U.S. launches new global initiative to prevent infectious-disease threats


Shafe Mowlid, a laboratory technician from the CDC and Kenya Medical Research Institute collaboration, examines samples collected from Congolese refugees in Rwanda to detect parasitic infections. (Michelle Russell/Centers for Disease Control and Prevention)

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, strengthen 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 initiative.

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.


Lab workers in Vietnam run diagnostic tests, one of many activities to improve the health of global citizens and U.S.-bound travelers. CDC experts provide training to enhance Vietnam’s ability to confirm detection of new pathogens such as H7N9 and MERS-coronavirus. (Niki Pham/CDC Vietnam)

Diseases that until recently weren’t found in the United States have become widespread, including mosquito-borne illnesses related to West Nile ­virus. 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 school , and three cases were reported at a Fairfax County high school in June.

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 fever, 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,” Andrew Weber, assistant secretary of defense for nuclear, chemical and biological defense programs, said in conference call with reporters Wednesday.

The WHO, the U.N. 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 pandemic 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 months.

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, 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 Ethi­o­pia, 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, 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 workers flared after revelations in 2011 that the CIA had sponsored an immunization campaign to gain information about Osama bin Laden before U.S. forces killed him in Pakistan.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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