CP+Surveillance

=Draft as of Aug 3rd= [|__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__] [Ksutt] Jonathan R. **__Davis__** **__and__** Joshua **__Lederber__**__g__, //Editors// Forum on Emerging Infections/Board on Global Health, **’__01__,** The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary [|__http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf____[KSutt__]] David L. __Heymann__, Director, emerging and other communicable diseases surveillance and control **– WHO, 5-15-**__97__ **(Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis)** Stephanie **__Berger__**, professor at Columbia University’s Mailman School of Public Health, 6/17/**__07__**, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, [|__http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php__] Declan **Butler, “**Nature” staff writer, 3/1/”**06**, “Disease surveillance needs a revolution” [|http://www.nature.com/nature /journal/v440/n7080/full /440006a.html] [|__http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__][Ksutt]
 * Observation 1: Inherency**
 * Severe lack of funding for the Global Disease Detection program now**
 * __CDC Professional Judgment__** FY 2008 4/20/0**__7__**
 * Surveillance in Africa is crucial to improve health.**
 * US leadership of surveillance initiatives is the best strategy**
 * __IOM__**, March 200**__3__**, “Microbial Threats to Health: Emergence, Detection, and Response”
 * Funding for CDC towards disease is getting cut at the most crucial moment.**
 * Global Health Initiative, ’07,** CDC Funding Cuts Compromise U.S. And Global Health, [|__http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__]
 * Advantage One: Disease**
 * First is Emerging diseases**
 * Emerging diseases are the greatest threat to human health – monitoring is key.**
 * And, Effective disease surveillance is prevented by lack of resources**
 * US Key to solve extinction from pandemics**
 * __Benatar and Fox 05__** – Professor of Medicine and Bioethics @ University of Cape Town //and// Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” __Perspectives in Biology and Medicine__ 48.3 (2005) 344-361//Project Muse]
 * 2. Avian Flu**
 * Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa**
 * Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now**
 * __TFAH__**. Trust for America's Health, 4/13/20**__07__**,

Anthony S**. __Fauci__,** Nancy A**. __Touchette__, __and__** Gregory K. **__Folkers__,** doctors of National Institutes of Health, **__’05,__** (Emerging Infectious Diseases: a 10-year perspective form the National Institute of Allergy and Infectious Diseases 3/15) [|__http://www.cdc.gov/ncidod/eid /vol11no04/04-1167.htm__] [|__http://wwwnotes.reliefweb.int /w/rwb.nsf/6686f45896f15dbc8525 67ae00530132/1434fb5f54c18d15c1 256c4e0053f5f4?OpenDocument__] [|__http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__] [|http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html]
 * Avian flu has potential to kill millions of people and will become the next pandemic if not contained.**
 * 3. Ebola**
 * Ebola exists now in Sub-Saharan Africa and will spread**
 * __African Development Bank, ’02,__** ( The African Development Bank approves US $500,000 grant for the surveillance of the Ebola type haemorragic fever in Gabon, 10/2)
 * There is a huge threat of a global pandemic only increased resources and surveillance can solve an outbreak**
 * __CNN__**, 10/18/**__95,__** (“Deadly Ebola virus lurks in the shadows”,
 * Ebola is one of the deadliest diseases known to man it is worse than HIV/Aids**
 * __CNN__**, 10/18/**__95,__** (“Deadly Ebola virus lurks in the shadows”,
 * 4. Sleeping Sickness**

[|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__] [|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__] Karen **__Iley__**, Reuters staff writer, 2/19/0**__4__**, (“Sleeping sickness spreading in Angola, MSF says”, [|__http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__]) [|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__] Peter **__Brookes__** is Director of the Asian Studies Center, **__and__** Ji Hye **__Shin__** Research Assistant in the Asian Studies Center, at The Heritage Foundation, “China's Influence in Africa: Implications for the United States”, Backgrounder #1916, February 22, 20**__06__**, [|__ht__][|__tp://www.heritage.org/Research /AsiaandthePacific/bg1916.cfm__]
 * Sleeping Sickness is rising in prevalence and must be dealt with now**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”,
 * Without increased surveillance Sleeping sickness will spread killing millions**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”,
 * Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading**
 * Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”,
 * Advantage Two: Global Health Diplomacy**
 * US Aid to Sub-Saharan Africa increases US influence in the region**

Jacques **__DeLisle__**, Director of FPRI’s Asia Program and Professor of Law @ U. of Penn, February 20**__07__**, “Into Africa: China’s Quest for Resource and Influence,”, [|__http://www.fpri.org/enotes /200702.delisle.intoafricachina squest.html__]) John **__Mearsheimer__**, prof of poli sci @ uchicago, Jan/Feb20**__05__**, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46 [|http://www.interpol.int/Public /BioTerrorism/default.asp]) [APATRA] Valerie **__Gregg__**, National Science Foundation Scientist, Spring 20**02**, Public Health [|http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html] [APATRA]
 * US and China influence in Africa is zero sum**
 * If China continues to rise it will go to war with the US**
 * US China war means the end of civilization**
 * __The Straits Times ’00__** (Ching Cheong, June 25, “No one gains in war over Taiwan” ln)
 * Advantage Three: Bioterrorism**
 * The world is at a huge risk of bioterrorism**
 * __(Interpol__**, Bioterrorism, 18 July 20**__07__**, Interpol
 * Early response systems best warn against bioterrorism**
 * Surveillance systems prevent bioterrorism by analyzing data**
 * __Chang__** M, **__Glynn__** MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 20**__03__** May [|http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm] [APATRA]
 * Bioterrorism the most severe threat to extinction**

Jason **__Matheny__**, Department of Agricultural and Resource Economics, University of Maryland, 10/7/**__06__**__,__ (“Reducing the risk of human extinction”, [|__http://www.acceleratingfuture .com/papers/extinction.htm__])

