An interagency Government working group on emerging infectious diseases was formed in December 1994 under the auspices of the National Science and Technology Council's Committee on International Science, Engineering, and Technology (CISET). Led by CDC, the Department of State, USAID, Food and Drug Administration, NIH, and the Department of Defense, the working group makes the following recommendations for action by the U.S. Government.

Work in partnership with other countries, with WHO, and with other international organizations to improve worldwide disease surveillance, reporting, and response by

1. Establishing regional disease surveillance and response networks linking national health ministries, WHO regional offices, U.S. Government laboratories and field stations abroad, foreign laboratories and medical centers, WHO Collaborating Centers, and WHO.

2. Ensuring that reliable lines of communication exist between local and national medical centers and between national and regional or international reference facilities, especially in parts of the world where modern communications are lacking.

3. Developing a global alert system whereby national governments can inform appropriate worldwide health authorities of outbreaks of infectious diseases in a timely manner, and whereby individual health authorities can access regional centers.

4. Identifying regional and international resources that can provide diagnostic reagents for low incidence diseases and help identify rare and unusual diseases.

5. Assisting WHO to establish global surveillance of antibiotic resistance and drug use, as a first-step toward the development of international agreements on antibiotic usage.

6. Encouraging and assisting other countries to make infectious disease detection and control a national priority.

7. Preserving existing U.S. Government activities that enhance other countries abilities to prevent and control emerging and re-emerging health threats.

8. Identifying and strengthening WHO Collaborating Centers that serve as unique reference centers for diseases whose re-emergence is feared.

9. Establishing the authority of relevant U.S. Government agencies to make the most effective use of their expertise in building a worldwide disease surveillance and response network.

   Strengthen the U.S. capacity to combat emerging infectious diseases by

10. Enhancing collaborations among U.S. agencies to ensure maximum use of existing resources for domestic and international surveillance and response activities. Supporting the G7-initiated project on public health care applications of the Global Information Infrastructure, entitled "Toward a Global Public Health Network."

11. Rebuilding the U.S. infectious disease surveillance public health infrastructure at the local, state, and federal levels.

12. Working with the private and public sectors to improve U.S. capacity for the emergency production of diagnostic tests, drugs, and vaccines.

13. Supporting an active community of epidemiologists, clinical investigators, laboratory scientists, health experts, and behavioral scientists ready and able to seek new solutions for new disease threats.

14. Strengthening technical training programs in disciplines related to infectious disease surveillance and response.

15. Providing accurate and timely health information to private citizens and health providers, both in the United States and abroad, when a disease outbreak occurs.

16. Strengthening infectious disease screening and quarantine efforts at ports of entry into the United States.

17. Strengthening the training of American physicians and microbiologists in the recognition of tropical diseases and in travel medicine in general.

18. Establishing an Interagency Task Force to coordinate the implementation of these recommendations.

19. Establishing a private sector subcommittee of the Interagency Task Force that includes representatives of the U.S. pharmaceutical industry, medical practitioners and educators, and biomedical scientists.