[Emerging Infectious Diseases]                                                         
[Volume 4 No. 3 / July - September 1998]

Special Issue

International Cooperation

James LeDuc
Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Experts from the World Health Organization (WHO), the European Union (EU),
the U.S. Department of Defense (DoD), and other organizations summarized
existing and planned collaborations on emerging infectious diseases. The
session was chaired by David Heymann, WHO, and James LeDuc, CDC.

One speaker, V. Ramalingaswami, All India Institute of Medical Sciences,
India, summarized lessons learned from the plague outbreak in Surat, India.
The plague outbreak, the first in many years, found the country
ill-prepared to diagnose this disease, and young clinicians lacked
experience in recognizing or managing plague-infected patients.

Two speakers examined regional collaborations. Christopher Bartlett, Public
Health Laboratory Service, London, summarized the development of
international surveillance within EU. The Maastricht Treaty provided the
political will to underpin these activities; since the treaty, the heads of
European institutes with responsibility for national surveillance have met
regularly to assist in strategic development of surveillance activities.
Disease-specific networks have been established, each with an operational
protocol that sets out agreed case definitions and standard methods and use
of information obtained. High quality and timely information is now being
provided on a steadily increasing spectrum of infectious diseases through
weekly electronic and monthly surveillance bulletin publications. Oyewale
Tomori, regional virologist for Africa from WHO, explained that despite
substantial advances in disease prevention and control, communicable
diseases still constitute a major health problem for Africa. Concern about
the deplorable and worsening state of disease control in Africa has led
ministers of health in the region to pass several resolutions on prevention
of epidemic infectious diseases, yet frequent epidemics continue. Apart
from the development of a few disease-specific laboratory diagnostic
networks, laboratory services in Africa remain rudimentary and
underdeveloped. The WHO Regional Office for Africa has recently formulated
a strategic plan for integrated disease surveillance and an action plan to
strengthen laboratory capacity in Africa; international support is urgently
needed to implement these plans.

Global collaborations were also discussed. Nils Daulaire, U.S. Agency for
International Development (USAID), described the recently announced $50
million initiative to address infectious diseases globally. These funds
will be used to focus activities on tuberculosis, malaria, antimicrobial
resistance, and surveillance, both in countries with USAID missions, as
well as regionally. Michael McCarthy, DoD, summarized the new DoD
initiative on emerging infectious diseases and explained how the overseas
laboratories in Thailand, Kenya, Peru, Brazil, Egypt, and Indonesia will
work closely with their host nations and DoD scientists to address emerging
endemic disease threats. Maria Neira, WHO, described recent activities to
address cholera and other diarrheal diseases of epidemic potential
globally. These activities included the secondment of a CDC medical
epidemiologist to the WHO subregional office for southern Africa, where in
the past several years a plan to improve recognition and response to
epidemic diarrheal diseases has been developed and implemented. Included in
the program are training on improved patient management, strengthened
laboratory capacity, and better communication both within and between
countries of southern Africa.


Emerging Infectious Diseases
National Center for Infectious Diseases
Centers for Disease Control and Prevention
Atlanta, GA

URL: ftp://ftp.cdc.gov/pub/EID/vol4no3/ascii/ledu.txt

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