[|**__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__**] **[Ksutt]** “Satellites tracking climate changes and links to disease outbreaks in Africa” [|**__http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__**] **[KSutt]** Stephen **__Blount__** M.D., M.P.H., CDC Director of Global Health, 3/3/**__98__** “Testimony on Global Health: the United States Response to Infectious Diseases” [|__http://www.hhs.gov/asl/testify /t980303a.html__] [Ksutt] Amy **__Sands__**, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-**0__2__** (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, [|http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf], p. 48 [KSutt]
 * Thus we offer the following plan:**
 * THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN THE USAID’S AFRICAN REGION.**
 * FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS.**
 * WE RESERVE THE RIGHT TO CLARIFY**
 * Observation Three: Solvency**
 * A funding increase would strengthen the GDD to a point of useful aid**
 * __CDC Professional Judgment__** __FY 2008 4/20/0__**__7__**
 * Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness**
 * __NASA__,** Goddard Space Flight Center “Top Story” News, 2/5/0**__2__**
 * CDC Surveillance is at the forefront of disease prevention and has worked in the past**
 * Plan key to public health diplomacy**
 * Benatar and Fox 05** – Professor of Medicine and Bioethics @ University of Cape Town //and// Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” __Perspectives in Biology and Medicine__ 48.3 (2005) 344-361//Project Muse]
 * The US must lead disease surveillance to ensure national security on bioweapons.**

= = =Draft pre practice rounds=

[|__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__] [KSutt] __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 Jonathan R. **__Davis__** **__and__** Joshua **__Lederber__**__g__, //Editors// Forum on Emerging Infections/Board on Global Health, **’__01__,** The National Academies Press: Emerging Infectious Diseases from the Global to the Local Perspective: Workshop Summary As a region, __Africa is__ characterized by the greatest infectious disease burden and, overall__, the weakest public health infrastructure among all regions in the world.__ Frequently, vertically oriented __disease surveillance programs at the national level and above in Africa often result in too much paperwork, too many different instructions, different terminologies, too many administrators, and conflicting priorities. Streamlined communications, strengthened public health surveillance, the use of standard case definitions, criteria for minimum data requirements, and emphasis on feedback through integrated forms, as well as research and training opportunities, are among the important tools available to improve the situation.__ Yet, efforts to establish fully more effective public health infrastructures may take a period of years to decades.
 * __1AC__**
 * Observation 1: Inherency**
 * Severe lack of funding for the Global Disease Detection program now**
 * __CDC Professional Judgment__** FY 2008 4/20/0**__7__**
 * Surveillance in Africa is crucial to improve health.**

[|__http://www.iom.edu/Object.File /Master/6/146/MicrobialThreat8p gFINAL.pdf__][KSutt]
 * US leadership of surveillance initiatives is the best strategy**
 * __IOM__**, March 200**__3__**, “Microbial Threats to Health: Emergence, Detection, and Response”
 * __The United States should take a leadership role in promoting the implementation of a comprehensive system of surveillance for global infectious diseases that builds on the current global capacity of infectious disease monitoring__**. To this end, __CDC should enhance its regional infectious disease surveillance__; DOD should expand and increase in number its Global Emerging Infections Surveillance overseas program sites; and NIH should increase its global surveillance research. In addition, **__CDC, DOD__**, and NIH **__should intensify their efforts to develop and arrange for distribution of laboratory diagnostic reagents needed for global surveillance, transferring technology to other nations where feasible to ensure self-sufficiency and sustainable surveillance capacity__.** __Overseas activities should be coordinated by a single federal agency such as CDC__. Sustainable progress and ultimate success in these efforts will require health agencies to broaden partnerships to include nonhealth agencies and institutions such as the World Bank.

The __President’s proposed__ __budget for__ fiscal year (FY) 20__08__ __once again cuts funding for the core programs of the Centers for Disease Control and Prevention__ (CDC). __This proposal continues a dangerous trend that threatens the CDC’s capacity to prevent and control disease. At a time when public health risks are becoming increasingly complex, a budget proposal that handicaps the world’s foremost public health agency is simply unacceptable. Emerging and re-emerging epidemics such as SARS, tuberculosis (TB), and avian fl u show that infectious diseases do not recognize national borders. The CDC’s global disease surveillance, control, and research expertise are needed now more than ever.__
 * Funding for CDC towards disease is getting cut at the most crucial moment.**
 * Global Health Initiative, ’07,** CDC Funding Cuts Compromise U.S. And Global Health, [|__http://www.familiesusa.org /assets/pdfs/cdc-cuts-compromis e-health.pdf__]

David L. **__Heymann__**, Director, emerging and other communicable diseases surveillance and control – WHO, 5-15-**__97__** (Federal News Service, In The News, Before the Senate Committee on Appropriations Subcommittee on Foreign Operations, Lexis)
 * Advantage One: Disease**
 * First is Emerging diseases**
 * Emerging diseases are the greatest threat to human health – monitoring is key.**

__Few public health concerns__ today __carry as much__ sense of __urgency and importance as emerging__ and re-emerging communicable (__infectious__) __diseases.__ Many factors contribute to these diseases, including population growth, migration, urbanization and poverty compounded by inadequate or deteriorating public health infrastructures for disease control. Changes in human behavior and alteration in land use, agricultural practices, climate and environmental conditions contribute to increased exposure to and spread of infectious disease agents. __Humans__, through world travel and trade unprecedented in history, __have__ themselves __become a principal vector of infectious diseases, transporting them easily from one country to another within__ periods __less than 24 hours. Fresh concerns have arisen about__ the ability of __infectious agents of animal origin to cross the species barrier__ from animal to man. Not least, __resistance of microorganisms to the drugs used to combat them and resistance of vectors to pesticides__ used to control them __have profound implications for our ability to deal effectively with infectious diseases.__ Resistance threatens the very base of infectious disease control. Furthermore, __infectious diseases can have many sources, from natural__ human or animal occurrences due to the changing world environment just described __to__ potentially __intentional release of pathogens with the objective of harming__ human __health__ or the health of animals and plants on which humans depend. __The urgency and importance for public health__ of emerging and re- emerging infectious diseases __create an urgent need to monitor the situation__ nationally and globally __and__ to __respond__ in a rapid and effective manner. __Effective monitoring and response can only be ensured by international collaboration and the solidarity of many different__ partners ranging from __countries__ and international organizations to non-governmental organizations, business and industry, government and private public health and laboratory systems, and universities.

