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Moreover, unforeseen disease problems continue to appear. Recent examples include vancomycin-resistant infections of Staphylococcus aureus in the United States and Japan, avian influenza in Hong Kong, a new disease called Nipah virus encephalitis in Malaysia, and outbreaks of dengue fever in Texas and West Nile encephalitis in New York. Increased CDC engagement in efforts to improve global disease surveillance and outbreak response will help us detect new or unusual diseases of any kind and respond to health emergencies of any kindincluding both naturally occurring and intentionally caused outbreaks. Left unchecked, todays emerging diseases can become the endemic diseases of tomorrow. This is what happened with HIV/AIDS, which spread from a remote part of Africa to all other continents 20 years ago, and is now entrenched all over the world, necessitating a major international control effort. Because U.S. and international health are inextricably linked, the fulfillment of CDCs domestic missionto protect the health of the U.S. populationrequires global awareness and strategic thinking. This document, Protecting the Nations Health in an Era of Globalization: CDCs Global Infectious Disease Strategy, describes how CDC and its international partners can collaborate to prevent the emergence and spread of infectious diseases. U.S. Investment in Global Public Health The United States must participate more fully in combating infectious disease threats around the world. These efforts will yield multiple benefits:
Although the United States participates in health projects in many parts of the world, much more can be done, at relatively low cost, with political will, national leadership, and a clearly articulated global strategy. CDCs Role in Promoting Global Public Health CDC, which is dedicated to the prevention and control of disease and the promotion of health, works by invitation in many different jurisdictions, including U.S. states and cities and other nations. Throughout its history, CDC has provided international leadership in public health, serving as a technical consultant to the World Health Organization (WHO) and ministries of health on projects that address infectious disease problems related to endemic diseases, wars, famines, or other disasters. Many of these projects have been funded and coordinated by the U.S. Agency for International Development (USAID). CDC has also supported research and public health education on diseases of regional or international importance, provided resources and leadership for the smallpox eradication effort, and established long-term collaborative research partnerships with several developing nations. While considerable effort has been devoted to these international activities, CDCs primary focus has remained on domestic health. In recent years, however, CDCs overseas role has expanded rapidly. Global polio eradication and HIV/AIDS control programs have led to substantial investments of CDC personnel and financial resources, as have a succession of complex international emergencies. Between 1990 and 2000, CDC provided outbreak assistance on an ad hoc basis to nations in Asia, Africa, Europe, and Latin America to help investigate outbreaks of unknown, highly dangerous, and highly infectious diseases, and provided diagnostic support for hundreds of local investigations around the globe. Although there are no formal structures and designated resources for international outbreak response, U.S. citizensas well as foreign governmentshave come to rely on CDC to provide outbreak assistance and public health information whenever a new or reemerging disease threat is detected anywhere on the globe. Oubreak assistance by CDC would also be required if an intentionally caused outbreak occurred at home or abroad. CDCs growing presence overseas presents new opportunities and new challenges. This documentdeveloped in consultation with public and private sector partners, at home and abroadrepresents an active effort to further define CDCs evolving global mission. It considers how CDC and its international partners can work together over the long term to improve the capacity to detect, control, and prevent infectious diseases. CDCs ongoing efforts to strengthen U.S. domestic public health infrastructure are critical to the success of these international collaborations. Six Priority Areas Protecting the Nation's Health in an Era of Globalization: CDCs Global Strategy for Addressing Infectious Diseases defines CDCs global infectious disease priorities in six areas, selected in consultation with global public health partners. In looking towards the future, CDC envisions increased activity and progress in each area:
Implementation of specific objectives in these six areas will help realize CDCs vision of a world in which U.S. citizens and people throughout the world are better protected from infectious diseases. Partnerships and Implementation CDC's global infectious disease strategy was prepared by the National Center for Infectious Diseases, in collaboration with other CDC centers and offices, including the Office of Global Health, the National Center for HIV, STD, and TB Prevention, the National Immunization Program, the Epidemiology Program Office, and the Public Health Practice Program Office. Many global health organizations and agencies provided consultation and assistance during its development.
The strategy will be implemented incrementally over the next five years, as funds become available, beginning with the highest priorities for 2001-2002 (Box 1). As CDC carries out this strategy, it will coordinate with foreign governments, international organizations (including WHO, the Joint United Nations Programme on AIDS [UNAIDS], and the United Nations Childrens Fund [UNICEF]), other U.S. agencies (including USAID, the National Institutes of Health [NIH], the Food and Drug Administration [FDA], the Department of Defense [DoD], the Department of State, the Department of Veterans Affairs [DVA], the U.S. Department of Agriculture [USDA], the National Oceanic and Atmospheric Administration [NOAA], and the National Aeronautics and Space Agency [NASA]), professional societies, research institutions, and schools of public health, medicine, nursing, and veterinary science. CDC will also participate in international coalitions that support disease eradication efforts and other regional and global health initiatives. These coalitions may include national and local nongovernmental organizations, community-based and faith-based organizations, and communities of color. Other implementation partners will include pharmaceutical and biotechnology companies, nongovernmental organizations that address health problems, and development agencies, development banks, foundations, and other organizations that aim to reduce poverty by reducing the incidence of endemic diseases. Web site addresses for selected organizations and health publications and reports referred to in this document are provided in Appendix A. |
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Date published: 2002 |
National
Center for Infectious Diseases |