance to national health authorities in public health management of diseases targeted by global health initiatives, working through the Sustainable Management Development Program and other mechanisms. In some countries this will include integrating specialized HIV, TB, and STD surveillance programs into national surveillance and laboratory service systems for infectious diseases.
  • Improve coordination among CDC personnel who work overseas in the same country or region.

Enhance Support for Disease Control, Elimination, and Eradication Programs

  •   Box 7
      The World Health Organization Global Polio Laboratory Network
    Help complete the eradication of polio by 2005. The global effort to eradicate polio is led by WHO, in partnership with an international coalition that includes CDC, Rotary International, UNICEF, and the governments of many countries ( The WHO Global Polio Laboratory Network (Box 7), which uses molecular techniques to determine whether wild-type polio is circulating in areas undergoing eradication efforts, should be expanded to include monitoring for other vaccine-preventable diseases, such as measles and rubella.
  • Work with PAHO to complete the elimination of indigenous (i.e., nonimported) cases of measles in the Americas, and work with WHO, UNICEF, the UN Foundation, USAID, the American Red Cross, the International Federation of Red Cross and Red Crescent Societies (IFRC), and other partners to reduce by 50% by 2005 the nearly 900,000 annual measles deaths worldwide.17

Participate in the Roll Back Malaria Initiative

  • Contribute to Roll Back MalariaDisclaimer (RBM) through full endorsement and active promotion of RBM strategics in malaria-endemic countries in sub-Saharan Africa, Southeast Asia, and the Americas. Although RBM strategies vary by region and by local malaria transmission dynamics, 90% of the world’s malaria is in sub-Saharan Africa, where the strategies for malaria prevention and control include
    • Prompt effective case management of malaria illness
    • Prevention of malaria and its consequences in pregnancy, through prophylaxis or preventive intermittent treatment regimens with an effective antimalarial drug
    • Widespread use of insecticide treated bednets, particularly by young children and pregnant women
    • Prompt recognition and management of malaria epidemics
  • Conduct operations research on
    • Antimalarial drug efficacy and the management and prevention of antimalarial drug resistance
    • Malaria prevention in pregnancy
    • Transmission reduction through the use of insecticide-treated bednets and other strategies
    • Malaria assessment in complex emergencies, such as outbreaks that occur among refugees or outbreaks that occur after hurricanes or other natural disasters
    • Malaria diagnostics
    • Social attitudes and practices that facilitate or hinder the effectiveness of malaria control programs
    • Malaria surveillance, monitoring, and evaluation strategies


  • Provide technical assistance to the African Integrated Malaria InitiativeDisclaimer (see also Appendix A), a USAID-sponsored initiative that enhances integrated malaria treatment and prevention in Kenya, Malawi, Zambia, and Benin by promoting the use of interventions in the home (e.g., insecticide-impregnated bednets), in healthcare facilities (e.g., chemoprophylaxis), and among pregnant women (e.g., protective intermittent chloroquine therapy, as recommended by the USAID Safe Motherhood Initiative). During 2001, the African Integrated Malaria Initiative will be extended to the Democratic Republic of the Congo, Nigeria, Senegal, and Uganda.
  • Assist ministries of health in malaria control efforts and in the monitoring and evaluation of antimalarial drug efficacy. CDC is currently working on national malaria control programs in Kenya, Tanzania, Peru, and Nepal.

Strengthen the Stop TB Program

  • Contribute to Stop TBDisclaimer by
    • Assigning an epidemiologist to WHO’s Stop TB secretariat
    • Providing technical assistance to facilitate the use of the directly observed therapy short-course strategy (DOTS) for TB. (See also Priority Area 4)
    • Strengthening TB treatment programs in LIFE Initiative/Global AIDS Program countries (see below)
    • Supporting demonstration projects on the medical management of drug-resistant TB
    • Providing technical assistance to improve hospital TB control and detect hospital and community outbreaks in communities with high HIV prevalence
    • Assigning a medical officer to the International Union Against TB and Lung Diseases (IUATLD) to train a cadre of international TB experts, as a joint effort with USAID and WHO
    • Providing technical assistance and laboratory support to implement global antituberculosis drug resistance surveys

  • Consult with ministries of health in Russia, Vietnam, and other countries on training issues related to TB diagnosis and treatment.
  • Conduct operations research on
    • TB surveillance, program management, and program evaluation strategies
    • Multidrug-resistant TB treatment approaches and evaluation strategies
    • Treatment strategies for latent TB among persons with HIV infection
    • Factors that improve adherence to antituberculosis therapy
    • New diagnostic methods, drugs, and vaccine for TB
  Box 6
  Global Health Initiatives
  Box 21
  The Global AIDS Program

Expand the LIFE Initiative and Other International Efforts To Address HIV/AIDS

CDC will work with foreign ministries of health and public and private sector partners in countries targeted by the LIFE Initiative/Global AIDS Program (Boxes 6 and 21) to

  • Prevent primary transmission of HIV by
    • Expanding voluntary counseling and testing programs for youth and other vulnerable populations
    • Building large-scale programs to reduce mother-to-child transmission
    • Strengthening programs to reduce bloodborne HIV transmission
    • Strengthening medical management of sexually transmitted infections (STIs)
    • Supporting and strengthening national education and mobilization efforts for disease prevention

  • Improve community and homebased care and treatment by
    • Expanding and strengthening TB prevention and care
    • Enhancing care and treatment of HIV/AIDS and AIDS-related opportunistic infections
    • Exploring the innovative use of antiretroviral therapy

  • Build public health and medical infrastructure by
    • Expanding and strengthening surveillance for HIV, STIs, and TB
    • Providing laboratory support for diagnosis and surveillance of HIV, STIs, TB, and opportunistic infections, as well as for HIV screening of blood supplies
    • Expanding and strengthening public health information systems
    • Providing training in managing and implementing HIV treatment and prevention programs (see Objectives for Priority Area 6).
    • Enhancing evaluation of HIV/AIDS prevention and care programs.

Support Global Vaccine Initiatives

  • Help GAVIDisclaimer partners develop and implement strategies to strengthen routine immunization services and monitor their effectiveness.
  • Provide assistance to GAVI in assessing the burden of hepatitis B, yellow fever, Haemophilus influenzae type b, pneumococcus, rotavirus, meningococcus A, measles, and congenital rubella syndrome in developing countries and use this information to design, implement, and evaluate immunization programs against these infections.
  • Support efforts by GAVI partners—including pharmaceutical companies, foundations and development banks—to develop and evaluate new vaccines that are needed in developing countries, and to promote their availability. (See also Priority 3.)

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Booklet Contents
item Contributors
item Table of Contents
item Preface
item Executive Summary
item Introduction
item International Cooperation To Combat Infectious Diseases
item U.S. Investment in Global Public Health
item Protecting the health of U.S. citizens at home and abroad
item Furthering U.S. humanitarian efforts
item Providing economic and diplomatic benefits
item Enhancing security
item CDC's Role in Promoting Global Public Health
item An evolving mission
item Vision for the Future
item Partnerships and Implementation
item Priorities and Objectives
1. International Outbreak Assistance
item Objectives
2. A Global Approach to Disease Surveillance
item Objectives
3. Applied Research on Diseases of Global Importance
item Objectives
4. Application of Proven Public Health Tools
item Objectives
5. Global Initiatives for Disease Control
item Objectives
6. Public Health Training and Capacity Building
item Objectives
item List of Boxes
item Acronyms
item Appendix A
item Appendix B
item Appendix C
item Appendix D
item Appendix E
item Acknowledgments
item References

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Date published: 2002

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