Stephanie **__Berger__**, professor at Columbia University’s Mailman School of Public Health, 6/17/**__07__**, “Progress in infectious disease surveillance but gaps remain, says Mailman School of Public Health”, [|http://www.eurekalert.org/pub _releases/2007-07/cums-pii07170 7.php] July 16, 2007 -- __The key to control any pandemic is early identification and rapid response. Although considerable progress has been made in global infectious disease surveillance__, few scientists are optimistic that an effective early warning system is in place, and __many gaps remain__, according to researchers at Columbia University’s Mailman School of Public Health. A paper entitled “Global Infectious Disease Surveillance and Health Intelligence,” in the July/August issue of Health Affairs, calls for increasing resources for improved coordination and sharing of information, and additional research to develop the most rigorous triggers for action. __Current concerns about the spread of infectious diseases, especially unexpected, emerging infections, have renewed focus on the critical importance of global early warning and rapid response__. “__The development of effective, interconnected systems of infectious disease surveillance is essential to our survival__,” said Stephen S. Morse, PhD, associate professor of clinical Epidemiology in the Department of Epidemiology at the Mailman School, and the paper’s author. “__Fortunately, while the increasing availability of communications and information technologies worldwide does offer new opportunities for reporting even in low-capacity settings,__ **__resource constraints__** __remain the missing elements for much of the world.__” These information technologies include the Program for Monitoring Emerging Diseases (ProMED), a scientist-to-scientist network connecting more than 30,000 subscribers in 155 countries, and the World Health Organization’s Global Outbreak and Response Network (GOARN).
 * And, Effective disease surveillance is prevented by lack of resources**

There is a "back to the future" irony in the fact that __the eruption and spread of__ a multitude of "old" and "new" __infectious diseases has become__ **__the most serious global threat to__** the health of **__humankind__** (Benatar 2001a; Garrett 1994). The current epidemics of infectious diseases—including the "white plague" of tuberculosis that was supposed to have yielded to the powers of antibiotics—take their greatest toll on populations of so-called developing countries, and also among disadvantaged groups in privileged "developed" societies (Benatar 2001b; Gandy and Zumla 2003). The recent epidemic of severe acute respiratory syndrome (SARS; Lee et al. 2003) is __a__ small-scale example of the **__new, acute, rapidly fatal infectious diseases__** that __may__, like the 1918–1919 flu epidemic, **__sweep through the world with high mortality rates__** __in all countries__, with accompanying profound social and economic implications. This paper, by a South African physician and an American medical sociologist, considers challenges that face global health, health care professionals, and governments at the beginning of the 21st century. Our reflections rest on three major premises: that __global health problems pose__ major medical, social, and economic **__threats to all countries__**; that it is in the long-term self-interest of wealthy nations to address the forces that significantly affect the health of whole populations; and that __at this historical juncture, the U__nited __S__tates __is the country with the most potential for favorably influencing global health trends__. In addition to discussing the nature of threats to global health, we explore some of the major impediments to efforts that could be undertaken to foster alterations in policies that would effectively address the tragic discrepancies in health care and research that currently exist, and to overcome global apathy to the HIV/AIDS pandemic (Hogg et al. 2002). These obstacles involve a confluence of important American values, exemplified by political ideologies that have global as well as national health import; the prevailing ethos of bioethics in the United States; and the current views of many other countries towards the international policies and actions of the United States. As sociologist Robert N. Bellah (2002) has provocatively stated, in and through the "relentless" process of globalization, __the__ **__U__**nited **__S__**tates **__has become a__** "cultural **__model__** and economic dynamo" as well as a military superpower, and more "by default" than by intention, a country with "imperial power." In our view, because of its singularity in these respects (for better or for worse), __the U__nited __S__tates __not only has the scientific, political, and economic capacity to assume major responsibility for improving world health, but also the moral obligation to__ exemplify and implement values in action that are conducive to this advancement. We make this statement with two caveats. First, we are wary about [End Page 345] unduly promoting the dominance of American influence in the world by encouraging its moral hegemony in global health. Second, as noted above, we are mindful of the cultural and political factors that curtail the readiness and willingness of the United States to __assume__ such __a leadership role__, and that contribute to health inequities __in__ the American __health care__ system that call for reform rather than emulation. We believe, however, that these caveats should be superseded **__by__** the moral imperative of **__facing up to national and global threats posed by__** disparities in health and **__emerging epidemics__**. Moreover, we believe that **__the long-term interests of__** Americans, and indeed of **__all__** privileged **__people__** and their societies, **__will be served__** __by major improvements in global health__ (Benatar 2003).
 * US Key solve extinction from pandemics**
 * __Benatar and Fox 05__** – Professor of Medicine and Bioethics @ University of Cape Town //and// Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” __Perspectives in Biology and Medicine__ 48.3 (2005) 344-361//Project Muse]

Declan **Butler, “**Nature” staff writer, 3/1/”**06**, “Disease surveillance needs a revolution” [|__http://www.nature.com/nature /journal/v440/n7080/full /440006a.html__]
 * 2. Avian Flu**
 * Avian flu is spreading around the world the only way to stop its catastrophic impact is US surveillance in Africa**

__With avian flu spreading around the world at a frightening rate, scientists are welcoming an international proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and disease-surveillance systems.__ __Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa__. "H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information systems company in Redlands, California. __Developing countries, in particular, lack decent human-disease surveillance, and animal monitoring is often virtually nonexistent, with few basic laboratory and epidemiological resources available__. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess." Currently, the __US and the rest of the world are facing a very real threat posed by the highly pathogenic avian influenza__. As demonstrated with the SARS outbreak, a __highly infectious disease in a remote region of the world can spread in a matter of days and weeks. Investments in infrastructure and human capacity are needed to increase intelligence about global health__. Currently, __CDC's capacity to identify and respond rapidly to international outbreaks of infectious diseases and to intentional threats is insufficient. Additional disease surveillance tools, laboratory capacity, and CDC expertise deployed abroad can rapidly improve CDC's ability to recognize and intervene in emergent threats—including a possible deadly avian influenza pandemic— before they become significant problems within U.S. borders__
 * Surveillance Key to Solve for Avian Flu Outbreak CDC is too weak now**
 * __TFAH__**. Trust for America's Health, 4/13/20**__07__**, [|__http://healthvamericans.org /policv/criticalcare/GlobalDete ction.pdf__][KSutt]

