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1. A Strategy for Infectious Diseases
Infectious diseases are a major global threat: to health, to prosperity, to social stability, to security. They account for 41 per cent of the global disease burden with infections such as HIV/AIDS, tuberculosis and malaria accounting for millions of deaths in the world each year.
Constant vigilance is required against the risk of new and re-emerging diseases. History has taught us that infections such as HIV/AIDS, variant CJD and West Nile Fever can come apparently from nowhere and cause major problems for the health of our population.
The problem is never static. Micro-organisms co-exist with people and share a common environment. A number of important factors can create change in this delicate balance - for example, travel and trade; the growth of technology; adaptation of micro-organisms producing strains that are more virulent and resistant to treatment; increases in the numbers of people with weakened immune systems (for example, cancer and transplant patients); and changes in environmental and land use. Combined, these factors represent a threat to human health.
For this reason, I published a strategy to tackle infectious diseases called Getting Ahead of the Curve in January 2002.
Getting Ahead of the Curve: a strategy for combating infectious diseases
The report, Getting Ahead of the Curve, recommended giving much greater priority to infectious diseases and wider aspects of health protection (threats from chemicals, radiation and other environmental hazards). It recommended strengthening surveillance for infectious diseases so that we can have better, early warning of new disease problems or changes in the pattern of existing infectious disease. The report also recommended a new national panel to deal with the threat of new and emerging diseases.
Another key recommendation of my report was the creation of a new Health Protection Agency, which is now up and running just over a year after it was first proposed. This is a remarkable achievement and shows a high degree of commitment by many stakeholders to integrating health protection.
The Agency is one of the most exciting and innovative developments ever in the field of health protection. In the face of new and continuing threats from infectious disease and environmental hazards, it builds on the huge strengths of four existing national agencies combining them into one new powerful national body responsible for all aspects of health protection, including the control of infectious diseases.
The Health Protection Agency is a world first in integrating these health protection functions at national, regional and local level. The arrangements put the country in a strong position to respond to the natural threat to health posed by these agents but will also provide a health focus for the very important task of protecting our public against the threat of terrorism using biological, chemical and radiation agents.
My report also identified four specific issues that require strengthened or new control measures:
- Health care associated infection;
- Tuberculosis;
- Antimicrobial resistance;
- Blood-borne and sexually transmitted viruses (HIV/AIDS, hepatitis B and hepatitis C)
Each of these problems will have a targeted action plan in place in early 2003. The plans will build on existing measures and will aim to reduce the relatively high levels of infection and disease.
Immunisation
With safe, effective vaccines, lives are saved and the risks of serious illness are reduced. It is imperative that high uptake of vaccines is maintained and that more research is done to develop new ones. Ensuring public and professional confidence will continue to be crucial to successful immunisation programmes.
Emergency Planning
Extensive planning had already been undertaken to protect the public from the deliberate release of biological, chemical or radiological agents before September 11th 2001.
Further intensive planning has taken place and detailed guidance has been issued to health and local authorities and emergency services. In addition, strategic stockpiles of drugs and vaccines have been arranged, and there has been co-operation with both the US and Europe on planning for such emergencies.
Summary
The strategy sets out to:
- describe the scope and nature of the threat posed by infectious diseases to the health of the population of England;
- establish the priorities for action to combat the present as well as the possible future threat posed by infectious diseases;
- integrate the infectious disease challenge with wider health protection needs;
- propose a strengthened and modernised system to respond to these challenges.
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