SS+GunnarsdottirRein+-+Disease+Surveillance

Previous version(s) that may have more info are here
= = = = =1AC as of Day 1 tournament - Aug 5th= == ==Text: For areas with United States Agency for International Development African missions, the United States federal government should increase surveillance infrastructure and recruit personnel for the Centers for Disease Control and Prevention’s Global Disease Detection Program and provide all results to these areas. We will clarify.==

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Contention One – Inherency
Global Disease Detection program lacks crucial funding to maintain current operations [“Professional Judgment FY 2008,” 4/20, http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf] __CDC’s mission-critical health statistics and similar data systems are currently on **life support**. Investments have simply not kept pace with expenses and technologic advances that support the ongoing information compass for local, state and national decisions about the health of the population and the operation of the healthcare system. Without adequate funding, CDC will be unable to maintain the current scope and quality of data collection and timeliness of data releases. With enhancements beyond those essential to continuity of existing programs, CDC would provide timely, accurate estimates of high priority health measures__ including health insurance coverage and monitor the success of CDC Health Protection Goals, including critical information about subgroups at risk for health disparities
 * C**enters for **D**isease **C**ontrol and Prevention, **20****07**

There are no cross-border disease surveillance programs in Africa– this means diseases are misdiagnosed and undetected
Jakob **Zinsstag et al**, Department of Public Health and Epidemiology at the Swiss Tropical Institute, **2007** [“Human benefits of animal interventions for zoonosis control,” U.S. National Center for Infectious Diseases, April 1, Lexis] Rein The spread of highly pathogenic avian influenza is a global threat to all countries that have a poultry industry, semicommercial poultry production, or backyard poultry operations and has already caused enormous economic losses (19). Moreover, the risk for human pandemic influenza originating from highly pathogenic avian influenza in conjunction with human influenza A virus is very high, with an estimate of >100,000 deaths for the United States alone (20). __To implement disease prevention and control measures, early identification of emerging patterns of disease is necessary and uses economic methods to determine which mix of measures is most cost-effective. Resource-limited countries in__ __Africa__ __are almost devoid of surveillance capacity and efficient early warning systems, which would be crucial. Surveillance of cross-border diseases cannot be restricted to countries that have the funds__. High-income countries would ultimately benefit by providing funding for surveillance and control to low-income countries. Comprehensive economic assessment of this issue are, however, lacking so far. Awareness, Knowledge, and Information __Many countries__, especially those with resource constraints and those __in__ sub Saharan __Africa____, lack information on the distribution of zoonotic diseases. Risks for zoonoses are considered negligible compared with those for diseases of higher consequence because the societal consequences of zoonoses are not recognized by the individual sectors__. For example, __outbreaks of Rift Valley fever in persons in__ __Mauritania__ __were mistakenly identified as yellow fever. The correct diagnosis was made only after public health services contacted livestock services__, which informed them of abortions in cattle (21). In resource limited and transitioning countries, __many zoonoses are not controlled effectively because adequate policies and funding are lacking__. However, __transmission of zoonoses to humans can already be greatly reduced by health information and behavior__. Authorities in Kyrgyzstan, for example, have started an information campaign to reduce brucellosis transmission to small-ruminant herders by encouraging them to wear gloves for lambing and to boil milk before consuming. Interventions in livestock should always be accompanied by mass information, education, and communication programs.

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Having more information about diseases and sharing that information with the public prevents panic and quarantines – a lack of surveillance results in stereotyping – history proves
Margaret **Humphreys**, teaches the history of medicine and public health at Duke University, Editor of the Journal of the History of Medicine and Allied Sciences, **2002** [“No Safe Place: Disease and Panic in American History,” //American Literary History// 14.4 (2002) 845-857, MUSE] Rein __Rumor is key to the panic. **Incomplete information escalates the fear**. Throughout the nineteenth century the public feared that government officials were covering up cases of yellow fever to prevent panic, which had the **opposite effect**__. Since a case of yellow fever did stir panic, flight, and total disruption of social and commercial life, public health officials were very cautious in diagnosing the first case of an epidemic season. And since yellow fever mimicked hepatitis B and alcoholic liver disease, two diseases common among the sailors and other inhabitants who frequented the docklands where yellow fever was often first found, the physician's task was genuinely complex. __Given how quickly "urban legend" stories can travel around a community, state, and region, it is no surprise that the merest whisper of a yellow fever case would quickly raise panic in a population. Given that the panic diseases were foreigners threatening the safety of the home place, **attempts at quarantine were near universal in response**__. Until 1900, when Walter Reed and colleagues proved that yellow fever was spread by the aedes aegypti mosquito, debates raged over its contagiousness and the need for isolation. Similar controversies characterize the cholera discourse, which is not surprising given its role as the other major panic disease of the nineteenth-century US. But quarantine and isolationism featured in the popular response to each appearance of these diseases, even when doctors were disputing their usefulness. Trying to erect a barrier to keep the home place safe while keeping disease out is an inevitable response to a traveling, panic disease. Yellow fever adapted to modern modes of transportation to move within the nineteenth-century countryside, and Southerners modified their quarantine ideas accordingly. Ships were still suspect, including steamboats moving from yellow fever ports up the Mississippi, Ohio, and Missouri Rivers, which might be refused the right to dock by suspicious townspeople. Trains likewise were [End Page 850] death carriers, and more than one set of train tracks was destroyed to prevent their passage. Both trains and steamboats might be met by citizens who enforced their cordon sanitaire with shotguns, leading to congressional discussions of shotgun quarantines and their subsequent suppression of trade. People traveling the roads by foot or wagon might likewise be turned back, forced to sleep in the fields when no one would take them in. In spite of medical reassurance to the contrary, __most of the population believed yellow fever was contagious, and they created barriers to ensure that their border of safety was not breached. One alternate response to the panic of yellow fever or cholera was to claim that the diseases did not travel at all__, but were created de novo in the locality. This was always a hard sell to the general public, but the consequence of such argument, the general cleansing of a municipality, was popular anyway. __Such arguments, that disease arose spontaneously from the filthy streets under the right circumstances, often accorded with the best of medical theory.__ Yet it had to contend with the problem of explaining why epidemics appeared in some years and not others. Medical authors tended to argue for some peculiar conjunction of weather and filth to explain this epidemiological pattern—which made them quite vulnerable to ridicule. Most often, calls for urban purification were most acceptable to the general population when used in addition to protective barriers. The idea of making the home place better able to resist infection accorded well with a simultaneous creation of a stronger border. __Driven by panic, the urge to contain the infected could lead to bizarre quarantine practices. In 1900 a Chinese man died of bubonic plague in__ __San Francisco____. The response was to quarantine Chinatown__, allowing Caucasians to move across its borders but prohibiting the passage of Asians. __Officials decreed that Chinese bodies were most susceptible to plague, perhaps because their rice diets were low in protein__, and thus the way to protect the city was to keep the Chinese walled into Chinatown. __A federal judge recognized the irrationality of this conclusion, noting that public health authorities had **no evidence for their hypothesis** about Asian susceptibilities, and ordered the quarantine called off.__ The epidemic smoldered until it disappeared in 1904, only to return three years later in pockets scattered over the Bay area. In the interim scientists had discovered the connection between plague and rats, so this time the panic focused on rat catching, and Chinatown was spared. 3 The purveyors of American disinfectants and pesticides have been well aware of the public's fear of contagion and the invasion of the home place. In The Gospel of Germs Nancy Tomes [End Page 851] has emphasized the process by which American housewives were taught to view their homes as "whited sepulchers," places that looked safe and clean on the surface but which harbored death dealing bacteria heretofore unnoticed. Likewise, Americans had to be taught to fear the insects that spread disease and to buy the screens and pesticides that would protect against them. In a time when public health officials blamed flies for spreading polio and typhoid, cartoons depicted monster flies threatening innocent babies (see Rogers). And a popular advertising series of mosquito cartoons drawn by Ted Geisel (a.k.a. Dr. Seuss) urged Americans to think "Quick Henry, the Flit" whenever a mosquito appeared. Most Americans over 55 remember this insecticide, which was sprayed via the Flit gun, familiar from old animated cartoons (Humphreys 56). The theme in all these messages was the same—you think your home is safe, but these hitherto unseen contaminants or unappreciated, dangerous beasts are threatening your family with death and disease. Your home place is not safe, but you can make it so by applying our purifying product. __Another way to create a border between oneself and the infected space is to **map the trouble areas** and thus be able to study and control them. This is one of the core tools of epidemiology__. Its use by __John Snow__ is probably the most famous early example of the technique. He __hypothesized that cholera could be spread through the water supply and noted that in one London neighborhood there were two water companies__, one that drew from an area of the Thames less contaminated by sewage than the second. __He mapped the houses that received water from the two companies and then mapped cholera incidence in the same neighborhood, showing that the dirtier water correlated with a greater likelihood of infection. Maps of yellow fever epidemics have been employed to demonstrate proximity to the waterfront and other factors in an attempt to explain the disease. Mapping is about where the disease is, and drawing the picture begins to **give some idea of how to contain and understand it**__. 4

