[Congressional Record Volume 142, Number 117 (Friday, August 2, 1996)]
[Senate]
[Pages S9627-S9628]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      CENTERS FOR DISEASE CONTROL AND PREVENTION: 50th ANNIVERSARY

 Mrs. KASSEBAUM. Mr. President, this summer, the eyes of the 
world are turned toward Atlanta, the host of the centennial Olympic 
games. But a careful look reveals another anniversary taking place in 
Atlanta--an anniversary that we should herald as well. On July 1, 1996, 
the Centers for Disease Control and Prevention [CDC] reached a 
milestone: The agency turned 50 years old. What began during World War 
II as a program to stop the spread of malaria among U.S. military 
personnel has become a world-renowned scientific agency the mission of 
which is to prevent and control disease, disability, and injury. With 
time-tested expertise in communicable disease control, the agency has 
led efforts in developing a strategy to address the newly emerging 
infectious diseases of today. The Senate Committee on Labor and Human 
Resources, which I am honored to chair, has held hearings on this major 
global public health issue and the role which the United States plays 
in fighting the spread of communicable diseases, and I am personally 
committed to this battle. Recently, President Clinton, recognizing the 
threat that infectious diseases present, issued a Presidential Decision 
Directive on Emerging Infectious Diseases. In recognition of CDC's 
golden anniversary, I would like to summarize the problem, along with 
the prevention strategy that CDC has developed.


 addressing emerging infectious disease threats: a prevention strategy 
                         for the united states

  Two to three decades ago, many scientists believed that infectious 
diseases could and would be eliminated as a public health problem in 
their lifetimes. Today, those very same diseases remain the leading 
cause of death worldwide, and a major cause of illness, death, and 
escalating medical costs in the United States.
  More and more Americans recognize the threat that emerging and re-
emerging infectious diseases pose to domestic and global health. 
Accordingly, they understand the need to improve surveillance and 
response capacity inside and outside our borders--infectious microbes 
know no borders and disregard immigration laws.
  Several dramatic changes in our behavior and environment have 
contributed to the resurgence of infectious diseases. Across the globe, 
explosive population growth has led to unprecedented migration of 
people across borders. These population shifts are aggravated by 
rapidly changing technology and increasing international travel.

[[Page S9628]]

The widespread misuse of anti-microbial drugs has accelerated the 
emergence of new drug-resistant microorganisms. In addition, scientists 
are identifying, with remarkable frequency, a growing number of new 
infectious diseases along with microorganisms that cause previously 
unexplained chronic diseases.
  In response to the threat of emerging infectious diseases, CDC 
developed a plan designed to safeguard our Nation's health. Entitled 
``Addressing Emerging Infectious Disease Threats: A Prevention Strategy 
for the United States'', 1994, the plan was developed in cooperation 
with local and State public health officials, various Federal agencies, 
medical and public health professional associations, infectious disease 
experts from academia and clinical practice, and international and 
public service organization. The plan lays down CDC's domestic and 
international strategy for addressing emerging and reemerging 
infectious disease threats. The plan has four goals:

  First, surveillance and response. The first goal is to improve the 
detection, investigation, and monitoring of emerging pathogens, the 
diseases they cause, and the factors influencing their emergence. 
Essential to this goal is an adequate laboratory capacity that assures 
accurate diagnosis of infectious diseases.
  Second, research. The second goal is to integrate laboratory science 
with surveillance to optimize public health practice. CDC, in 
partnership with pubic agencies, universities, and private industry, 
will support research programs to address a number of pressing issues. 
They include: development and application of modern and rapid 
laboratory techniques for identification of new pathogens and drug-
resistant organisms; determination of how behavioral factors influence 
emerging infections; and evaluation of the economic benefit of 
prevention and control strategies.
  Third, prevention and control. The third goal is to enhance 
communication of public health information about emerging diseases. 
This would ensure prompt implementation of prevention strategies.
  Fourth, infrastructure. The fourth goal is to strengthen 
infrastructure at local, State, and Federal public health levels. This 
includes plans for addressing the diminished capacity of health 
agencies to respond to infectious diseases. Critical losses in 
personnel over the past years have resulted in dangerous limitations in 
laboratory expertise. To respond to these losses, CDC has placed a top 
priority on building and maintaining expertise in rare or unusual 
diseases through the establishment of appropriate training programs for 
young health professionals.
  CDC's initial efforts have focused resources on improving the 
capacity of the United States to address emerging infectious diseases 
through collaborations among State and local health departments and 
academic institutions. Thus far, CDC has provided funds through 
cooperative agreements to 14 States and two large local health 
departments to enhance their ability to monitor and respond to 
infectious diseases, including foodborne disease, drug-resistant 
infections, and a variety of other infectious disease public health 
programs. Health departments have used these funds to improve State 
health laboratories, build epidemiologic capacity to investigate out-
breaks, and develop electronic technology for disease reporting and 
tracking.
  CDC has also begun developing a national network of emerging 
infections programs. This network will conduct special surveillance 
projects and develop and improve surveillance methods. Emerging 
infections programs [EIP] address a variety of infectious disease 
problems, including food- and water-borne disease caused by E. coli and 
cyptosporidium, tickborne diseases such as Lyme disease, and the newly 
recognized ehrlichiosis, and antibiotic resistance.
  Through cooperative agreements with State health departments and 
their collaborators in local health departments and academic 
institutions, CDC has provided funds to establish the first four such 
programs in health departments in California, Connecticut, Minnesota, 
and Oregon; a fifth EIP will be initiated this year. As resources 
permit, CDC will institute three additional EIPs in fiscal year 1997 in 
other State health departments.
  With new microbe threats confronting us daily, CDC had developed a 
public health microbiology fellowship program in partnership with the 
Association of State and Territorial Pubic Health Laboratory Directors. 
CDC has also reinstituted an extramural research program that is 
focusing initially on tickborne disease and antibiotic resistance.
  Although extensive work to address emerging infections has begun, 
substantial further effort is needed to strengthen defenses against 
potential disasters caused by infectious microorganisms. Long-term 
cooperation and partnerships are needed with clinicians, 
microbiologists, public agencies, universities, private industry, and 
communities. It is indeed critical that we all work together to ensure 
rapid, comprehensive responses to the microbial risks challenging the 
health of the world's population. I commend CDC on their 50th 
anniversary and on their outstanding effort to control and eliminate 
emerging infectious diseases.

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