U.S. public health experts say the world is inadequately prepared to fight infectious diseases such as the pneumonia-like illness emerging from Asia. A panel that studied the issue for the U.S. National Academy of Sciences says the United States should do more to increase the global capacity to respond to disease outbreaks.
The mysterious illness that has sickened and killed people in China, Hong Kong, and Vietnam was unknown when the panel of experts began looking into the threat infectious diseases pose to the world last year. But group member Ruth Berkelman of Emory University's School of Public Health in Atlanta says it is only the latest example of the problem.
"The current outbreak of severe respiratory syndrome is a clear illustration of many of the things in the report - the need for global surveillance, the need for early detection, and the need for early diagnosis," she said.
Dr. Berkelman and her colleagues say the U.S. ability to track and respond quickly to infectious diseases has suffered from years of neglect. They point out that U.S. disease surveillance systems are fragmented and technologically outdated, while health care professionals across the country lack essential diagnostic and related skills.
Panel co-chair Margaret Hamburg, who focuses on biological issues for the Nuclear Threat Initiative in Washington, says the increasing focus on combating bioterrorism has helped improve the country's ability to address infections, but much more needs to be done.
"Over the past decade, the United States has taken important steps to strengthen its capacity to address threats posed by infectious diseases," she said. "But the present reality is that we are inadequately prepared. We must do more to improve our ability to prevent, detect, and control emerging as well as resurgent microbial threats to health."
The National Academy of Sciences group says an effective U.S. response must be a global response because of the speed with which diseases travel. It calls on Washington to enhance international disease detection and reaction by coordinating with the World Health Organization and private sector groups.
The panel's report says public and private institutions should provide more financial and technical assistance, particularly to developing countries, where infectious diseases kill one of every two people.
Dr. Hamburg says the most critical control elements are expanding surveillance, laboratory capacity, and systems to share information quickly. "The ability of infectious agents to destabilize populations, economies and governments is fast becoming an unfortunate fact of life," said Margaret Hamburg. "As the severe respiratory syndrome outbreak so vividly demonstrates, national borders offer little impediment to such threats."
Other recommendations from the panel are to develop new drugs and vaccines and make better use of ones that exist. To fight disease resistance to drugs, they call for a ban on antibiotics for farm animals if they are also used in humans.
Dr. Patricia Quinlisk of the Iowa Department of Public Health says the world should better prepare for nature's biological unpredictability. "It may be an old disease with a new manifestation," she said. "It may be a new disease. We need to be flexible because nature is going to continue to surprise us."
