knowledge of most globally important diseases is incomplete at best; for many there is very little information.

  • Understanding the Threats: Despite progress in basic and applied infectious disease research, gaps remain in our knowledge about most bacteria, viruses, protozoans, helminths, and fungi. These scientific ''blind spots" have slowed or prevented efforts to understand the variety of factors responsible for disease emergence and reemergence. The diversion of funds for emergencies or, in some cases, inconsistent levels of funding have made it especially difficult to address the full range of research opportunities and needs.

  • Responding to the Threats: Once emerging microbial threats are detected, responses to them are often feeble. Diseases that appear not to threaten the United States directly rarely elicit the political support necessary to maintain control efforts. U.S. support for surveillance, control, and research activities in other countries is extremely limited. Here, as in other nations, failure to sustain domestic efforts to control infectious diseases is an equally serious problem. Ill-informed decision making can prevent accurate assessments of the actual danger posed by microbial threats to health, and it can slow or even halt steps to address an emerging disease problem. Ironically, these same forces can produce an overresponse to less serious situations. Finally, profit and liability concerns have undercut the market incentives for manufacturers of vaccines, drugs, and pesticides to develop and distribute needed supplies to the most impoverished populations both in the United States and in other countries.

History has shown and this committee believes that the threat from the emergence of infectious diseases is not one to be taken lightly. The development of a strategy for addressing emerging infectious disease threats requires that we understand the factors that precipitate the emergence of these agents and the resultant diseases. These factors are examined in Chapter 2.

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