Status quo surveillance causes false alarms – it’s like the boy who cried wolf
Dena M. **Bravata et al**, Stanford University School of Medicine, **2004** [“Systematic Review: Surveillance Systems for Early Detection of Bioterrorism-Related Diseases,” Annals of Internal Medicine, Volume 140, Issue 11, Pages 910-922, June 1, http://www.annals.org/cgi/content/full/140/11/910#FN] Rein Bioterrorism __surveillance systems with inadequate sensitivity may fail to detect cases of__ bioterrorism-related __illness, which could result in substantial delays in detection and potentially catastrophic increases in morbidity and mortality. Systems with inadequate specificity may have frequent **false alarms**, which may result in costly actions by clinicians and public health officials or,__ perhaps even worse, __officials ignoring the system when it reports a suspicious event__. Because sensitivity and specificity are related, they must be evaluated simultaneously. However, only 3 reports of 3 systems provided numeric data for both sensitivity and specificity of the system (90, 117, 175). This substantially limits our understanding of the accuracy of existing surveillance systems for bioterrorism-related illness. 

And – Bush will use martial law to quarantine people in the US if the bird flu spreads, but provide no assistance
Howard **Friel**, Coauthor (with Richard Falk) of The Record of the Paper: How The New York Times Misreports US Foreign Policy, **2007** [“Bird Flu, Martial Law, and the 2008 Elections,” Feb 27, http://www.commondreams.org/views07/0227-32.htm] Rein Last fall, Lawrence Wilkerson, who was chief of staff to Secretary of State Colin Powell, said about the Bush administration that “__if something comes along that is truly serious, something like a nuclear weapon going off in a major American city, or something like a major pandemic, you are going to see the ineptitude of this government in a way that will take you back” to the eighteenth century__. (“Transcript: Colonel Wilkerson on US Foreign Policy,” Financial Times, Oct. 20, 2005) The administration, in fact, seems determined to sink beneath even this standard of expectation. Apparently eager to duplicate the do-nothing response to Hurricane Katrina, __presidential spokespersons have already announced that the administration will **do nothing** in response to a bird-flu pandemic by way of providing any help to cities, states, and hospitals__. Michael Leavitt, Secretary of Health and Human Services, has been saying this for months. Here is one such statement: “Any community that fails to prepare [for a pandemic] with the expectation that the federal government will throw them a lifeline is tragically wrong…. [__E]very community will have to take care of its own.”__ (“U.S. Health Chief Says Flu Pandemic Would Be Dramatic,” Associated Press, Jan. 13, 2006) By way of heeding Wilkerson’s warning, it might be prudent for every state, community, hospital, and citizen to assume that __there will be no help from the federal government in response to what may be the worst disease pandemic in human history.__ This would be bad enough, but without immediate congressional intervention, federal ineptitude isn’t the only thing that may accompany a pandemic. In October 2005, rather than offer financial assistance to states, communities, and hospitals, or oversee a major “surge” in vaccine research and production capacity, President __Bush announced his intention to use the US military in a domestic law-enforcement capacity in response to a bird-flu pandemic__. In this regard, the president said: “__I’m concerned about what an avian flu outbreak could mean for the United States. One option is the use of a military that’s able to plan and move. I think the president ought to have all options on the table__—all assets on the table—__to be able to deal with something this significant.”__ The problem in 2005 was that __the Posse Comitatus Act of 1878 prohibited a president from using the military for police actions in the United States__. In response to the president’s statements at the time, Irwin Redlener, associate dean of the Mailman School of Public Health at Columbia University, who is involved in pandemic preparations for the city of New York, stated that __giving the military a law enforcement role would be an “extraordinarily **Draconian measure**” and would lead to “**martial law** in the United States.”__ (“Bush Military Bird Flu Role Slammed,” CNN, Oct. 5, 2005)

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New diseases are inevitable – studies prove
Declan **Butler**, Freelance Journalist, **2006** [“Disease Surveillance needs a revolution,” Nature, 3/1, http://www.nature.com/news/2006/060227/full/440006a.html] Many hope that resources pumped into avian flu will benefit the surveillance of emerging diseases generally by strengthening infrastructure. But the money available so far is only a start. __And the rate at which new diseases appear — currently around one a year — is increasing__. Mark Woolhouse, __an epidemiologist at the University of Edinburgh__, UK, __has analysed all recognized human pathogens and he suggests that this rise is mainly due to changes in land use and the way that people live. Of the 117 emergent human diseases that he has studied, more than half jumped from animals. "The world has to get to grips with the fact that what is happening now is going to happen repeatedly," says Roeder. "We have to develop a global structure to tackle emerging diseases__.

