diarrheal diseases, a simplified short-term therapy 

 (oral rehydration) was recently developed which permits 

 control at a public health level. The strategy for 

 controlling smallpox by rapid surveillance and 

 containment, which emerged from the global eradication 

 campaign, is undoubtedly applicable to other diseases 

 such as yaws. Some kind of effective intervention is 

 now possible for each of the diseases listed in Table 



a. 



There are constraints, however, to applying science 

 and technology to infectious diseases. These include 

 the guantitative and gualitative inadequacy of health 

 delivery systems; the large scale of these disease 

 problems and the consequent high costs of applying 

 solutions even when treatment is inexpensive on a unit- 

 cost basis; the complexities of the scientific 

 guestions involved and the uncertainty of predicting 

 breakthroughs; the long time it takes to find 

 solutions; and the fact that development activities in 

 other sectors may exacerbate these problems (e.g., when 

 water impoundment for irrigation or power projects 

 increases the incidence of schistosomiasis, malaria, or 

 f ilariasis) . 



Where support for basic biological research is 

 contemplated, it should be remembered that effective 

 research can only occur in the context of an extremely 

 complex set of supporting systems. It requires a 

 critical mass of scientists, well-trained support 

 staff, libraries, logistic support, parts, maintenance, 

 an adequate supply of clean water, reliable 

 electricity, and the like. 



The interest of developing countries in addressing 

 infectious diseases is apparent from past regional 

 efforts to control smallpox, yaws, malaria, and measles 

 and current support for WHO-sponsored programs for 

 onchocerciasis control in six West African countries, 

 for expanding routine immunization services (DPT, 

 polio, measles, BCG) , and for research and training in 

 six other tropical diseases (malaria, schistosomiasis, 

 f ilariasis, trypanosomiasis, leprosy, and 

 leishmaniasis) . 



It is in the U.S. interest to help fight infectious 

 diseases. Study of how trypanosomes, schistosomes, and 

 leishmania block host defenses, for example, is likely 

 to produce research leads of considerable significance 

 to domestic health problems such as cancer. Also, 

 since diseases do not respect national borders, there 

 is some risk of importing such diseases as Lassa fever 

 and Marburg disease (a hemorrhagic viral disease) to 

 the United States and a continuing risk to U.S. 

 citizens traveling abroad. 



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