Despite remarkable advances in medical research and treatments during the 20th century, infectious diseases remain among the leading causes of death worldwide for three reasons: (1) emergence of new infectious diseases; (2) re-emergence of old infectious diseases; and (3) persistence of intractable infectious diseases. Many logistical and scientific challenges stand in the way of better prevention, treatment, and control strategies for emerging diseases and those infectious diseases that primarily affect the developing world. Addressing these challenges will require collaboration among the biomedical industry, government agencies, international organizations, and private foundations.
Expanded studies in microbiology and infectious disease ecology will improve prediction and prevention. Research in specialized fields, such as molecular biology, genetics, cell biology, population and evolutionary biology, mathematical modeling, computer science, and remote sensing technology, is essential to this effort.
Rapid, sensitive methods for pathogen identification and disease diagnosis, determination of the drug sensitivity of microbes, and determination of the pesticide sensitivity of arthropod vectors would significantly increase the quality of patient care and simplify infectious disease control and surveillance programs. New research suggests that many "noncommunicable" diseases are caused or exacerbated by infectious agents.
The potential health burden of these diseases warrants more extensive analysis of the contributions of infectious agents to chronic diseases.
Examples of Emerging/Re-emerging Infectious Diseases
The goal of treatment research is to identify targets of vulnerability during the complex processes of colonization, replication, and eventual transmission to new hosts. Recent advances in structural biology, computer modeling, crystallography, combinatorial chemistry in drug design, and robotic technology for high-throughput screening must be harnessed to identify and produce candidate compounds for therapeutic use. Design of therapies against unknown pathogens, whether naturally emerging or the result of bioengineering, poses a special challenge and emphasizes the need for developing better broad-spectrum antimicrobial agents.
Development of resistance is fueled by increased and/or inappropriate use of therapeutic drugs and amplified by person-to-person or common-source transmission in crowded settings such as hospitals. Agricultural practices that include extensive use of antibiotics in livestock and pesticides on crops are adding selective pressure on microbes.
Improving our global ability to combat infectious diseases that are resistant to current control strategies presents many unique research challenges. Basic research is needed to understand how pathogens evade normal host defenses, and epidemiological and field- based research is needed to understand the natural history of disease.
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Last Updated November 09, 2000