Ineffective surveillance in Africa prevents a global understanding of future disease spread and current disease containment – accurate analysis allows for effective local response
[“Challenges in Improving Infectious Disease Surveillance Systems,” August] __Weaknesses in developing country systems reduce the ability of public health authorities at every level to understand and control infectious disease threats. These shortcomings__ limit the success of ambitious international programs such as the polio eradication effort, and __impair the routine surveillance of other diseases and the identification and control of outbreaks, newly emerging diseases, and antimicrobial resistance. The surveillance achievements recorded by programs such as the polio eradication effort have been possible only because intensive international assistance has been given to developing countries so that they can participate in these programs. In spite of this assistance, poor surveillance in developing countries has continued to limit the ability of these programs to achieve their goals__. For example, according to CDC, four countries in southern Africa were unable to meet international expectations in 1999 for detecting cases of acute flaccid paralysis, a key indicator of polio surveillance quality. Seven countries in the region fell short of the targeted 80-percent rate for collecting stool samples from suspected cases. The African region as a whole performed more poorly than any other, detecting less than the target number of potential polio cases and attaining less than the 90-percent goal for completeness of reporting. According to CDC, __completing the global eradication effort is complicated by systemic weaknesses in the remaining endemic areas, which are located primarily in__ sub-Saharan __Africa__ and South Asia.27 __Ineffective routine surveillance seriously compromises the international community’s ability to understand global disease burdens and trends. As already indicated with regard to yellow fever, cholera, and dengue, the global incidence of many diseases is unknown.__ One WHO official noted that health authorities in Equatorial Guinea, which lies within the yellow fever endemic zone of Africa, had informed him that their country has never experienced an outbreak of yellow fever. This statement cannot be disproved because no surveillance for yellow fever exists in Equatorial Guinea. __Even when adequate data exist to identify gross trends, the data generally are not adequate for in-depth analyses or informed decisions about targeting resources to achieve specific control objectives. Developing countries often cannot investigate or address outbreaks on their own. **CDC’s investigative expertise, including laboratory support, is comparatively rare in the rest of the world.**__ Many of the African surveillance assessments we reviewed indicated that outbreaks there are often not thoroughly investigated, if they are investigated at all. Health officials in countries we visited and at WHO headquarters in Geneva noted that serious outbreaks strain developing countries’ relatively weak public health systems, requiring them to request international assistance to cope. For example, India experienced an outbreak of plague in 1994 that resulted in hundreds of cases across the country, 56 deaths, and over a billion dollars in economic damage from the travel restrictions and trade embargoes imposed by other countries. The outbreak was severe in part because India had largely discontinued surveillance for plague. Health authorities did not respond to initial complaints of flea infestation and did not take appropriate measures to contain the outbreak. The disease spread to crowded urban slums where it progressed unchecked to its highly contagious, pneumonic form and became a serious national problem.
 * GAO**, United States General Accounting Office, **2001**

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A sleeping sickness epidemic will cause thousands of deaths
Pierre **Cattand et al**, President of The Association Against Trypanosomiasis in Africa, **2001** [“Sleeping sickness surveillance: an essential step towards elimination,” Tropical Medicine & International Health 6 (5), 348–361, May, Blackwell Synergy] Rein __The impact of sleeping sickness in terms of public health lies not in the annual incidence, but in its potential for the development of **explosive epidemics causing thousands of deaths**__. If incidence alone is considered, the disease appears as a minor health problem compared with other parasitic diseases like malaria and helminthic infections. However, __because of its severity, a single case in a family will affect all members__ (Kuzoe 1989). __Outbreaks not only affect families but also place a major burden on the whole community by reducing the labour force, interrupting agricultural activities, disrupting the local economy and jeopardizing food security. In the past, many thousands of people have died during large-scale epidemics__. If the Disability Adjusted Life Year (DALY) figures (i.e. loss of healthy life years by premature mortality and disability) are considered, the social and economic impact of trypanosomiasis ranks third behind malaria and schistosomiasis in sub-Saharan Africa (A. Moore, personal communication). __The number of deaths due to Human African Trypanosomiasis (HAT) each year is estimated at 100 000__. Populations fleeing sleeping sickness leave behind them vast deserted regions (Ekwanzala 1996). A comparable exodus due to a disease can only be found in regions with river blindness, caused by the filariid Onchocerca volvulus. __Dissemination of sleeping sickness can be effectively prevented by regular surveillance of the population at risk__, including diagnosis and treatment, and in certain areas, by controlling the tsetse fly population. __The epidemiology of sleeping sickness is characterized by its occurrence in discreet foci. Over time the geographical extent of foci changes significantly, because of environmental changes favouring or hindering the fly’s multiplication, density and dissemination__ (Leak 1999). __Flare-ups often occur within larger endemic areas. This peculiarity requires tailoring surveillance and control to curb transmission and spread of the disease. Without surveillance and control, the disease will amplify until the **human population is decimated** or until the last survivors abandon the affected area for fear of infection__ (Ekwanzala 1996).

Surveillance is the only way to stop the spread of sleeping sickness
Pierre **Cattand et al**, President of The Association Against Trypanosomiasis in Africa, **2001** “Sleeping sickness surveillance: an essential step towards elimination,” Tropical Medicine & International Health 6 (5), 348–361, May, Blackwell Synergy] Rein __A surveillance system must answer a need, which in sleeping sickness concerns avoiding the occurrence of a deadly epidemic. The system must be useful, simple, sensitive, specific, adaptable, reactive and acceptable__. Thus it must be a compromise between ‘ideal’ and ‘operational’. It must be efficient and cost-effective, taking into account field constraints and available means. Bearing these parameters and the need of a consistent system in mind, __a geographical standard unit was required for reporting. With the advent of Global Positioning Systems (GPS) and computer based Geographical Information Systems (GIS), it became evident that__, from an operational point of view, __villages and hamlets would be the most appropriate reporting unit. This is opposed to the classical concept of reporting prevalence of whole endemic or epidemic areas. By obtaining the spatial co-ordinates of villages and hamlets, they can be unequivocally identified and all information of interest to the epidemiologist and other staff responsible to control diseases could then be attached to this clearly identified geographical ‘unit’.__ In areas where disease control activities were ongoing, __the surveillance system would use the observations made during operations: case search, diagnosis and treatment, vector control. The data collected would then be analysed to evaluate control operations__; thus __surveillance is also a monitoring tool. In areas without control operations, a minimal amount of data would be collected to assess the epidemiological situation. It is no longer a simple observation of ongoing activities, but an activity of its own. The analytical results would then provide the information necessary to identify the resurgence of the disease and its epidemiological trend__; thus surveillance is a warning tool.

