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Emerging Infections: Microbial Threats to Health in the United States
laboratories supported by the United States. DoD has maintained overseas research activities since 1900, when the Yellow Fever Commission was established in Cuba. The U.S. Army supported laboratories in the Philippines from 1900 to 1934, and in Panama from 1936 to 1945. During World War II, the Navy established a tropical disease research laboratory on Guam, which was later designated the Naval Medical Research Unit No. 2 (NAMRU-2). This was followed by the establishment of additional laboratories in Burma and Egypt, the latter being the forerunner of the current NAMRU-3 laboratory in Cairo (Armed Forces Epidemiological Board, 1991).
Since that time, the DoD has supported a total of 20 strategically located overseas laboratories, research teams, and research units. At present, the department operates laboratories in Thailand, Indonesia, Egypt, Brazil, Kenya, Peru, and Korea; all of them cooperate with scientists of the host country and serve as focal points for basic and applied disease research, especially on diseases of military significance. In addition to being well situated to recognize and study emerging disease threats, the laboratories are valuable sites for testing new drugs and vaccines, since they are located in areas in which the targeted diseases are endemic. The laboratories are also a vital resource for recruiting and training medical personnel for the U.S. military (Armed Forces Epidemiological Board, 1991). The committee is concerned that some of these laboratories have been closed in the past, for reasons related both to insufficient funding and changes in mission priorities, and that further closings could jeopardize the United States' ability to detect and respond to emerging infectious disease threats.
The committee recommends continued support—at a minimum, at their current level of funding—of Department of Defense overseas infectious disease laboratories.
An excellent model of U.S. involvement in tropical infectious disease research is the USAID-supported International Center for Diarrheal Disease Research, Bangladesh (ICDDR, B), earlier known as the Cholera Research Laboratory. The ICDDR, B was founded in 1959 in Dhaka with funds from the International Cooperation Agency, the USAID predecessor. Much of our current understanding of cholera epidemiology and treatment is the result of studies conducted in Dhaka. The center's involvement in the development of oral rehydration therapy for cholera was a major contribution to international health. Over time, with additional support from numerous countries, the facility has evolved into a high-caliber multinational research organization.
Another potentially useful program model is the National Health Service Corps (NHSC). The NHSC was created in 1970 by Public Law 91-623 to