The constantly changing and unpredictable factors that contribute to the resurgence of infectious diseases in Colombia require increased and sustained surveillance.

Elsa L. Segura, Ph.D.

Director, Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán” (ANLIS MALBRAN), Ministry of Health Buenos Aires, Argentina

Emerging infectious diseases have increasingly been detected in Argentina, starting with epidemic outbreaks of Argentine hemorrhagic fever (AHF) in the 1950s, human immunodeficiency virus infection (HIV)/AIDS and leishmaniasis in the 1980s, and cholera, antimicrobial resistance (e.g., resistance of meningococcus type B and Mycobacterium tuberculosis), hantavirus, and dengue in the 1990s.

Argentina has a population of 36 million and comprises a federal organization of 23 provincial states and the city of Buenos Aires. The national health system is coordinated at the political and technical levels by the Federal Health Council (COFESA), which meets at least six times a year. At the central level, the Directorate of Epidemiology is in charge of national epidemiological surveillance. Laboratory responsibilities are led by the Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán” (ANLIS MALBRAN), a decentralized national administration that coordinates 11 health institutes and centers and a network of 650 laboratories distributed throughout the country, with a presence in each one of the provincial states. Networked activities include research and development, training, production of biologicals, and quality control for the diagnosis of diseases affecting public health. In recent years there has been enhanced cooperation of these networks with the epidemiological efforts of the Argentine Ministry of Health.

External quality control was enacted in 78 percent of the network laboratories in 1999. As a direct result of these efforts, the laboratories cooperated in writing national guidelines for diseases subject to mandatory notification.

The objectives of the strategic plan of ANLIS MALBRAN for emerging and reemerging infectious diseases are research and analysis of the results obtained by the diagnostic laboratories and application of these analyses to surveillance and policy development. Since 1960 the Argentine National Epidemiological Surveillance System (enacted by law) each week has collected information on 60 infectious diseases for which notification by provincial public hospitals is mandatory, making its findings available to the public. Since 1992—after a cholera

Front Matter (R1-R16)

Summary and Assessment (1-28)

Introduction (29-34)

Emerging Infections in Latin America (35-51)

Emerging Infections in Africa (52-61)

Emerging Infections in Asia and the Pacific (62-71)

Emerging Infections in Europe (72-84)

References (85-86)

Appendix A: Glossary and Acronyms (87-94)

Appendix B: Workshop Agenda (95-99)

Appendix C: Workshop Participants (100-106)

Appendix D: Forum Member and Staff Biographies (107-118)