Anthony S**. __Fauci__,** Nancy A**. __Touchette__, __and__** Gregory K. **__Folkers__,** doctors of National Institutes of Health, **__’05,__** (Emerging Infectious Diseases: a 10-year perspective form the National Institute of Allergy and Infectious Diseases 3/15) [|__http://www.cdc.gov/ncidod/eid /vol11no04/04-1167.htm__] __Each year, influenza develops in up to 20% of all Americans, and >200,000 are hospitalized with the disease. Although influenza is commonplace and generally self-limited, an estimated 36,000 Americans die each year from complications of the disease__ ([|__26__]). __Worldwide, severe influenza infections develop in 3–5 million people annually, and 250,000–500,000 deaths occur__ ([|__27__]). __Outbreaks of avian influenza recently have drawn attention worldwide, particularly in Southeast Asia, where at least 55 persons have been infected and 42 have died since January 2004. The current strain of H5N1 avian influenza is highly pathogenic; it has killed millions of chickens and other birds__. Although the virus can cross species to infect humans, few suspected cases of human-to-human transmission have been reported ([|__27__]). However, the __virus could acquire characteristics that allow it to be readily transmitted among humans, which could cause a worldwide influenza pandemic, with the potential for killing millions of people__. In 1918, a pandemic of the "Spanish Flu" killed 20–50 million people worldwide ([|__26,27__]). Recently, the NIH Influenza Genomics Project was initiated; it will conduct rapid sequencing of the complete genomes of the several thousand known avian and human influenza viruses as well as those that emerge in the future. Approximately 60 genomes are expected to be sequenced each month. This project should also illuminate the molecular basis of how new strains of influenza virus emerge and provide information on characteristics that contribute to increased virulence. __Many researchers believe that the H5N1 virus shows the greatest potential for evolving into the next human pandemic strain. Avian H9N2 viruses also have infected humans and have the potential to cause a pandemic.__ To prepare for this possibility, the development of vaccines to prevent infection with H5N1 and H9N2 viral strains is being supported ([|__28__]). Researchers also are working to develop a live-attenuated vaccine candidate directed against each of the 15 hemagglutinin proteins that have been isolated, an effort that may speed the development of a vaccine against a potential pandemic strain.
 * Avian flu has potential to kill millions of people and will become the next pandemic if not contained.**

__Since 1972, outbreaks of the Ebola type haemorrhagic fever have been identified in the Central African sub-region, namely in the Democratic Republic of Congo, Gabon and Congo__. The outbreaks of the epidemic in Gabon occurred respectively in Minkouka in 1994, 1996 in Mayibou II and Makokou in the Ogooué-Ivindo Province, in 1996 and 1997 in the districts of Ovan and Booue in the Province of Ogooué-Ivindo and Koumemeyong. __Between October 2001 and May 2002,__ __Gabon experienced its fifth epidemic of the Ebola haemorrhagic fever__, which remained confined to two departments (Zadiée and Ivindo) of the Ogooué-Ivindo Province in the country's north-east.
 * 3. Ebola**
 * Ebola exists now in Sub-Saharan Africa and will spread**
 * __African Development Bank, ’02,__** ( The African Development Bank approves US $500,000 grant for the surveillance of the Ebola type haemorragic fever in Gabon, 10/2) [|__http://wwwnotes.reliefweb.int /w/rwb.nsf/6686f45896f15dbc8525 67ae00530132/1434fb5f54c18d15c1 256c4e0053f5f4?OpenDocument__]

__World Health Organization experts say that they have the tools and the skills to fight infectious diseases worldwide, but that's not enough. "What remains to be done is to get an international team of experts on standby which is ready within 24 hours to stop an epidemic should it start anywhere__," said Dr. David Heymann of WHO. __Such a team would focus on the fundamentals, including how humanity's changing social behavior poses risks. In developing countries, hundreds of thousands of people leave rural areas to seek a better life in major cities. The result is overcrowding and a lack of clean water and sanitation -- a perfect setting for the outbreak of disease.__
 * There is a huge threat of a global pandemic only increased resources and surveillance can solve an outbreak**
 * __CNN__**, 10/18/**__95,__** (“Deadly Ebola virus lurks in the shadows”, [|__http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__]

__Ebola virus victims usually "crash and bleed__," a military term __which literally means the virus attacks every organ of the body and transforms every part of the body into a digested slime of virus particle__s. "__Ebola does in ten days what it takes HIV ten years to accomplish,"__ wrote Richard Preston in his best-selling non-fiction book "The Hot Zone." Dr. Lindsay Martinez Dr. Lindsey Martinez of __the World Health Organization said that no one knows where Ebola hides in between epidemics. "And the investigations are still going on, looking at the animal reservoir to try and find which animal or insect may be harboring the virus and allowing it to re-emerge from time to time as happened in Zaire__," Martinez said.
 * Ebola is one of the deadliest diseases known to man it is worse than HIV/Aids**
 * __CNN__**, 10/18/**__95,__** (“Deadly Ebola virus lurks in the shadows”, [|__http://www.cnn.com/HEALTH/9510 /emerging_diseases/index.html__]


 * 4. Sleeping Sickness**

Dr. Michaleen Richer of the International Medical Corps said __t__**__he prevalence of sleeping sickness has risen by more than 15 percent__**. "__This is an epidemic of really catastrophic proportions__," Michaleen added. __The__ IMC, U.S. __C__enters for __D__isease __C__ontrol and Prevention, CARE __and other organizations are in the midst of a major effort__, which began last year, __to__ identify people infected with sleeping sickness and __contain the epidemic__. __But the organizations say their efforts could take years__. Meanwhile, **__WHO estimates that every year some 250,000 to 300,000 men, women and children are left to suffer and die because their illness is going undiagnosed and untreated.__** __And every untreated, undiagnosed human creates a new host for each uninfected tsetse fly, which means the disease spreads exponentially.__ Perhaps the saddest commentary on the lives lost is that the illness is relatively easy to treat. But medicine is expensive. It can cost more than $1,000 to cure a sleeping sickness victim. "__One__ **__hundred percent of these people will die if they don't receive medication__**," said Dr. Sandra Clark of the IMC. "__These people have virtually nothing, and they are dependent on the outside world for help."__ WHO estimates it costs $27 million a year to fight the disease in the 36 endemic countries, and another $1.5 million a year to coordinate field efforts, technical support and operational research. __Some pharmaceutical companies have donated medicine to the cause.__
 * Sleeping Sickness is rising in prevalence and must be dealt with now**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”, [|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__]

