Oct 15, 2007

Dual Use Epidemiological Intelligence

Dual Use technology often carries with it the potential for both great good and horrific harm - and lots of fuzziness there in between.

Not too seldom do we hear mention of the Dual Use nature of a particular set of technologies in the context of rogue entities accused of attempting to acquire Faustian asymmetrical advantage over the forces of Good through the Trojan of a benign aim and its enabling technology.

Likewise, intelligence efforts can be of a Dual Use nature and cut many other ways than the strictly ameliorative or prophylactic. An epidemiological intelligence program as described below by excerpts from the recent (Oct 4, 2007) GAO study: Global Health - U.S. Agencies Support Programs to Build Overseas Capacity for Infectious Disease Surveillance [21-page pdf] has the capacity for several aggressive applications.

The GAO suffices to stick to outlining the program's primaries, official aims, and endearing and admirable applications. Good call. There are a thousand Greeks in that belly.

The rapid spread of severe acute respiratory syndrome (SARS) in 2003 showed that disease outbreaks pose a threat beyond the borders of the country where they originate. The United States has initiated a broad effort to ensure that countries can detect outbreaks that may constitute a public health emergency of international concern. Three U.S. agencies—the Centers for Disease Control and Prevention (CDC), the U.S. Agency for International Development (USAID), and the Department of Defense (DOD)—support programs aimed at building this broader capacity to detect a variety of infectious diseases.

The U.S. government operates or supports four key programs (as shown in the graphic below) aimed at building overseas surveillance capacity for infectious diseases. In fiscal years 2004-2006, U.S. agencies obligated approximately $84 million for these programs, which operate in developing countries around the world. Global Disease Detection is CDC’s main effort to help build capacity for infectious disease surveillance in developing countries. The Field Epidemiology Training Programs, which CDC and USAID support, are another tool used to help build infectious disease surveillance capacity worldwide. Additionally, USAID supports CDC and the World Health Organization’s Regional Office for Africa in designing and implementing Integrated Disease Surveillance and Response in 46 countries in Africa, with additional technical assistance to 8 African countries. DOD’s Global Emerging Infections Surveillance and Response System also contributes to capacity building through projects undertaken at DOD overseas research laboratories. USAID supports additional capacity-building projects in various developing countries.

For each of the four key surveillance capacity-building programs, the U.S. agencies monitor activities such as the number of epidemiologists trained, the number of outbreak investigations conducted, and types of laboratory training completed. In addition, CDC and USAID recently began systematic efforts to evaluate the impact of their programs; however, because no evaluations had been completed as of July 2007, it is too early to assess whether these evaluation efforts will demonstrate progress in building surveillance capacity.

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