Three decades of responding to infectious disease outbreaks

November 14, 2017, NIH/National Institute of Allergy and Infectious Diseases
Maps showing global examples of emerging and re-emerging infectious diseases. Credit: NIAID

Soon after his appointment in 1984 as director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, Anthony S. Fauci, M.D., testified before Congress showing a world map annotated with a single emerging infectious disease threat, HIV/AIDS. Since then, diseases and pathogens including chikungunya, H1N1 influenza, severe acute respiratory syndrome (SARS), West Nile, Ebola and Zika viruses were added, providing a powerful visual reminder of the enduring need to anticipate, detect and manage new and emerging infectious diseases around the globe. In an essay in Annals of Internal Medicine published online today, Dr. Fauci reflects on the ways efforts have been marshalled to address infectious disease outbreaks of the past three decades.

Initial responses to a newly recognized disease, now known as HIV/AIDS, in the early 1980s were criticized as being too slow, the essay notes. "The insidious emergence of HIV/AIDS and the lack of due attention by policymakers illustrate how some outbreaks that start subtly can grow to global proportions if they are not aggressively addressed early on," Dr. Fauci writes. Between the early 1980s and the early 1990s, federal funding for HIV/AIDS research increased markedly, reaching $1 billion by the end of 1992. The accelerated government response supported both research and research infrastructure, and yielded advances in countering the HIV/AIDS pandemic domestically and internationally. Ultimately, notes Dr. Fauci, sustained support for scientific research coupled with political and community engagement helped transform HIV/AIDS from a nearly universally fatal disease to a condition that can be managed with appropriate treatment.

In contrast to HIV/AIDS, when outbreaks of respiratory diseases caused by SARS coronavirus and influenza viruses have occurred, they generated immediate widespread public attention and prompted concerted responses by presidential administrations and Congress. For example, the 2009 influenza pandemic began in April and an experimental vaccine entered clinical trials by August. However, despite intense efforts to test and manufacture the new vaccine, adequate supplies to protect the broad U.S. population were not available until early winter, after the had peaked. "This experience," writes Dr. Fauci, "served as a striking reminder of the inadequacy of our pandemic preparedness capabilities and underscored the need, now being actively pursued, to develop platform technologies that can be applied rapidly to develop vaccines for evolving outbreaks."

The essay also considers how presidential administrations have responded to the appearance of pathogens ranging from West Nile virus and Ebola to, most recently, the arrival of Zika virus in the Americas. "Leadership at the NIAID has learned many valuable lessons through experiences during the prior administrations with regard to optimal responses to such outbreaks," Dr. Fauci concludes. "It is critical to apply these lessons to the infectious threats that we will inevitably face in the current administration and beyond."

Explore further: Durable end to the HIV/AIDS pandemic likely will require an HIV vaccine

More information: Catharine I. Paules et al, What Recent History Has Taught Us About Responding to Emerging Infectious Disease Threats, Annals of Internal Medicine (2017). DOI: 10.7326/M17-2496

Related Stories

Durable end to the HIV/AIDS pandemic likely will require an HIV vaccine

October 9, 2017
Despite remarkable gains in the treatment and prevention of HIV infection, development of an effective HIV vaccine likely will be necessary to achieve a durable end to the HIV/AIDS pandemic, according to a new commentary ...

Multiple research approaches are key to pandemic preparedness, NIAID officials say

October 5, 2017
Preparedness in the face of major disease outbreaks can save thousands of lives: Rapid deployment of effective diagnostics, treatments, and vaccines may even stop the disease from potentially exploding into a pandemic. A ...

Study examines trends in infectious disease mortality in US

November 22, 2016
In a study appearing in the November 22/29 issue of JAMA, Heidi E. Brown, Ph.D., of the University of Arizona, Tucson, and colleagues investigated trends in infectious disease mortality in the United States from 1980 through ...

Infectious outbreaks must be combatted strategically, experts argue

April 21, 2016
New funding is not enough to guarantee success against emerging infectious diseases around the world. Rather, good governance, a long-term technology investment strategy and strong product management skills are essential, ...

Scientists explore 1510 influenza pandemic and lessons learned

November 12, 2010
History's first recognized influenza pandemic originated in Asia and rapidly spread to other continents 500 years ago, in the summer of 1510. A new commentary by researchers at the National Institute of Allergy and Infectious ...

Recommended for you

Blood signature could improve early tuberculosis diagnosis

June 19, 2018
A gene signature in the bloodstream could reveal whether someone is going to develop active tuberculosis (TB) disease months before symptoms begin. Such a signature has now been developed by a team led by the Francis Crick ...

Scientists uncover a factor important for Zika virus host species restriction

June 19, 2018
Princeton University researchers Qiang Ding, Alexander Ploss, and colleagues have identified one of the mechanisms by which Zika virus (ZIKV) circumvents immune control to replicate in human cells. The paper detailing this ...

Toothpaste and hand wash may contribute to antibiotic resistance

June 19, 2018
A common ingredient in toothpaste and hand wash could be contributing to antibiotic resistance, according to University of Queensland research.

Combining different malaria vaccines could reduce cases by 91 percent

June 19, 2018
Using two experimental anti-malarial vaccines, which work in different ways, can greatly reduce the number of malaria infections in animal studies.

Children's immune system could hold the key to preventing sepsis

June 19, 2018
Children's immune systems could hold the key to preventing life-threatening infections and sepsis, a new study has revealed.

Beware of getting a tattoo if your immune system isn't up to scratch, doctors warn

June 18, 2018
Getting a tattoo may have some unexpected complications if your immune system isn't up to scratch, warn doctors in the journal BMJ Case Reports.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.