(CNN) -- __On the African continent, in the narrow band between the 15th parallels that bookend the equator, a tiny fly is jeopardizing the lives of 55 million people and could be responsible for one of the largest epidemics of this century.__ The narrow arc along the equator ventures through 36 sub-Saharan nations, 22 of which are among the most underdeveloped in the world. In every land, the tsetse fly thrives. Warfare isn't the only force taking a toll on lives in Sudan __The tsetse fly feeds on the blood of animals and humans. Its bite can carry a parasite that will work its way through your body and, if left untreated, put you on course for a slow, agonizing and certain death.__ It's called the __sleeping sickness__. __The W__orld __H__ealth __O__rganization __says if the entire at-risk population were put under medical surveillance, the number of diagnosed cases would reach 250,000 to 300,000__. __But accurate medical surveillance is difficult in a region wracked by civil wars, economic turmoil, environmental changes and displaced populations. WHO estimates that one-tenth of the at-risk population is under surveillance, which has allowed about 25,000 new cases of sleeping sickness to be diagnosed each year.__ Karen **__Iley__**, Reuters staff writer, 2/19/0**__4__**, (“Sleeping sickness spreading in Angola, MSF says”, [|__http://www.alertnet.org /thefacts/reliefresources /107720076221.htm__]) __Both Manuel and Engracia were to be put on drips containing the drug eflornithine__ (DFMO) to fight the infection coursing through their brains. __DFMO__, supplied free by French drug giant Aventis__,__ __is only slightly less toxic than the main drug used to treat the disease, Melarsoprol__ (Arsobal), __which is based on arsenic and can cause inflammation of the brain.__ __Melarsopal kills around seven percent of patients who use it__. __Mathela is calling for more research and development to find less toxic, more effective drugs that can treat the disease over the long term__. “Yes, __we can treat patients, but more and more people are dying every day because of these old, toxic drugs,” he said. “There is sometimes a resistance to the drugs and the patients have a relapse.__ “__What we need is good organisation, good collaboration to improve our strategies, make active screenings and improve our coverage. We need to find an alternative drug, and to improve our technique for screening patients so that not so many slip through the net__.” __MSF said it could not do this alone, and needed the support of public- and private-sector research institutes, governments and the international community to improve screening, control and treatment if the disease’s spread was to be curbed.__
 * Without increased surveillance Sleeping sickness will spread killing millions**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”, [|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__]
 * Current efforts and drugs only make the problem worse without surveillance and cooperation the disease will keep spreading**

__Much has been reported about the gruesome deaths associated with hemorrhagic fevers, like Ebola, which can bring a quick death__. __But imagine having your body slowly destroyed by a parasite that will literally drive you insane__. __That death is what the bite of the tsetse fly can bring.__ __In the beginning, you may think you have the flu__. You can run a high fever, have headaches, joint aches, even itching. __As the parasite spreads throughout your bloodstream, it takes its toll on your organs. You can develop anemia or endocrine disorders. You can develop heart and kidney problems. And pregnant women can lose their fetuses.__ __By the time the parasite reaches the central nervous system, you are vulnerable to unpredictable mood changes, and you are so weak that it wears you out to eat or even open your eyes__.] __You are a danger to yourself and others because you can suffer from sudden bouts of aggressiveness.__ In some villages, the people tie sleeping-sickness victims to huts or poles to keep them from harming others. __Eventually wasted and destroyed, sleeping-sickness victims slip into a deep coma and die__. An old threat __Records indicate that Africans have fought against the sleeping sickness as far back as the 14th century.__ __In 1906, an outbreak of sleeping sickness killed 4 million people in Uganda.__ __Health officials say at that time, sleeping sickness was considered the No. 1 public health threat in the tropics.__
 * Sleeping Sickness is one of the most gruesome deaths and if left untreated will kill millions**
 * __CNN__**, 2/28/**__98__**, (“Battling the deadly bite of the tsetse fly”, [|__http://www.cnn.com/HEALTH/9802 /28/sudan.sleeping.sickness/__]


 * Advantage Two: Global Health Diplomacy**

William **__Engdahl__**, May 20, 20**__07__** [|__http://www.engdahl.oilgeopoliti cs.net/print/China%20&%20US %20in%20Cold%20War%20over %20Africa's%20Oil.html__] __The case of Darfur__, a forbidding piece of sun-parched real estate in the southern part of Sudan, __illustrates the new Cold War over oil, where the dramatic rise in China’s oil demand to fuel its booming growth has led Beijing to embark on an aggressive policy of__ – ironically – __dollar diplomacy__. __With its more than $1.3 trillion in__ mainly US dollar __reserves at the People`s Bank of China, Beijing is engaging in active petroleum geopolitics.__ __Africa is a major focus,__ and in Africa, the central region between Sudan and Chad is priority. __This is defining a major new front in what, since the US invasion of Iraq in 2003, is a new Cold War between Washington and Beijing over control of major oil sources. So far Beijing has played its cards a bit more cleverly than Washington__. Darfur is a major battleground in this high-stakes contest for oil control. __In recent months, Beijing has embarked on a series of initiatives designed to secure long-term raw materials sources from one of the planet’s most endowed regions – the African subcontinent__. __No raw material has higher priority in Beijing at present than the securing of long term oil sources.__ __Today China draws an estimated 30% of its crude oil from Africa. That explains an extraordinary series of diplomatic initiatives which have left Washington furious. China is using no-strings-attached dollar credits to gain access to Africa’s vast raw material wealth, leaving Washington’s typical control game__ via the World Bank and IMF out __in the cold.__ Who needs the painful medicine of the IMF when China gives easy terms and builds roads and schools to boot?
 * China and US at odds for Oil control in Africa**

“Africa: Angola: U.S. Advised To Strengthen Ties To Stabilize Oil Supply [|__http://query.nytimes.com/gst /fullpage.html?res=9E03E3DA1731 F93AA35756C0A9619C8B63&n=Top %2fReference%2fTimes%20Topics %2fSubjects%2fO%2fOil%20 %28Petroleum%29%20and%20Gasolin e__] A report sponsored by __the Council on Foreign Relations, the nongovernmental, nonpartisan organization__ with headquarters in New York, __said the United States should devote significant resources and diplomatic effort to developing ties with Angola, the second largest oil producer in sub-Saharan Africa after Nigeria, and strategically important for ensuring a steady supply of oil and the stability in the oil-rich Gulf of Guinea region.__ It noted that Angola had one of the world's fastest-growing economies but remained one of the world's least-developed countries. Cronyism and the labyrinthine bureaucracy that businesses must navigate to turn a profit frighten away all but the most courageous investors, the report said. CELIA W. DUGGER
 * US being asked for more involvement and aid to Africa**
 * __New York Times__** **,**Celia W. Dugger, Staff Writer 5/9/**__07__**

