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Military Model Proposed to Combat Infectious Disease

Since 2003, the H5N1 avian flu virus has spread to more than 30 countries, killing millions of birds and infecting 180 people who had contact with diseased poultry. Public health officials warn that the virus -- for which there is no vaccine -- could develop into a pandemic if it mutates so it can spread from person to person.

Scientists working with the U.S. Department of Defense propose tracking disease outbreaks with a new global network, modeled after military research labs that have long served U.S. troops and civilians abroad.

In 2005, a U.S. naval research laboratory in Indonesia helped detect the H5N1 strain of avian flu in that country. Another military facility in Egypt identified the deadly virus among birds in Central Asia and reported the first human case in Iraq.

These labs and three others -- in Peru, Kenya and Thailand -- are run by the U.S. Department of Defense. Lt. Jean-Paul Chretien is coordinator of the Overseas Research Laboratories. In a commentary in the journal Nature, he writes the military model is one worth copying.

"They are able to detect and respond to a broad range of infectious diseases, and they are able to do that because they have a broad range of diagnostic tests, and they have scientists who have expertise in different areas," he says, adding that these institutions have physicians, entomologists and veterinarians that can respond to human or animal outbreaks.

Surveillance is the first line of defense against any infectious disease. Scientists analyze clusters of infection in humans and in animals and use that information to make decisions about how to control its spread.

Lt. Chretien says many countries -- especially in Sub Saharan Africa and rural Central Asia and South America -- don't have the personnel or laboratory resources to address public health threats, and they badly need assistance to bridge that gap in the world's defenses. "What we are proposing is that WHO and potential sponsor countries and other organizations get together," he says, "to look at areas of the world where surveillance is weak and where infectious diseases might emerge, and try to prioritize these regions both in terms of their needs and in terms of where the work could feasibly be done."

Then, he says, a decision would be made about where to locate these facilities.

He stresses that using a military model does not mean the U.S. military would operate the labs. "In fact an idea that we are proposing is that these facilities really could be multilateral institutions and each one could have support from a number of different sponsor countries and other donors."

He suggests groups like WHO, CDC, and other public and private agencies would be involved. Lt. Chretien says the proposed network is not a cheap short-term solution, but rather a long-term investment. He says it is not surprising that the U.S. military has an interest in his plan. "Epidemics can come from overseas places to the U.S. very rapidly because travel is so easy," he says. "Epidemics could threaten deployed U.S. forces and could cause instability that might draw in U.S. involvement. So, certainly the Department of Defense has recognized emerging infections and emerging infections overseas as an important priority."

That priority is shared by Scott Dowell. He heads the Global Disease Detection Program for the Centers for Disease Control and Prevention and works closely with military labs. "From the perspective of public health, they certainly have been important contributors in the past and the strengthening of their contribution to the overall public health response capability would be welcome."

Health experts do not know whether H5N1 avian flu virus will develop into a pandemic. What is certain, Scott Dowell says, is that eventually, some infection will… and that a stronger global health network will slow its spread.