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In addition, surveillance solves malaria which kills 1-2 million people a year
David J. **Rogers**, University of Oxford, **2002** “Satellite imagery in the study and forecast of malaria,” Nature, Volume 415(6872), February, OVID] Rein More than 30 years ago, human beings looked back from the Moon to see the magnificent spectacle of Earthrise. The technology that put us into space has since been used to assess the damage we are doing to our natural environment and is now being harnessed to monitor and predict diseases through space and time. __Satellite sensor data promise the development of early-warning systems for diseases such as malaria, which **kills between 1 and 2 million people each year**__**.** Malaria caused by Plasmodium falciparum parasites exacts its greatest toll in sub-Saharan Africa, where it is one of the largest causes of morbidity and mortality, creating a significant barrier to economic development. Furthermore, this public health burden is increasing globally 1, exacerbated by failure of existing affordable drugs, population growth against declining per capita expenditure on health, human migration and poverty. As a step towards reversing this trend, __there is growing interest in the mapping and predictive modelling of the geographical limits, intensity and dynamics of the risk of malaria infection, using new tools of surveillance. An unprecedented amount of information on environmental conditions, remotely sensed by satellite sensors, is now available at temporal and spatial resolutions to match our epidemiological questions__. Here we show how these tools are used to investigate the factors that drive the dynamics of vector populations and malaria parasite transmission. __Because mosquito population processes and malaria incubation periods in vectors__, for example, __vary with temperature and moisture conditions on the ground, remotely sensed images of seasonal climate are powerful predictors of mosquito distribution patterns and average levels of transmission of malaria parasites by these vectors. Patterns of infection vary through time owing to extrinsic__ (for example, climate) __and intrinsic__ (for example, immunity) __effects. The balance of these factors depends upon the levels of malaria transmission in each place and will change over time with resistance to control of parasites and vectors. Early-warning systems__, therefore, __will require models that incorporate both intrinsic and extrinsic factors__.

== Furthermore, epidemics kill 54 million annually Matthew Carlberg, Marine Corps Command And Staff Coll Quantico va, 2002 [July, http://stinet.dtic.mil/oai/oai?&verb=getRecord&metadataPrefix=html&identifier=ADA403988] __Epidemics threaten national security by impacting the economic, political, and social aspects of national power. The AIDS epidemic in Sub-Saharan Africa bears stark witness to the magnitude of this threat. It also offers the opportunity for prospective study of the relationship between epidemics, state failures, and wars. There are roughly 54 million deaths annually worldwide from infectious diseases. Half of these deaths occur in Sub-Saharan Africa. The litany of resurgent and emerging infectious diseases, coupled with the phenomenon of antibiotic resistance, bring to light the magnitude of the threat both to national security and deployed forces.__

[“Right to Health Most Important Right of All,” Dec 10]
The horrendous figures that demand urgent action speak for themselves. An estimated __1.1 million deaths annually from malaria, 2.1 million from HIV/AIDS, almost 600,000 from TB, 4.8 million from child mortality, 300,000 from maternal mortality and that s not counting malnutrition, water borne diseases like typhoid and cholera, or cervical, breast, prostrate and other cancers; heart, liver, kidney and lung disease."__ Underlining the looming tragedy that the shocking figures demonstrate, Rotimi stated further: __"Unless they act without delay, the present generation of African leaders may well end up presiding over the beginning of the extinction of modern day Africa. The number of African lives lost annually to preventable, treatable and manageable health issues alone is equal to losing annually, the entire populations of Eritrea__ (4.4m people), __Libya__ (5.8m people), __Sierra Leone__ (5.5m people), __or Togo__ (6.1 people). __The coffins and burial business must be Africa s fastest growth industry. In the next 20 years Africa could lose more people than the 100 million it lost in all the 400 years of slavery and colonialism from which we are yet to fully recover. In 20 years an equivalent number to the population of Nigeria__ (130million) __Africa s most populous country could die__"

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Current surveillance is insufficient to contain the bird flu – Africa is a __critical__ region to prevent spread and mutation
Tiaji **Salaam-Blyther**, Coordinator Foreign Affairs, Defense, and Trade Division of the Congressional Research Service, **2006** [U.S. and International Responses to the Global Spread of Avian Flu: Issues for Congress, 1/9, http://fpc.state.gov/documents/organization/59025.pdf] Global Disease Surveillance A number of analysts have argued that __due to insufficient investment in disease surveillance and health care in many of the countries where H5N1 is endemic, a pandemic may progress before it is discovered. In this view, ill-equipped surveillance systems will be slow to determine the source of a pandemic, evaluate the rate of viral transmission, ascertain whether H5N1 has become efficiently transmissible among humans, or rate the effectiveness of anti-flu initiatives__. Senate Majority Leader Bill Frist has proposed $1 billion for a real-time international threat detection system.126 USAID and other U.S. government officials suspect that the lack of documented human cases of H5N1 in Laos has more to do with inadequate surveillance and reporting systems than an absence of infection.127 Some health experts believe that H5N1transmission could already be underway in Laos, since surrounding countries have already had human and animal outbreaks. Key U.S. agencies and international organizations have determined that Laos is a country that needs critical prevention, monitoring, and surveillance support in order to prevent full-blown human-to-human transmission of H5N1 that could emerge and sweep across the region without warning.128 Some experts have expressed increasing concern about the capacity of poorer countries that have not yet had H5N1 cases to effectively contain the spread of the virus and plan for pandemic influenza, particularly in sub-Saharan Africa. FAO has recently warned that the risk of H5N1 spreading to the Middle East and Africa has markedly increased. FAO is particularly wary of the virus reaching Eastern Africa, as the surveillance capacities and veterinary services in those countries are limited. According to Reuters, __a WHO representative declared that an H5N1 outbreak would likely be missed in Africa, as bird nutrition is poor and high mortality among poultry is common. Concurrently, human cluster cases are likely to be missed due to poor surveillance systems__. South Africa is reportedly the only country in sub-Saharan Africa to have drawn up a pandemic preparedness plan.129 __Some experts fear that an unabated H5N1 outbreak in East Africa could make the bird flu endemic there. “If the virus were to become endemic in eastern Africa, it could increase the risk that the virus would evolve through mutation or reassortment into a strain that could be transmitted to and between humans.__”130

