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Protecting Our Nation's Health in an Era of Globalization: CDC's Global Infectious Disease Strategy
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Priority Area 5: Global Initiatives for Disease Control
AIDS orphans in a Sub-Saharan country

Children from villages hard-hit by AIDS. Thirteen million children in sub-Saharan Africa have lost one or both parents to AIDS, and the number is expected to reach 40 million by 2010.15 The number of AIDS orphans is also growing in Asia and Latin America.

Global efforts are underway to help these children and prevent further devastation from HIV/AIDS and other infectious diseases. These global initiatives involve complex alliances among public and private groups, health and trade experts, and national and international donor organizations.

Photographer: Bobbie Person, Office of Health Communication, National Center for Infectious Diseases, CDC

Dr. Gro Bruntland, Director-General of WHO, has said that “solutions, like problems, have to be global in scope.” In accord with this idea, WHO is helping to coordinate major global initiatives to reduce deaths from malaria, TB, and HIV/AIDS—diseases that contribute to poverty and economic stagnation. This approach was endorsed by the Group of Eight Industrialized Nations at the Okinawa summit in July 2000. WHO is also helping to coordinate global initiatives to increase developing-country access to vaccines against acute respiratory diseases, yellow fever, hepatitis B, and other diseases, through the Global Alliance for Vaccines and Immunization Disclaimer(GAVI).

  Box 6
  Global Health Initiatives

Although these global initiatives have clearly stated goals and are supported by multiple private and public sector partners (Box 6), the details of their implementation are still under discussion. Previous efforts to eradicate malaria by using a narrow approach to vector control ended in failure. Because no proven vaccines are yet available against malaria, TB, or AIDS, “one-shot” solutions are not feasible, and it will be necessary to employ multiple control strategies, including behavioral interventions that require a high degree of cooperation and trust in affected communities. The incidence of TB, HIV/AIDS, and acute respiratory infections is high in poor, war-torn, or post-Communist countries in which public health infrastructures have deteriorated. Moreover, emerging drug resistance complicates the treatment and control of each of these diseases.

A new priority for CDC will be to elevate the level of its participation in these and other global initiatives (Box 6). CDC and its partners will also consult on future international priorities for disease control, elimination, and eradication efforts—as well as for antimicrobial resistance monitoring and pandemic influenza preparedness planning—and help evaluate progress through the collection and analysis of disease surveillance data.

  Box 21
  The Global AIDS Program

Increased participation in global health initiatives will require long-term partnerships with host countries, as well as improved coordination with public health partners throughout the world. CDC will build on its strengths in disease surveillance, laboratory science, and program evaluation to assist development agencies, international organizations, NGOs, and development banks that support international programs to strengthen healthcare systems and control disease. As a partner in the Global AIDS alliance (Boxes 6 and 21), for example, CDC has a special opportunity to work with UNAIDS and USAID to implement HIV/AIDS control programs on all continents ( As a partner in Roll Back MalariaDisclaimer , Stop TBDisclaimer , and GAVI, CDC can contribute to the Shared Agenda for Health in the AmericasDisclaimer 16 developed by PAHO, the Inter-American Development Bank, and the World Bank.

Increased participation in global health initiatives also will require additional staff to work on projects overseas, as well as to provide diagnostic support from CDC laboratories in the United States. Full participation in GAVI, for example, will require increased programmatic support and technical expertise in acute respiratory diseases, yellow fever, hepatitis B, and meningococcal meningitis. There remains a shortage of U.S. and world expertise in many infectious disease areas. (See also Priority Area 6.)

CDC staff will also continue to work with ministries of health, WHO, PAHO, USAID, and other partners on disease elimination or eradication campaigns. In addition, CDC staff will help further efforts to reduce illness and death from acute respiratory diseases and diarrheal diseases, which—in addition to HIV/AIDS, TB, and malaria—are the leading infectious causes of death, worldwide. CDC will also continue to conduct applied research to improve our understanding of the genetics, physiology, and pathogenesis of microbes that cause illnesses targeted by global initiatives for disease control. (See Priority Area 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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