The President today established a nationalpolicy to address the threat of emerging infectious diseases through improveddomestic and international surveillance, prevention, and response measures.
Emerging infectious diseases such asEbola, drug-resistant tuberculosis, and HIV/AIDS present one of the mostsignificant health and security challenges facing the global community.Deaths from infectious disease have risen sharply over the past decadein the United States and globally. In the United States alone, the deathrate from infectious diseases, excluding HIV/AIDS, rose by 22 percent between1980 and 1992. Contributing factors, such as climate change, ecosystemdisturbance, increased movement of people and goods, and the deteriorationof public health infrastructures, show no sign of abatement. Addressingthis challenge requires a global strategy as most cities in the UnitedStates are within a 36 hour commercial flight of any area of the world-- less time than the incubation period of many infectious diseases. Furthermore,the United States is vulnerable to a release of biological agents by roguenations or terrorists, which could result in the spread of infectious diseases.
The National Science and TechnologyCouncil (NSTC) has determined that the national and international systemof infectious disease surveillance, prevention, and response is inadequateto protect the health of U.S. citizens. The NSTC reports, "Infectious Disease-- A Global Health Threat" (September 1995), "Meeting the Challenge --A Research Agenda for Health, Safety, and Food" (February 1996), and "Proceedingsof the Conference on Human Health and Global Climate Change" (May 1996),make a number of recommendations to improve our surveillance, prevention,and response capabilities which are reflected in this policy.
2. Establish a global infectious diseasesurveillance and response system, based on regional hubs and linked bymodern communications.
3. Strengthen research activities toimprove diagnostics, treatment, and prevention, and to improve the understandingof the biology of infectious disease agents.
4. Ensure the availability of the drugs,vaccines, and diagnostic tests needed to combat infectious diseases andinfectious disease emergencies through public and private sector cooperation.
5. Expand missions and establish theauthority of relevant United States Government agencies to contribute toa worldwide infectious disease surveillance, prevention, and response network.
6. Promote public awareness of emerginginfectious diseases through cooperation with nongovernmental organizationsand the private sector.
- Strengthen research, training, andtechnology development for establishing new and more effective interventionsto combat emerging infectious diseases.
- The Federal government, in cooperationwith State and local governments, international organizations, the privatesector, and public health, medical and veterinary communities, will establisha national and international electronic network for surveillance and responseregarding emerging infectious diseases.
- Federal agencies will coordinate withthe private sector, as appropriate, including representatives of the pharmaceuticalindustry and the academic, medical, and public health communities.
- NIH will work with appropriate medicalcollege and public health school associations, urging them to advise theirmember institutions to expand training in emerging infectious diseasesand antimicrobial drug resistance, in student curricula.
- The National Security Council (NSC)will ensure that any recommendations support counterterrorism measures.
- The United States will urge the WHOto develop regional inventories of resources for combating emerging infectiousdiseases and will explore joint steps to strengthen surveillance and responsecapabilities of WHO and other international organizations, as appropriate.
- The U.S. Agency for International Development(USAID) will continue to address the root causes of emerging diseases throughits ongoing portfolio of assistance to developing countries.
- The mission of the Department of Defense(DoD) will be expanded to include support of global surveillance, training,research, and response to emerging infectious disease threats. DoD willstrengthen its global disease reduction efforts through: centralized coordination;improved preventive health programs and epidemiological capabilities; andenhanced involvement with military treatment facilities and United Statesand overseas laboratories.
- DoD will ensure the availability ofdiagnostic capabilities at its three domestic and six overseas laboratories.DoD will make available its overseas laboratory facilities, as appropriate,to serve as focal points for the training of foreign technicians and epidemiologists.
Coordination by a Standing Task Force
A standing Task Force of the NationalScience and Technology Council (NSTC) is established to provide strategicplanning and further coordination on issues of emerging infectious diseases.The Task Force will establish action groups as necessary to pursue specifictopics. In particular, the Task Force will act immediately to realize theobjectives and implementing actions described above.
The Task Force will be co-chaired bythe Centers for Disease Control and Prevention and the White House Officeof Science and Technology Policy. The Task Force will seek the views ofthe private sector and health service providers in implementing this initiative.
The Task Force will report to the Presidentthrough the NSTC and will provide annual reports on the progress realized,including recommendations for further action.
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