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Volume 2, Number 2—April 1996
Commentary

Needed: Comprehensive Response to the Spread of Infectious Diseases

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Harold M. Ginzburg
Author affiliation: Department of Psychiatry and Neurology, Tulane University Medical Center, New Orleans, Louisiana, USA

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In his article “Globalization, International Law, and Emerging Infectious Diseases,” Fidler recognizes that biological agents travel by themselves or with their hosts without any recognition of, or regard for, political borders. He notes that with the continued expansion of economic commerce across continents and more rapid transport and travel, persons infected with infectious diseases of very short incubation periods can act as vectors across several nations before they even become symptomatic. The protective effect of clipper ship travel is long gone.

Fidler examines the need for international treaties, agreements, and policies to manage the spread of new or reemerging infections diseases. His concern is that the current international climate requires more enforceable treaties with adequate resources to identify, track, interfere with, and contain the spread of infectious diseases perceived as an international or global threat.

International cooperation within the existing legislative mechanisms has, on occasion, been very successful. International eradication of smallpox was successful because a specific, cost-effective, efficient vaccine was developed; the disease attacked persons regardless of their economic, political, racial, religious, or social affiliations; the amount of funding was adequate; and all nations recognized the benefits of the eradication program. A similar effort currently in progress to eradicate poliomyelitis will also be successful because of international cooperation.

In contrast, international control of other infectious diseases, such as malaria and tuberculosis, has been attempted for decades with considerably less success. Notwithstanding the lack of efficacious vaccines, the reality is that only very limited resources are being committed to prevent and treat all infectious diseases. Outbreaks of Ebola virus infection and plague are routinely reported in the local, national, and international press. However, the continued increased incidence and prevalence of tuberculosis, AIDS, and other sexually transmitted diseases are accepted by many as problems of the poor, the immoral, and the expendable portion of society. Local, national, and international awareness and continued interest are significant problems.

International cooperation must extend beyond merely restricting the natural spread of specific diseases. One also has to recognize the need for effective international treaties to prevent the use of biological agents in either tactical or strategic circumstances. Fear of combatants using biological agents on military and civilian targets intensified during and since the Gulf War. The possibility of biological terrorism is no longer limited to the imagination of fiction writers. Fidler does not stress the issue of nonnatural outbreaks of diseases; a global need for an improved non-ad hoc response to emerging infectious disease agents should be completely considered by civilian and military planners. The threat of infectious diseases as weapons provides an additional incentive for cooperation among governments.

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DOI: 10.3201/eid0202.960215

Table of Contents – Volume 2, Number 2—April 1996

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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