House Committee Finishes HR4 Mark-Up

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Life Science
February 25, 1993
HOUSE COMMITTEE FINISHES HR4 MARK-UP
The mark-up of HR4, the House bill to reauthorize the National Institutes
of Health (NIH), was finished yesterday afternoon. Reportedly an amendment
parallel to Title XVIII in the Senate bill, S1, has been added. Title
XVIII would reorganize the NIH Office of Akids Research.
CDC DEVELOPS PLAN TO DEAL WITH NEW AND REEMERGING
INFECTIOUS DISEASE THREATS TO U.S. HEALTH
A draft plan for dealing with new and reemerging infectious dis.
threats to health in the United States is being finalized by the Cente
for Disease Control and Prevention (CDC). The plan is in part a respon
to the recent Institute of Medicine report, "Emerging Infections,
Microbial Threats to Health in the United States." (see Washingtc x
12/11, 12/14, 12/15/1992)
According to the proposed CDC plan, "Preparing for New and Reemerg:ing
Infectious Disease Threats to Health in the United States," policy-mak
have been lulled into a false sense of security regarding the incidenc of
infectious disease. "Unfortunately, historical success in treating and
controlling these diseases has left many health policy-makers with th:
false perception that the threat to public health from new and reemerg
infectious agents has disappeared," says CDC.
The existing public health complacency, says CDC, has been costly in terms
of both econo Ts and human mortality. Cholera is used as an example. The
disease repor Idly has returned to the Western Hemisphere in epidemic
prof rtions after almost a century of absence. The cholera epidemic
demonstrates how environmental mismanagement, poor sanitation, inadequate
water treatment and other similar failings in one continent interact w
global health by paving the way for increased microbal traffic to di. at
regions. Apparently cholera reemerged in Peru, but persons afflicted with
this potentially lethal disease have been identified as far north is the
United States.
The repcrt, cit >g figures indicating that 25% of all visits to physi
are due to infet.tious disease, suggests that infectious diseases coptin
to place a "significant economic burden" on the American public. Annual
direct medical costs due to influenza alone approach $5 billion, while the
cost of lost productivity due to influenza is $12 billion annually.
One fact noted in the background of CDC's plan is that in 1983 CDC,

+ through the Public Health Service (PHS), requested but was denied $36
million for a tuberculosis elimination program. Eight years later, in
1991, a tuberculosis containment program became necessary, with the
federal portion of costs to implement the National TB Action Plan
estimated at $500 million.
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