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Mutation of bird flu is inevitable
Satish **Chandra**, Deputy National Security Advisor of India – Center for Strategic Decision Research, **2004** [Global Security: A broader Concept for the 21st Century, 5/7, http://www.csdr.org/2004book/chandra.htm]

If the possibility of the collapse of the thermohaline circulation system is alarming, __the possibility of a human-to-human transmittable bird flu pandemic is a nightmare. What makes it so frightening is the fact that it could happen at any time and that we are ill prepared to face it__. At current mortality rates, it could result in the sudden death of 15 to 20 percent of mankind. The most severe health crisis in recent years in terms of numbers of deaths was the 1918–1919 influenza epidemic, which in the space of one year caused an estimated 40 million deaths worldwide. Begun in Kansas in March 1918, the epidemic spread to Europe and then to India, Australia, and New Zealand. The virulence and mortality rate of the first wave of the disease, in the spring of 1918, was only slightly above normal levels but the second wave, which began in the fall of 1918, was extraordinarily deadly, with mortality rates of 5 to 20 percent above normal levels. It is believed that the fall strain of the virus came about through genetic mutation and that the genetic structure of the virus was a form of a swine and avian influenza strain. Since 1918, the world has seen several influenza outbreaks, most notably the 1957 Asian flu outbreak and the 1968 Hong Kong flu outbreak, each of which killed a million people. While WHO now has an Influenza Surveillance Program in place as well as an Influenza Pandemic Preparedness Plan, we still need to examine the possibility of the highly pathogenic H5N1 bird flu becoming transmittable from human to human, the outcome of such a situation, and what must be done to address the possibility. Since the end of 2003, outbreaks of the highly pathogenic H5N1 strain of avian influenza, or bird flu, have occurred in eight Asian countries, resulting in the loss of 100 million poultry birds. __The implications for human health are worrisome because of the extreme pathogenic nature of this virus—it has the capability to infect humans and cause severe illness, with mortality rates of 60 to 70 percent__. It has already infected humans three times in the recent past: In 1997 and 2003 in Hong Kong and in 2004 in Vietnam and Thailand. So far the disease has been transmitted only to humans who came in contact with dead or diseased poultry—it has not yet mutated to being capable of human-to-human transmission. The Likelihood of a Pandemic Since the H5N1 strain has not been eliminated from its avian hosts, it is obviously endemic. __The risk, therefore, that the virus could take on a new form that would make it capable of human-to- human transmission is considerable, especially because mass vaccinations of chickens, aimed at mitigating the disaster facing poultry farmers, has allowed the virus to continue to circulate among the vaccinated birds. It can thus linger indefinitely in poultry, making the gene mutation required to make it transmittable from human to human an even greater possibility. It could be said that there are three prerequisites for the start of a pandemic__: 1) a new virus must emerge against which the general population has little or no immunity; 2) the new virus must be able to replicate in humans and cause disease; and 3) the new virus must be efficiently transmitted from one human to another. Dr. Anarji Asamoa Baah, Assistant Director General, Communicable Diseases, WHO, asserts that, __regarding H5N1, the first two prerequisites have already been met, and it is known that the virus can become more transmittable via two mechanisms, “adaptive mutation” and “genetic re-assortment.”__ Dr. Baah has further contended that __re-assortment of H5N1 with a human influenza virus can take place in humans without prior adaptation in other species such as swine.__ It is clear, therefore, that 1) the H5N1 virus will continue to circulate for a very long time in poultry birds; 2) the threat to public health will be there as long as the virus continues to circulate in poultry birds; 3) should the virus become transmittable from human to human, the consequences for human health worldwide, in the words of Dr. Baah, “could be devastating;” and 4) the world needs to be prepared to respond to the next influenza outbreak. During an Influenza Pandemic Preparedness meeting in Geneva in March 2004, the head of the World Health Organization warned, “**__We know another pandemic is inevitable. It is coming__**…we also know that we are unlikely to have enough drugs, vaccines, healthcare workers, and hospital capacity to cope in an ideal way.” On the basis of an epidemiological model project, WHO scientists predict that an influenza pandemic will result in 57 million to 132 million outpatient hospital visits, 1 million to 2.3 million admissions, and between 280,000 and 650,000 deaths in less than two years. The impact on poor nations would be much greater. But I submit that these projections are gross underestimates given the fact that the 1918–1919 influenza epidemic, with mortality rates of a maximum of 20 percent above normal level, caused as many as 40 million deaths. With mortality rates in excess of 60 percent, the H5N1 virus is bound to be much more deadly, particularly because __in today’s world of air connectivity, the spread of H5N1 would be much more rapid than that of the 1918 influenza epidemic__. Indeed, __the death toll could run into hundreds of millions__.

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Disease surveillance, labs, and CDC expertise are key to preventing the rapid spread of bird flu
Stephen B. **Blount**, MD, MPH, Director – Office for Global Health, **2007** [5/2, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html]

Currently, __the US and the rest of the world are facing a very real threat posed by the highly pathogenic H5N1 avian influenza virus. Our experience with SARS showed us how a highly infectious disease in a remote region of the world can **spread in a matter of days** and weeks. Thanks to the rapid and constant movement of people and commodities, pathogens can hitch rides on airplanes and boats and slip across national borders unnoticed. The key to interrupting these pathogenic journeys is early detection as close to the source as possible.__ An estimated 60% of all known human infectious diseases and approximately 75% of all recently recognized emerging infectious diseases affecting humans are of animal origin. We witnessed sobering evidence of the health impact of the human-animal interface during our rapid multidisciplinary response to the large epidemic of potentially fatal Rift Valley fever virus earlier this year in east Africa. __Additional disease surveillance tools, laboratory capacity, and CDC expertise deployed abroad can rapidly improve our ability to recognize and intervene to contain emerging threats—including a possible avian influenza pandemic__—before they become significant problems within U.S. borders. To prepare for a pandemic of influenza, key issues __we need to address are appropriate training and exercising of rapid response teams to identify, investigate, and contain local outbreaks. We also need to be able to trust that we have the **most accurate and reliable information** about influenza viruses and novel human influenza cases—through strong and established surveillance systems, laboratory capacity, and communication channels so we can respond effectively__.

