[Ip-health] Washington Post: U.S. launches new global initiative to prevent infectious disease threats

Thiru Balasubramaniam thiru at keionline.org
Mon Feb 17 02:31:31 PST 2014

U.S. launches new global initiative to prevent infectious disease
threatsBy Lena
H. Sun<http://www.washingtonpost.com/lena-h-sun/2011/03/03/ABUvPGP_page.html>
, Published: February 13

Faced with what they describe as a perfect storm of converging threats from
infectious-disease epidemics, U.S. officials launched a global effort
Thursday with more than two dozen countries and international organizations
to prevent deadly outbreaks from spreading.

The goal is to prevent, detect and respond to infectious-disease threats
where they start. That's more effective and less costly than treating sick
people after diseases spread. The new initiative is intended to bolster
security at infectious-disease laboratories, streng-then immunization
programs and set up emergency-response centers that can react to outbreaks
within two hours.

Despite advances in medicine and technology, Americans are at greater risk
than ever from new infectious diseases, drug-resistant infections and
potential bioterrorism organisms, said Thomas Frieden, director of the
Centers for Disease Control and Prevention, which is spearheading the

On Thursday -- even though federal offices in Washington were closed because
of a major snowstorm -- Health and Human Services Secretary Kathleen
Sebelius welcomed officials to a meeting held at department headquarters to
launch the effort. "Global health security is a shared responsibility. No
one country can achieve it alone," she said. "A threat anywhere is indeed a
threat everywhere."

Lisa Monaco, assistant to the president for homeland security and
counterterrorism, said biological threats can "emerge quickly, travel
quickly, and take lives." She cited the H7N9 bird flu virus, a virus first
reported in China last year, and Middle East respiratory syndrome (MERS),
first reported in Saudi Arabia in 2012.

Diseases that until recently weren't found in the United States have become
widespread, including mosquito-borneWest Nile virus-related
There has also been a resurgence of diseases such as drug-resistant
tuberculosis, a particularly dangerous form of the infectious lung disease.

Reports of TB are not uncommon in the Washington area and other major
metropolitan areas, which typically are home to large immigrant populations
and professionals who travel overseas frequently. Recently, there was a
tuberculosis case at a Montgomery County high
and more than a dozen cases were reported at a Fairfax County high
school <http://www.washingtonpost.com/local/education/at-least-1400-students-staff-at-lee-high-should-get-tb-tests-health-officials-say/2013/07/22/a6962d6e-f2c3-11e2-ae43-b31dc363c3bf_story.html>in

In recent weeks, another mosquito-borne virus common in Africa and Asia has
spread quickly through the eastern Caribbean, appearing for the first time
in the Western Hemisphere. Chikungunya
which is similar to dengue, was reported in December on the French side of
St. Martin and has spread to seven other jurisdictions, including
Martinique, Guadeloupe and the British Virgin Islands.

International regulations require nations to report outbreaks quickly to
the World Health Organization, but most countries have not complied.

"We hope this will be the shot in the arm, energizing the global health
security agenda," said Andrew Weber, assistant secretary of defense for
nuclear, chemical and biological defense programs, during a conference call
with reporters Wednesday.

The WHO, the Food and Agriculture Organization and the World Organization
for Animal Health are also participating in the effort.

This year, the CDC and the Defense Department are committing $40 million to
work with 10 countries, including Uganda and Vietnam. The CDC recently
completed pilot programs in those countries to improve diagnostic testing
and transportation of potentially infectious samples.

Uganda has battled the deadly Ebola virus, cholera and multidrug-resistant
TB. Vietnam has experienced outbreaks of SARS (severe acute respiratory
syndrome) and the H5N1 bird flu strain. The SARS
of 2003, which began in China, killed nearly 800 people in more than 30
countries, and its cost was estimated at $30 billion after just a few

Before the CDC pilot, Uganda had programs to diagnose children born to
HIV-positive mothers. But they operated in only one part of the country,
and they were aimed at only the one disease. Now, Uganda has a network
operating across the country to test patients for a range of pathogens and
transport samples by motorcycle to provincial capitals, where the samples
are sent by overnight mail to state-of-the-art labs in Kampala for testing,
Frieden said.

Test results are then delivered by special printers that operate on mobile
networks similar to those used by cellphones. The printers can transmit
results to officials in remote areas of the country within days, instead of
the months it used to take.

CDC officials also created a dipstick -- similar to those used in pregnancy
kits -- so local health officials can quickly test whether someone has pneumonic
plague <http://www.cdc.gov/plague/faq/index.html>, the most serious form of
the illness and the only form that can be spread from person to person.

As a result, not only can health officials speed up testing, but they also
can avoid having to grow tissue samples in petri dishes, which can produce
"billions of plague bacteria that could have the potential to become a
biological weapon," Frieden said.

Officials said the Defense Department is likely to be involved in improving
the physical security of laboratories to prevent specimens of potentially
lethal pathogens from being stolen or released inadvertently.

Among the other countries that U.S. officials hope to work with this year
are India, Kenya, Tanzania and Ethi-o-pia, according to health experts
familiar with the initiative.

Next year, the Obama administration is proposing to spend $45 million to
expand the program to include more countries; within five years, officials
hope to have 30 countries participating.

U.S. government agencies operate many programs related to infectious
diseases. But the new effort is the most-comprehensive so far, and experts
say it will help call attention to disease threats around the world.

Thursday's meeting drew participants from 26 countries, including China,
India, Russia, Saudi Arabia, South Africa, Uganda and Vietnam. Notably
absent was Pakistan<http://www.washingtonpost.com/world/politicians-muslim-scholars-join-vaccination-effort-as-violence-hinders-pakistan-polio-drive/2014/01/10/aacf96fc-768c-11e3-a647-a19deaf575b3_story.html>,
where 83 polio cases were reported last year, more than in either
Afghanistan or Nigeria, the other countries where polio is endemic.

Health workers and officials have tried for years to persuade conservative
Muslims to accept vaccination. Violence against polio
after revelations in 2011 that the CIA had sponsored an immunization
gain information about Osama bin Laden before U.S. forces killed him in

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