US BIOTERROR EFFORT MAY IMPACT GLOBAL DISEASE FIGHT 



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Last Updated

29 Jun 2003

Source: Reuters, April 16, 2002.

US Bioterror Effort May Impact Global Disease Fight

By Todd Zwillich

WASHINGTON (Reuters Health) - The United States' massive build-up of infrastructure to gird against bioterror attacks will probably help--but could actually hinder--the fight to contain the growing global problem of infectious disease, according to experts inside and outside the government.

President Bush asked Congress for nearly $6 billion for anti-bioterrorism efforts in the wake of last October's still-unsolved anthrax attacks that left 5 dead on the East Coast. In addition to spending billions to develop and buy vaccines, much of the money is likely to be targeted at building up the nation's systems for detecting and treating infectious diseases.

Conventional wisdom so far among public health experts has been that the huge cash infusion for domestic bioterror defense will also benefit US efforts to combat global infectious diseases.

While most experts agree that some positive "spillover" is likely, many attending a National Academies of Science forum on global infectious diseases warned that the United States' new focus could slow moves to help developing nations slip out from under the crushing burden of diseases like malaria, tuberculosis and HIV/AIDS.

"The country does have an unprecedented opportunity to rebuild the public health system," said Dr. James Hughes, the assistant surgeon general and the director of the national center for infectious diseases at the Centers for Disease Control and Prevention.

At the same time, Hughes said, "there is a small pool of people out there with the kinds of skills that are going to be needed" for America's bioterror efforts. Microbiologists and other disease experts are likely to be recruited for new programs at the expense of the overseas infectious disease work policy makers now consider a national security priority.

"There is likely to be a diversion of interests," said Dr. Stanley Lemon, dean of medicine at the University of Texas Medical Branch in Galveston and the forum's vice-chair.

Public health experts and policy makers are increasingly concerned with the threat infectious disease poses to world economic and political stability. American politicians at the highest levels of government have taken notice as HIV/AIDS, which infects some 40 million people, threatens to destabilize governments and cultures in Africa, Asia and Eastern Europe.

Meanwhile, tuberculosis bacteria infect up to one third of the world population, with 10% of those showing the full-blown respiratory disease. Most experts blame massive immigration waves and tourism travel, as well as poor disease surveillance, for rising rates of infection in many parts of the US.

Dr. Danielle Grondin, director of migration health for the International Organization for Migration in Geneva, said that wealthy countries can no longer rely on testing refugees and immigrants as a way to keep tuberculosis and other ailments from crossing their borders.

Recent research suggests that testing policies in the US and Canada have failed to detect massive numbers of visitors and immigrants who carry TB. "The rich countries need to do much more to promote testing in origin countries," she said in an interview.

American research experts, including leaders at the National Institutes of Health, have stepped up efforts to help developing countries improve their disease surveillance systems and extend disease treatment. They stress that the efforts will continue.

But others worried that those efforts will not immediately match up with the new American priorities of preventing anthrax, smallpox and tularemia attacks.

"You cannot expect them to care about 5 deaths from anthrax in our country," said Patrick Kelley, who directs the Pentagon's Global Emerging Infections Surveillance Response Systems.