Bird flu transmissions spread globally, killing a billion
Satish Chandra, Center for Strategic Decision Research, 2004 [Global Security: A broader Concept for the 21st Century, May 7, http://www.csdr.org/2004book/chandra.htm]

__This scenario__, as frightening as it is, __pales in comparison with what could overtake us by 2007 if the highly pathogenic form of bird flu__ “H5N1” __becomes transmittable human to human; all it would take for this to happen is a simple gene shift in the bird flu virus, which could happen any day. In a globalized world linked by rapid air travel, the disease would spread like a **raging forest fire**. If it did, it would overwhelm our public health system, cripple our economies, **and wipe out a billion people** **within the space of a few months**—a 60 percent mortality rate is estimated.__

==

Effective surveillance is essential to dealing with emerging and resistant diseases
[“Challenges in Improving Infectious Disease Surveillance Systems,” August]
 * GAO**, United States General Accounting Office, **2001**

__Shortcomings in developing country systems also limit the global community’s ability to identify and effectively control newly emerging and reemerging diseases. Several factors combine to make the emergence of new pathogens more likely in developing countries. These include accelerating urbanization and overcrowding without benefit of adequate water supply and sewage systems, population displacement due to civil wars and other disasters, and increased human incursion into ecosystems where contact with pathogens that previously affected only animals or insects is more likely to occur. Developing countries are poorly equipped to conduct surveillance for such pathogens. For example, during the 1980s a bacteria long recognized as a cause of routine eye infections evolved into a pathogen capable of causing an extremely serious disease—Brazilian Purpuric Fever.__ Since its first appearance, cases of this disease have been documented in Brazil and Australia. Experts observe that other cases may have occurred, only to be misdiagnosed as meningococcal disease. According to experts at the State University of New York at Buffalo and CDC, outbreaks of Brazilian Purpuric Fever appear to have waned. However, no organized surveillance exists for this disease, and its actual global distribution is unknown. In Uganda, local health professionals at the scene of the fall 2000 Ebola outbreak did not at first suspect the disease, despite the fact that Ebola outbreaks had previously occurred in two neighboring countries. Although antimicrobial resistance problems have emerged in industrialized countries, such problems are more likely to escape immediate attention and become severe in developing countries. __Impoverished developing countries are particularly ripe breeding grounds for the unchecked spread of drug-resistant strains due to their citizens’ poor access to medical facilities; high rates of self-medication; economic, educational, and logistical difficulties in completing full courses of drug treatment; and limited drug oversight by governments. While disease experts generally regard global surveillance for antimicrobial resistance as inadequate, developing countries conduct the least ambitious programs in this area. These countries’ weak laboratories are a key constraint.__

Finally, future diseases cause extinction
Kavita **Daswani,** **1996** [South China Morning Post, 1/4, Lexis]

Despite the importance of the discovery of the "facilitating" cell, it is not what Dr Ben-Abraham wants to talk about. There is a much more pressing medical crisis at hand - one he believes the world must be alerted to: the possibility of a virus deadlier than HIV. If this makes Dr Ben-Abraham sound like a prophet of doom, then he makes no apology for it. AIDS, the Ebola outbreak which killed more than 100 people in Africa last year, the flu epidemic that has now affected 200,000 in the former Soviet Union - they are all, according to Dr Ben-Abraham, the "tip of the iceberg". Two decades of intensive study and research in the field of virology have convinced him of one thing: in place of natural and man-made disasters or nuclear warfare, __humanity could **face extinction** because of a single virus, deadlier than HIV. "An airborne virus__ is a lively, complex and dangerous organism," he said. "It __can come from a rare animal or from anywhere and can mutate constantly. If there is no cure, it affects one person and then there is a **chain reaction and it is unstoppable**. It is a tragedy waiting to happen."__ That may sound like a far-fetched plot for a Hollywood film, but Dr Ben -Abraham said history has already proven his theory. Fifteen years ago, few could have predicted the impact of AIDS on the world. Ebola has had sporadic outbreaks over the past 20 years and the only way the deadly virus - which turns internal organs into liquid - could be contained was because it was killed before it had a chance to spread. Imagine, he says, if it was closer to home: an outbreak of that scale in London, New York or Hong Kong. It could happen anytime in the next 20 years - theoretically, it could happen tomorrow. The shock of the AIDS epidemic has prompted virus experts to admit "that __something new is indeed happening and that the threat of a deadly viral outbreak is **imminent**"__, said Joshua Lederberg of the Rockefeller University in New York, at a recent conference. He added that the problem was "very serious and is getting worse". Dr Ben-Abraham said: "Nature isn't benign. The survival of the human species is not a preordained evolutionary programme. Abundant sources of genetic variation exist for viruses to learn how to mutate and evade the immune system." He cites the 1968 Hong Kong flu outbreak as an example of how viruses have outsmarted human intelligence. And as new "mega-cities" are being developed in the Third World and rainforests are destroyed, disease-carrying animals and insects are forced into areas of human habitation. "This raises the very real possibility that lethal, mysterious viruses would, for the first time, infect humanity at a large scale and **imperil the survival of the human race**," he said. Dr. Ben-Abraham is the former chairman and chief executive officer of Biosante Pharmaceuticals Inc. "one of the 100 greatest minds in history" by super-IQ society Mensa

==

The CDC must expand its Global Disease Detection program to ensure effective global disease surveillance
Center for Disease Control, 2007 [“Professional judgment for fiscal year 2008”, developed in response to a request by the chairman, during the house appropriation Subcommittee on labor, health and human services, 4-20, http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf, p. 6]

CDC is a major partner in our nation’s frontline against emerging international health threats. __CDC’s Global Disease Detection program__, in partnership with host country governments and the WHO, __is a **key component** of this effort and forms the foundation of a transnational detection, prevention and response network to address emerging health threats__ including pandemic influenza. __With current funding levels, CDC has established 5 regional__ __response__ __Centers, but needs 18__ __– three in each WHO region -__ __to complete the network and properly protect the nation.__ __The__ __existing Centers have already proven their effectiveness and impact on detecting and responding to outbreaks__ including avian influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks, and many other serious infectious diseases and environmental health threats. __The Centers__ also __provide a platform for__ regional __training, surveillance, research, and health diplomacy activities that help promote sustainable health development in the targeted regions. CDC is a major global source of technical and scientific support to categorical disease control programs__ supported by USG, WHO, health ministries, PEPFAR, the Global Fund, and many other health organizations. __Our investment is modest and highly leveraged, but our capacity in most critical areas has been eroded by budget attrition and increases in the costs__ of science, travel, and infrastructure support __in the past few years. We need to continue and expand operational research to assure that investments__ the USG and others are making in international health __are__ __state-of-the science and__ __optimized to achieve results in the field.__ Critical areas that urgently need support include:

==

CDC's unique research and expertise means that the best and essential public health tools are used
[“Protecting the Nation’s Health in an Era of Globalization: CDC’s Global Infectious Disease Strategy,” prepared by the Dept of Health and Human Services, http://www.cdc.gov/globalidplan/global_id_plan.pdf]
 * DHHS**, Department of Health and Human Services, **2002**