  Drew **__Thompson__**, Assistant Director of the Freeman Chair in China Studies at the Center for Strategic and International Studies in Washington, DC, June 20**__05__**, “China’s Emerging Interests in Africa: Opportunities and Challenges for Africa and the United States” [|__http://www.hollerafrica.com /showArticle.php?artId=156 &catId=1__] __As China’s domestic economy grows, it is expanding and deepening political and economic relations in Africa, primarily to secure access to African markets and raw materials. There is rising concern among some in the United States that China’s growing influence in Africa is a zero-sum equation, whereby China’s rise will ultimately undermine U.S. interests in the region.__
 * China and US at zero sum game over resources in Africa**

John **__Mearsheimer__**, prof of poli sci @ uchicago, Jan/Feb20**__05__**, CLASH OF THE TITANS, Foreign Policy, Issue 146, p46 __China cannot rise peacefully, and if it continues its dramatic economic growth over the next few decades, the United States and China are likely to engage in an intense security competition with considerable potential for war.__ Most of China's neighbors, including India, Japan, Singapore, South Korea, Russia, and Vietnam, will likely join with the United States to contain China's power. To predict the future in Asia, one needs a theory that explains how rising powers are likely to act and how other states will react to them. My theory of international politics says that __the mightiest states attempt to establish hegemony in their own region while making sure that no rival great power dominates another region.__ __The ultimate goal of every great power is to maximize its share of world power and eventually dominate the system.__ __From China's point of view, it would be ideal to dominate Asia, and for Brazil, Argentina, or Mexico to became a great power__ and force the United States to concentrate on its own region. The great advantage the United States has at the moment is that no state in the Western Hemisphere can threaten its survival or security interests. So the United States is free to roam the world causing trouble in other people's backyards. Other states, including China of course, have a vested interest in causing trouble in the United States' backyard to keep it focused there. The picture I have painted is not a pretty one. I wish I could tell a more optimistic story about the future, but __international politics is a nasty and dangerous business. No amount of good will can ameliorate the intense security competition that will set in as an aspiring hegemon appears in Asia.__
 * If china continues to rise it will go to war with the US**
 * Contd…**

THE high-intensity scenario postulates __a cross-strait war escalating into a full-scale war between the US and China__. If Washington were to conclude that splitting China would better serve its national interests, then a full-scale war becomes unavoidable. Conflict on such a scale __would embroil other countries__ far and near __and__ -horror of horrors -__raise the possibility of a nuclear war__. Beijing has already told the US and Japan privately that it considers any country providing bases and logistics support to any US forces attacking China as belligerent parties open to its retaliation. In the region, this means South Korea, Japan, the Philippines and, to a lesser extent, Singapore. If China were to retaliate, East __Asia will be set on fire. And__ __the conflagration may not end there as opportunistic powers elsewhere may try to overturn the existing world order.__ With the US distracted, __Russia may seek to redefine Europe's political landscape__. The balance of power in the Middle East may be similarly upset by the likes of Iraq. In south Asia, __hostilities between India and Pakistan__, each armed with its own nuclear arsenal, __could enter a new and dangerous phase__. Will a full-scale Sino-US war lead to a nuclear war? According to General Matthew Ridgeway, commander of the US Eighth Army, which fought against the Chinese in the Korean War, the US had at the time thought of using nuclear weapons against China to save the US from military defeat. In his book The Korean War, a personal account of the military and political aspects of the conflict and its implications on future US foreign policy, Gen Ridgeway said that US was confronted with two choices in Korea -truce or a broadened war, which could have led to the use of nuclear weapons. If the US had to resort to nuclear weaponry to defeat China long before the latter acquired a similar capability, there is little hope of winning a war against China 50 years later, short of using nuclear weapons. The US estimates that China possesses about 20 nuclear warheads that can destroy major American cities. __Beijing__ also __seems prepared to go for the nuclear option__. A Chinese military officer disclosed recently that Beijing was considering a review of its "non first use" principle regarding nuclear weapons. Major-General Pan Zhangqiang, president of the military-funded Institute for Strategic Studies, told a gathering at the Woodrow Wilson International Centre for Scholars in Washington that although the government still abided by that principle, there were strong pressures from the military to drop it. He said military leaders considered the use of nuclear weapons mandatory if the country risked dismemberment as a result of foreign intervention. Gen Ridgeway said that should that come to pass, __we would see the destruction of civilisation__. __There would be no victors in such a war__. While __the prospect of a nuclear Armaggedon over Taiwan__ might seem inconceivable, it __cannot be ruled out__ entirely, __for China puts sovereignty above everything else.__
 * US-China war will cause a nuclear war ending civilization**
 * __The Straits Times 2K__** (Ching Cheong, June 25, “No one gains in war over Taiwan” ln)

Bio-technology is undergoing rapid evolution. This process, and the wide dissemination of developments, is already proving difficult to manage. __There is evidence that terrorist organizations have a heightened interest in the use of biological weapons, establishing terrorist support cells in different regions around the world with the ability and motivation to carry out attacks.__ __Recognising the imminent dangers represented by this lethal form of crime is the first step in countering the threat. Thereafter it is vital to put in place the tools which will enable society to take appropriate measures.__ Valerie **__Gregg__**, National Science Foundation Scientist, Spring 20**02**, Public Health [|http://www.whsc.emory.edu/ _pubs/ph/spring02/innocence .html] [APATRA] __Bioterrorism requires a public health system that is strong and well coordinated__ at every level, Berkelman says. __“Early detection by health care providers is our best early–warning system, and education of clinicians is an important defense. In turn, public health officials and health care providers must be tightly linked to assure early recognition and prompt response.__ Public health agencies and the health care system must, in turn, work seamlessly with other involved agencies, including law enforcement.” Ensuring the strength of each link in the public health system is essential to controlling epidemics of any infectious disease, including those caused by bioterrorism. “The relationships are vital,” she says. __“Surveillance for diseases caused by bioterrorism requires the same system as for other infectious disease. If we can make our public health departments stronger to prepare for bioterrorism, they will be better able to deal with other health threats like influenza, E. coli__ 0157, __and meningococcal disease.__”
 * Advantage Three: Bioterrorism**
 * The world is at a huge risk of bioterrorism**
 * __(Interpol__**, Bioterrorism, 18 July 20**__07__**, Interpol [|http://www.interpol.int/Public /BioTerrorism/default.asp]) [APATRA]
 * Why is bioterrorism such a threat?** __The world is largely unaware of, and__ therefore __largely unprepared for, bioterrorist attacks. Bio-weapons threaten thousands of casualties in addition to other disastrous long term consequences. Criminal networks can covertly transport lethal agents across borders and terrorists have already proven that anthrax can be fatally deployed.__
 * An easy option?** __An effective biological weapon is potentially devastating and much easier to make and transport than a nuclear weapon. Bio-weapons are, however, relatively safe for the terrorist. Pathogens (biological agents or germs) are virtually undetectable and can be brought reasonably easily into a country by an individual and can then be propagated in large quantities.__
 * Early response systems best warn against bioterrorism**

