OSTP NSIA Addressing The Threat Of Emerging Infectious Diseases

Office of Scienceand Technology Policy
FOR IMMEDIATE RELEASE                                 June 12, 1996 Contact: (202)456-6020


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.

Policy Goals

1. Strengthen the domestic infectiousdisease surveillance and response system, both at the Federal, State, andlocal levels and at ports of entry into the United States, in cooperationwith the private sector and with public health and medical communities.

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.

U.S. Government Roles and Responsibilities
 1. Enhance the surveillance and responsecomponents of our domestic and international public health infrastructure.
 - Strengthen Federal and State laboratoryand epidemiological response capabilities. The Centers for Disease Controland Prevention (CDC) will coordinate Federal government efforts to strengthenFederal, State and local health departments surveillance and response capabilities. 

- 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.

2. Enhance biomedical and behavioral researchefforts on emerging infectious diseases.
 - The National Institutes of Health(NIH) will lead Federal government efforts to strengthen research on thedevelopment of new tools to detect and control emerging infectious diseasesand on the biology and pathology of infectious agents, with particularemphasis on antimicrobial drug resistance. Research will include the developmentof new mechanisms for the control and prevention of zoonotic infectiousagents, which are derived from domesticated and wild animals, and the healtheffects of climate change. 

- Federal agencies will coordinate withthe private sector, as appropriate, including representatives of the pharmaceuticalindustry and the academic, medical, and public health communities.

3. Expand formal training for health careproviders.
 - Senior United States Government officialswill work with health care provider, health research organizations, andprofessional organizations to urge that emerging infectious diseases begiven greater emphasis in fellowship programs and on certifying and re-certifyingexaminations.

- 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.

4. Review and update regulations, procedures,and resources for screening and quarantine at ports of entry into the UnitedStates.
 - CDC will lead an interagency groupto review and update current screening and quarantine regulations, procedures,and resources aimed at minimizing the threats disease outbreaks can poseto national health and security. Issues considered should include earlywarning systems abroad, stricter controls at ports of entry, and improvedsurveillance after persons, animals, or material have entered the UnitedStates.

- The National Security Council (NSC)will ensure that any recommendations support counterterrorism measures.

5. Make information about ill internationaltravelers with communicable diseases more accessible to domestic healthauthorities.
 - CDC will be the lead agency in thedevelopment of cooperative arrangements with the transportation industryto provide needed information when follow-up of passengers with communicablediseases arriving at United States ports of entry is required.
6. Encourage other nations and internationalorganizations to assign higher priority to emerging infectious diseases.
 - The Department of State and Officeof Science and Technology Policy (OSTP), in consultation with other agencies,will develop and coordinate a sustained effort to enlist support from othernations and international bodies. State will raise the issue of emerginginfectious diseases in bilateral, regional, and multilateral discussionsand will negotiate cooperative agreements with other nations to promotethe establishment of a global surveillance and response network.
7. Support the World Health Organization(WHO) and other bodies in playing a stronger role in the surveillance,prevention, and response to emerging infectious diseases.
 - The United States will participatein the WHO-proposed revision of the International Health Regulations toensure improved screening and quarantine capabilities. 

- 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.

8. Expand United States agency missionsand mandates in order to ensure that responsible agencies are providedwith the authority, emergency procurement powers, and resources to respondto worldwide disease outbreaks that have the potential to adversely affectthe United States.
 - CDC's mandate to protect the healthof United States citizens will be more clearly stated to allow conductof surveillance and response activities, including outbreak investigationsand selected responses to epidemics overseas. In disaster relief operationsinvolving infectious diseases, CDC will operate as part of the United Stateseffort, 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.

Reporting Requirements

The Task Force will report to the Presidentthrough the NSTC and will provide annual reports on the progress realized,including recommendations for further action.

Officeof Science and Technology Policy
1600 Pennsylvania Ave,N.W
Washington, DC 20502

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