Maryland's healthy effort overseas


WASHINGTON -- The state of Maryland has come under criticism for recently agreeing to send doctors and nurses to Third World countries to tackle health problems. Some critics argue that the state should first address the unmet health care needs here.

But Maryland's apparently unique pact with the World Health Organization is an essential element in the battle to prevent communicable diseases from reaching our shores. A recent report produced by the Department of Defense, the National Security Council, the Centers for Disease Control and 15 other federal agencies, identified "emerging and re-emerging infectious diseases" (ERIDS) as a serious threat to our nation's security.

The threat

The report, "Global Microbial Threats in the 1990s," documents the absolute certainty of accidental microbial invasions.

From this new perspective on national security, there is no wiser investment than assisting all humanity in achieving a basic standard of healthy living.

Imagine the social and economic chaos that would be caused by an Ebola-like virus spreading with the common cold, emerging from some Third World country and landing at Baltimore-Washington International Airport. The movie "Outbreak" is a Hollywood worst-case scenario; its fantasy plot has doctors finding a cure for the virus in 48 hours. Our fight against AIDS and the common cold gives a more sobering look at our current chances against biological invaders.

For example, by the time Indian officials notified LaGuardia Airport officials last fall that an outbreak of the bubonic plague had gone airborne, nine passengers had already arrived in New York from India and dispersed to unknown points.

To microbes we are just another piece of meat on the food chain. To make matters worse, we have inadvertently and dramatically increased infectious microbial strength, numbers and varieties by continuing to ignore their most fertile breeding ground -- abject poverty, ignorance and indifference. Our nation's health defenses are weak with 20 million Americans without affordable health care, but our greatest strategic failure is our lack of humanitarian efforts for the poorest half of humanity. Ensuring adequate food, health care, clean water, housing and sanitation for all on Earth should now be our nation's top defense strategy.

On the defense

Defending Americans from foreign aggressors is a top priority of any elected official, but a healthy financial return on international health investments also provides convincing reason. Just 20 years ago, the United States invested only $32 million in the global campaign to eradicate smallpox. It has paid off. A few more millions invested now in the global elimination of polio and measles and the control of tuberculosis could be saving us billions annually in U.S. vaccines, health care and antibiotic development costs. Stopping microbes at all U.S. ports of entry is not a reasonable or affordable option. Dealing with them at their source brings us the cheapest and surest national security.

J. Brian Atwood is administrator of the U.S. Agency for International Development.

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