Using this guidance, __public health systems can address the threat of bioterrorism by increasing healthcare sector awareness of and surveillance for these bioterrorism-related agents and the diseases they cause__ ([|__10__]). In the United States, public health surveillance for conditions caused by the identified critical biologic agents is conducted in multiple ways. Although data regarding these agents are reported to different national surveillance systems at CDC, no single system is specifically designed for conducting surveillance for all bioterrorism-related agents or conditions. However, many states have routinely conducted surveillance for some of these conditions and report incidence data to CDC’s National Notifiable Diseases Surveillance System (NNDSS) each week ([|__Table 1__]). __We describe disease-specific trends in demographic characteristics and geographic and seasonal distribution of selected conditions caused by critical biologic agents__ reported to NNDSS. These __diseases and conditions include anthrax,__ botulism, brucellosis, __cholera,__ __plague,__ tularemia, and selected viral encephalitides. __By identifying patterns of endemic disease associated with critical agents, we establish a baseline against which future disease incidence can be compared. This process should allow easier identification of unusual reports of disease incidence, which in turn will enhance the ability of the public health community to identify and investigate outbreaks.__
 * Surveillance systems prevent bioterrorism by analyzing data**
 * __Chang__** M, **__Glynn__** MK, Groseclose SL. Endemic, notifiable bioterrorism-related diseases, United States, 1992-1999. Emerg Infect Dis [serial online] 20**__03__** May [|http://www.cdc.gov/ncidod/EID /vol9no5/02-0477.htm] [APATRA]
 * Bioterrorism the most severe threat to extinction**

Jason **__Matheny__**, Department of Agricultural and Resource Economics, University of Maryland, 10/7/**__06__**__,__ (“Reducing the risk of human extinction”, [|http://www.acceleratingfuture .com/papers/extinction.htm]) __Of current extinction risks, the most severe may be bioterrorism__. __The knowledge needed to synthesize a virus is modest compared to that needed to build a nuclear weapon; the necessary equipment and materials are increasingly accessible__; __and because biological agents are self-replicating, a single weapon can have an exponential effect on a population__ (Warrick, 2006). Current U.S. biodefense efforts are funded at $6 billion per year to develop and stockpile new vaccines and treatments, monitor biological agents and emerging diseases, and strengthen the capacities of local health systems to respond to pandemics.


 * Thus we offer the following plan:**
 * THE UNITED STATES FEDERAL GOVERNMENT SHOULD SUBSTANTIALLY INCREASE ITS PUBLIC HEALTH ASSISTANCE TO SUB-SAHARAN AFRICA BY EXPANDING THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTER FOR DISEASE CONTROL AND PREVENTION’S GLOBAL DISEASE DETECTION PROGRAM TO 3 CENTERS TO BE LOCATED IN SUB-SAHARN AFRICA.**
 * FUNDING AND ENFORCEMENT GUARANTEED THROUGH NORMAL MEANS.**
 * WE RESERVE THE RIGHT TO CLARIFY**

[|__http://www.fundcdc.org/document s/CDCFY2008PJ_000.pdf__] [KSutt] 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 muand impact on detecting and responding to outbreak__**__s 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__**__.__
 * Observation Three: Solvency**
 * A funding increase would strengthen the GDD to a point of useful aid**
 * __CDC Professional Judgment__** FY 2008 4/20/0**__7__**

“Satellites tracking climate changes and links to disease outbreaks in Africa” [|__http://www.gsfc.nasa.gov /topstory/20020204riftvalley .html__] [KSutt] Accurate prediction of epidemics is still years away. But in the short term, **__satellite monitoring could still benefit public health in developing countries where resources to combat disease are limited.__** __"__**__So far, our team has mapped areas of Africa at risk for RVF outbreaks,"__** __Anyamba said. "Satellite mapping has identified where and when RVF outbreaks will occur__."
 * Surveillance and prediction through U.S. satellites is integral in developing countries to increase health worker effectiveness**
 * __NASA__,** Goddard Space Flight Center “Top Story” News, 2/5/0**__2__**
 * __"It is not feasible to send health workers everywhere__**," Anyamba said. "**__But if we know where outbreaks are likely, those areas can be targeted. We can focus our efforts where they are needed."__**
 * __Locating those areas requires the use of polar orbiting satellites, such as the Terra satellite, which NASA scientists use to monitor vegetation on the ground__**. Since green vegetation cover varies with rainfall, it is a good indicator of climate variability, and therefore of conditions necessary for disease outbreaks.

Stephen **__Blount__** M.D., M.P.H., CDC Director of Global Health, 3/3/**__98__** “Testimony on Global Health: the United States Response to Infectious Diseases” [|__http://www.hhs.gov/asl/testify /t980303a.html__] [KSutt] I'd also like to mention __CDC's work in regard to surveillance and response to a few specific diseases, including influenza__ -- a disease that has recently been on our minds and in the news. **__Over the past year, CDC has augmented its international influenza network by increasing the number of surveillance sites in China from 6 to 12__**, __and by training laboratorians from 14 countries in Latin Americ__a and the Caribbean. It has also provided resources for enhanced influenza surveillance in Russia. In addition, __CDC has worked with the Pan American Health Organization to provide training in the diagnosis of influenza__ and dengue hemorrhagic fever to support active surveillance for these diseases in the Americas. **__CDC has played a major role in the development and distribution of reagents through the WHO network for diagnosis and surveillance of the new strain of influenza__** __identified in Hong Kong. In conjunction with WHO,__ **__CDC has also provided leadership in the development of a protocol for enhanced surveillance for this new strain__**
 * CDC Surveillance is at the forefront of disease prevention and has worked in the past**

