ICAAC Lecture: Emerging Infectious Diseases

At the keynote lecture of the 34th Interscience Conference on Anti-microbial and Infectious Diseases, the director of the Centers for Disease Control and Prevention in the USA, David Satcher, said that "emerging infectious diseases are among the most urgent threats to health that we confront today."

Once expected by some to be eliminated as a public health problem in the USA, infectious diseases remain the leading cause of death worldwide, said Dr Satcher. Dramatic changes in society, technological changes and changes in the environment, together with diminished effectiveness of certain approaches to disease control, have propelled the USA and the rest of the world into a new era. The spectrum of infectious diseases is expanding as pathogens find new niches, and infectious diseases once thought to be conquered are increasing in incidence.

Three reports published in the USA in recent years serve to highlight the growing problems in this area. The first, from the National Academy of Sciences, points to the dangers and limited success of efforts to contain tropical diseases, such as Ebola, Lassa fever, cholera, dengue fever and malaria. The second, from the Institute of Medicine, states that the public health system in the USA is in disarray. In part, because of the struggle of the public health system to "backstop" the health care delivery system, there has been a deterioration in the public health system, which has become more reactive than proactive. The third, compiled by an infectious disease specialist committee for a number of government agencies, emphasizes the ongoing threat to domestic and global health from emerging infectious diseases and notes that increased vigilance and enhanced responsiveness is needed to overcome years of complacency.