__A____nother major priority for CDC is to translate research innovations into practical public health tools and ensure that they are disseminated widely and rapidly for the benefit of people all over the world. Examples of public health tools that have had a major impact on global infectious disease control are antibiotics, childhood vaccines, oral rehydration therapy, and vitamin supplements. There is often a long delay between the development of a new public health tool and its widespread implementation__. A country may lack the means to buy a new medical product or it may lack a public health delivery system and trained workers to administer it. __There may be__ low demand, because the public is not informed about a new drug or vaccine, or __low political interest, because the national government is not convinced that the drug or vaccine will be cost-effective. CDC can use its experience in disease surveillance to demonstrate the value of public health tools to ministries of health and finance and to the public, using pilot studies, demonstration projects, and health education campaigns__ (Box 19). For example, __CDC will continue to work with USAID, WHO, and other partners to demonstrate that mechanisms for the prevention or control of malaria__ (via vector control, chemotherapy, and insecticide-treated bednets) __are ready for national or regional implementation, pending the availability of resources and political commitment__(see Priority Area 5). CDC can also help development agencies, NGOs, and other partners address problems related to public health training and to drug or vaccine delivery (see also Priority Area 6). As part of the global strategy, __CDC will intensify efforts to couple applied research with research on ways to promote the use of newly developed tools for disease control__ (“implementation research”). __CDC will help identify the most effective tools and actively encourage their international use, applying expertise and resources in laboratory research__, public health policy, program management, __and health communications to overcome scientific, financial, and cultural barriers.__ __Examples of new tools with the potential for significant worldwide impact include point-of-use disinfection and safe water storage to prevent waterborne diseases__; auto-disable (one-use) syringes to prevent bloodborne transmission of hepatitis B and C viruses and HIV; and diethylcarbamazine and albendazole therapy to eliminate lymphatic filariasis.

== The CDC is the only agency that can coordinate surveillance – effective surveillance is key to detection and prevention of disease

Louis Jacobson, associate editor at National Journal, 1995 [“Disease Detectives,” National Journal, Government Executive, Section: Health, May, Lexis]

Today, though, __the world's surveillance network faces unprecedented troubles. Neglect and budget cuts have crippled__ some parts of __the safety net__, and __even CDC,__ the healthiest link, __could prove unequal to the rising tide of infections.__ While the public's attention has been focused on the dangers of emerging infections by the hit movie Outbreak and the publication last year of several popular books and countless articles on the subject, the __hype doesn't seem to be translating into real efforts to strengthen the ailing U.S. surveillance system.__ The Surveillance Challenge The need for good surveillance seems self-evident. "My main pitch," says Christopher H. Foreman Jr., author of Plagues, Products, and Politics (Brookings Institution, 1994), "is that __surveillance is the one element in all these hazards that is essential.__ __Surveillance is the one__ __stage where professionals run the show__ and where there's relatively little controversy about what is right to do." __Coordinating that surveillance__, however, __is a huge challenge.__ In the United States alone, __epidemiologists must rely on physicians to notify local authorities about patients with unusual or serious infections. Local officials pass information up the ladder to state officials, who then tell CDC__. Meanwhile, __CDC has to coordinate with other federal agencies__, notably the Agriculture Department (which handles animal and some food-borne diseases) __and the military__, whose far-flung outposts serve as sentinels for overseas outbreaks and whose research labs (thanks to longstanding concerns over biological warfare) rival and often surpass CDC's. Finally, __the United States has to work with foreign nations and such umbrella groups as the World Health Organization to track global disease movements.__ __Even if all__ __the__ __links were strong, creating a functioning whole would be challenging.__ __But__ __weaknesses abound.__ A study by Michael Osterholm, Minnesota's state epidemiologist, found that most states have no more than one person tracking all communicable diseases (excepting those whose tracking is supported by federal funds). Yet an association of state epidemiologists has just agreed to add half a dozen diseases to the list of roughly 50 upon which it is suggested that states report to the CDC.

==

Better research and scientists means the US is uniquely capable of surveillance – other countries will follow US leadership
[“The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases,” Population and Development Review, Vol. 22, No. 1, Match, JSTOR]
 * Population Council, 1996**

Thus, the effort to build a global surveillance and response system is in accord with the national security and foreign policy goals of the United States. Moreover, __leadership in global infectious disease surveillance and control is a natural role for the United States. American business leaders and scientists are **in the forefront** of the computer communications and biomedical research communities__ (both public and private sector) __that provide the technical and scientific underpinning for disease surveillance__. Furthermore, __American scientists and public health professionals have been among the most important contributors to the international efforts to eradicate smallpox and polio__. The challenge ahead outstrips the means available to any one country or to international organizations. __The U.S. Government must__ not only improve its capacity to meet the growing threat of emerging infectious diseases, but also __work in concert with other nations and international bodies.__ Although international efforts must be coordinated to prevent global pandemics, disease surveillance must be the responsibility of each sovereign nation. However, __individual governments may not easily share national disease surveillance information, fearing losses in trade, tourism and national prestige__. Nevertheless, __because U.S. experts are often consulted on problems of infectious disease recognition and control, the U.S. Government is usually informed about major disease outbreaks in other countries__, although not always in an official or timely fashion. __To ensure that we continue to be notified when an unusual outbreak occurs, we must encourage and support other countries' efforts in national disease surveillance and respond when asked for assistance__. We must strive to develop a sense of shared responsibility and mutual confidence in the international effort to combat infectious diseases. There is much room for optimism. **__If the United States takes the lead, we can expect that other nations will contribute resources to a global surveillance system__**. Both Canada and the European Union have recently decided- in spite of tight budgets-to provide substantial funds ($7 and $10 million per year, respectively) to strengthen infectious disease surveillance and control. __It is also absolutely critical that developing nations be engaged in an international effort that is in their own interests__. In May 1995, WHO passed a resolution urging member states "to strengthen national and local programmes of surveillance for infectious diseases, ensuring that outbreaks of new, emerging, and reemerging infectious diseases are identified." Soon after the resolution was drafted, WHO issued a report urging the strengthening of global disease surveillance and control, and encouraging greater use of WHO Collaborating Centers in this endeavor. = =

==

Disease surveillance it is a prerequisite to all other forms of disease care – it can get at the problem quickly and provide information for treatment and containment
Mac W. **Otten**, Jr., MD, MPH, Medical Epidemiologist, African Regional Office (WHO) **and** Helen **Perry**, MA, Educational Design Specialist, Division of International Health (CDC), **2001** [“Technical Guidelines for Integrated Disease Surveillance and Response in the African Region,”6/01, http://www.cdc.gov/idsr/focus/surv_sys_strengthening/tech_guidelines-integrated-diseaseENG.pdf]