Self-Interest as a Force for Improving Global Health - Just as America has sought widespread solidarity in its campaign against terrorism, so is it now in __America__'s best interests to go beyond merely expressing concern about global health. It __should set the example of providing solidarity with__ [End Page 356] __others in their quest for__ access to the basic requirements for decent and __healthy__ __living__ that would give hope for their futures. In this sphere, self-interest and a globally responsive and responsible purview coincide. A glimmer that such thinking could increasingly impact on action is evident in the report from the U.S. Council of Foreign Relations and the Milbank Memorial Fund, outlining the importance of health to American foreign policy (Kassalow 2001). American economist Jeffrey Sach's work on the Commission on Macroeconomics for Health, the inauguration of a Global Health Fund, and President Bush's announcement that the United States will increase its annual development aid from $10 billion to $15 billion—while as yet only partially realized promises—are manifestations of both a deeper understanding of the importance of global health and an acknowledgement of the moral responsibility of developed nations to address this constructively (Friedman 2002; Global Fund 2002/3; WHO 2001). __For the best American values__—embracing both individual freedom and community responsibility—**__to become globally pervasive and sustainable, it will be necessary for the power of moral example__** and long-term national interest **__to complement economic and military power__**__. Unless the world's most powerful country moves towards showing concern for the__ lives, __health__, and well-being __of the underprivileged__, both within its own borders and beyond, __it is likely that the lives of the privileged in America and elsewhere will be progressively devalued by those who have little to lose__ (Nye 2002). __The war on Iraq has severely damaged the reputation of the U__nited __S__tates __as a source of admired values and commitment to human well-being. It has also reduced the potential for the best of American values to be widely emulated__ (Soros 2004). **__The challenge of improving health for millions of people provides a window of opportunity to reclaim lost ground__** for the benefit of Americans and others. The vast gap between the 2004 U.S. military expenditure of $450 billion and official development assistance of only $15 billion illustrates the potential for innovative global health initiatives led by the United States (Sachs 2004). The Role of the American Medical Profession - In our view, __it is both__ **__crucial and obligatory for the American medical profession to play a central role__** __in the transformation of thought and action that would enable the U__nited __S__tates __to assume symbolic and substantive leadership in meeting present challenges to global health__. As economist Jeffrey Sachs (2004) has stated: "For the first time in decades, __we must strive to understand__ problems—tropical __diseases__, malnutrition, and the like—[__that] are urgent concerns of people abroad. In the case of a superpower ignorance is not bliss; it is a threat to Americans and to humanity.__" The members of __the American medical profession have the trained competence to understand these problems__. What is more, as [End Page 357] physicians, they have a collective professional responsibility to be the "conscience of society" in matters that affect and are affected by health and illness. There are those both within and outside the U.S. medical profession who would respond to this exhortation with the claim that at this historical juncture, individually and collectively, American physicians do not have sufficient authority to assume the leadership role being asked of them—that they are too demoralized by the barrage of criticism for excessive dominance and autonomy to which they have been subject from the 1970s through the 1990s, and by their struggles to practice, under the current system of managed care, the kind of medicine that meets their standards of clinical and moral excellence. In response to this contention, we join with medical historian Rosemary Stevens in affirming that there are strong reasons to believe that __if the profession mobilizes itself organizationally, its role as moral leaders could be effective:__ **__The profession__ __has long had an authoritative voice in American culture__**. . . . Despite the doom and gloom expressed over managed care from the early 1990s to the present, __doctors have not lost their normative role__ in American society. __They embody__ **__a huge reservoir of goodwill__** __inherited from the past__. __This is derived__ in various parts: __from long respect of the doctor__ as healer; from the ideology of medicine as public service and the doctor as hero; from the huge advances of scientific medicine in the 20th century, continuing through promises to the future; from claims for scientific objectivity; from the symbolic value of medicine as culturally suited to other American values. . . __and__. . . from __the__ sheer v__isibility of national medical organizations, even in the absence of a unified governmental health policy__. (Stevens 2001, pp. 348–49)
 * Plan key to public health diplomacy**
 * Benatar and Fox 05** – Professor of Medicine and Bioethics @ University of Cape Town// and //Professor of Sociology and Bioethics @ University of Pennsylvania [Solomon R. Benatar and Renée C. Fox, “Meeting Threats to Global Health: A call for American leadership,” __Perspectives in Biology and Medicine__ 48.3 (2005) 344-361//Project Muse]

Amy **__Sands__**, Ph.D., Deputy Director, Center For Nonproliferation Studies, Monterey Institute Of International Studies, 3-19-**__02__** (‘Reducing The Threat Of Chemical And Biological Weapons”, Hearing Before The Committee On Foreign Relations United States Senate One Hundred Seventh Congress, [|http://www.globalsecurity.org /military/library/congress /2002_hr/shrg319.pdf], p. 48 [KSutt] To initiate such a process, the United States should work with Europe, Japan and other like-minded states to develop the national legislation needed to prevent misuse and unauthorized access to dangerous biological agents and toxins. Using these efforts as models, __the U.S. must lead the effort on an international level__ and with industry and academia __to define international standards__ of safety and security in the bio-technology sector __so that we will have more control over where the materials of concern are, who has access to them, how they are controlled and how they are stored and transferred.__ A second recommendation is that __we strengthen the public health sector__ within the United States and __internationally. We need__, obviously it’s been said already today, to improve our own public health sector, but we also need __to work with other international groups and foreign governments to the same internationally.__ The proposed draft legislation of Senator Biden and Helms called the Global Disease Surveillance Act of 2002 reflects the fact that given the speed of international travel, migration patterns and commercial transportation networks, __it will not be enough to shore up American public health capabilities__ and capacities, recognizing __that the best BW delivery system might be humans__ either knowingly or not. Therefore __we must assist others to develop capabilities for disease monitoring, surveillanc__e and response __or else leave ourselves vulnerable to the possible exposure to dangerous diseases that could be locally contained.__ Having recognized the need for more support in this area, the challenge, though, will now be to sustain these efforts both in the United States and elsewhere. Since __these activities have dual benefits enhancing both national and international security and public health__, it is hoped that their value will be clearly evident and funding will become an integral and ongoing element of our national and public security systems
 * The US must lead disease surveillance to ensure national security on bioweapons.**