Communicable diseases are the most common causes of death, disability and illness in the African region. While these diseases present a large threat to the well-being of African communities, there are well-known interventions that are available for controlling and preventing them. __Surveillance data can guide health personnel in the decision making needed to implement the proper strategies for disease control and lead to activities for preventing future cases__. Surveillance is a watchful, vigilant approach to information gathering that serves to improve or maintain the health of the population. __A functional disease surveillance system is essential for defining problems and taking action. Using epidemiological methods in the service of surveillance equips district and local health teams to set priorities, plan interventions, mobilize and allocate resources and predict or provide early detection of outbreaks.__ Depending on the goal of the disease prevention programme, __the surveillance activity objectives guides programme managers towards selecting data that would be the most useful to collect and use for making evidenced-based decisions for public health actions__. A disease control program may want to know what progress is being made with its prevention activities. __The program collects age and vaccination statues for cases of vaccine-preventable diseases__. If the program’s goal is to prevent outbreaks, __the surveillance unit can monitor the epidemiology of a particular disease so that the program can more accurately identify where the next cases might occur or the populations at highest risk__. In addition, __improving laboratory support for disease surveillance is essential for confirming causes of illness and early detection of outbreaks. Casebased investigation and laboratory confirmation provide the most precise__ 2 __information about where action must be taken to achieve an elimination target. Monitoring populations at highest risk for a particular disease can help to predict future outbreaks and focus prevention activities in the areas where they are most needed__.

= = =1AC as of Aug 1st= ==Text: The United States federal government should allocate necessary resources to expand the Center for Disease Control and Prevention’s Global Disease Detection Program in the USAID’s African region. We’ll clarify.==

Initially note, countries in Sub-Saharan Africa can’t afford cross-border disease surveillance technology – that means they misdiagnose diseases and perpetuate disease spread
Jakob **Zinsstag et al**, Department of Public Health and Epidemiology at the Swiss Tropical Institute, **2007** [“Human benefits of animal interventions for zoonosis control,” U.S. National Center for Infectious Diseases, April 1, Lexis] Rein

New diseases are inevitable and are appearing constantly
Declan **Butler**, Freelance Journalist, **2006** [“Disease Surveillance needs a revolution,” Nature, 3/1, http://www.nature.com/news/2006/060227/full/440006a.html]

Ineffective surveillance in Africa prevents global understanding of future disease spread and current disease containment—accurate analysis allows for effective local response
[“Challenges in Improving Infectious Disease Surveillance Systems,” August]
 * GAO**, United States General Accounting Office, **2001**

Sub-Saharan epidemics kill 27 million annually

Matthew Carlberg, Marine Corps Command And Staff Coll Quantico va, 2002 [July, http://stinet.dtic.mil/oai/oai?&verb=getRecord&metadataPrefix=html&identifier=ADA403988]

For example, surveillance in Sub-Saharan Africa is insufficient to contain the bird flu – Sub-Saharan Africa is a __critical__ region to prevent spread and mutation
Tiaji **Salaam-Blyther**, Coordinator Foreign Affairs, Defense, and Trade Division of the Congressional Research Service, **2006** [U.S. and International Responses to the Global Spread of Avian Flu: Issues for Congress, 1/9, http://fpc.state.gov/documents/organization/59025.pdf]

Mutation of bird flu is inevitable and a pandemic could be triggered at any moment
Satish **Chandra**, Deputy National Security Advisor of India – Center for Strategic Decision Research, **2004** [Global Security: A broader Concept for the 21st Century, 5/7, http://www.csdr.org/2004book/chandra.htm]

=1AC=

Disease surveillance, labs, and CDC expertise are key to preventing the rapid spread of bird flu
Stephen B. **Blount**, MD, MPH, Director – Office for Global Health, **2007** [5/2, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html]

Bird flu transmissions spread globally, instantly killing a billion
Satish Chandra, Center for Strategic Decision Research, 2004 [Global Security: A broader Concept for the 21st Century, May 7th http://www.csdr.org/2004book/chandra.htm]

Expanding human and animal disease surveillance is necessary to link the two together, improving the effectiveness of targeting and the containing disease

 * T.** **Kuiken****,** Department of Virology, Erasmus MC, **2005**
 * [“**Pathogen Surveillance in Animals,” Science Magazine, Vol. 309. no. 5741, pp. 1680 – 1681, http://www.sciencemag.org/cgi/content/full/309/5741/1680#AFF1] Rein

Surveillance can halt the transformation of animal diseases to future human epidemics by catching the disease early and creating disease databases to better understand and diagnose future diseases
Nathan D. **Wolfe et al**, Department of Epidemiology at UCLA, **2007** [“Origins of major human infectious diseases,” //Nature// 447, 279-283, May 17, http://www.nature.com/nature/journal/v447/n7142/full/nature05775.html#a1] Rein

CDC is unique in its ability to solve these zoonotic diseases
[“Protecting the Nation’s Health in an Era of Globalization: CDC’s Global Infectious Disease Strategy,” prepared by the Dept of Health and Human Services, http://www.cdc.gov/globalidplan/global_id_plan.pdf]
 * DHHS**, Department of Health and Human Services, **2002**

Effective surveillance is key to detection and prevention of new super-diseases – the CDC is the only agency that can coordinate surveillance

Louis Jacobson, associate editor at National Journal, 1995 [“Disease Detectives,” National Journal, Government Executive, Section: Health, May, Lexis]

Finally, future diseases cause extinction
Kavita **Daswani,** **1996** [South China Morning Post, 1/4, Lexis]

=1AC=

The CDC must expand its Global Disease Detection program to ensure effective global disease surveillance
Center for Disease Control, 2007 [“Professional judgment for fiscal year 2008”, developed in response to a request by the chairman, during the house appropriation Subcommittee on labor, health and human services, 4-20, http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf, p. 6]

The US is uniquely capable of surveillance – they have the best research and scientists and other countries will follow US leadership
[“The National Science and Technology Council on Emerging and Re-emerging Infectious Diseases,” Population and Development Review, Vol. 22, No. 1, Match, JSTOR]
 * Population Council****, 1996**

Disease surveillance is a prerequisite to all other forms of disease care – only disease surveillance can get at the problem quickly and provide information for treatment and containment
Mac W. **Otten**, Jr., MD, MPH, Medical Epidemiologist, African Regional Office (WHO) **and** Helen **Perry**, MA, Educational Design Specialist, Division of International Health (CDC), **2001** [“Technical Guidelines for Integrated Disease Surveillance and Response in the African Region,”6/01, http://www.cdc.gov/idsr/focus/surv_sys_strengthening/tech_guidelines-integrated-diseaseENG.pdf]