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American Journal of Epidemiology
Copyright © 2003 by the Johns Hopkins Bloomberg School of Public Health
All rights reserved
Vol. 158, No. 6
Printed in U.S.A.
PRACTICE
BOOK
REVIEW
OF EPIDEMIOLOGY
The Global Threat of New and Reemerging Infectious Diseases: Reconciling U.S.
National Security and Public Health Policy
By Jennifer Brower and Peter Chalk
ISBN 0-8330-3293-3, RAND Corporation, Santa Monica, California (Telephone: 877-584-8642, Fax: 310-451-6915,
World Wide Web URL: http://www.rand.org), 2003, 163 pp., $20.00 (paperback)
scape produced by the anthrax episode of 2001. Much of the
federal financial response was already in place by the first
half of 2002, and funding of new programs, largely
involving the ability to respond to infectious diseases, actually occurred in the second half of the year. There is little
mention in the book of any of this activity—not even
detailed coverage of the enormous political impact of the
anthrax episode that started it. While this situation may be a
result of the timing of the RAND study, it still means that the
book’s conclusions are, to an extent, out of date.
This small volume may be of use to policy-makers in
giving them an overview of the issues pertaining to emerging
infections. However, it would be far better for epidemiologists to consult the original documents, starting with the
Institute of Medicine report (1) and the response of the
Centers for Disease Control and Prevention (3).
REFERENCES
1. Shope RE, Oaks SC Jr, Lederberg JS, eds. Emerging infections:
microbial threats to human health in the United States. Washington, DC: National Academy Press, 1992.
2. Brower J, Chalk P. The global threat of new and reemerging
infectious diseases: reconciling U.S. national security and public health policy. Santa Monica, CA: RAND Corporation, 2002.
3. Centers for Disease Control and Prevention. Addressing emerging infectious disease threats: a prevention strategy for the
United States. Atlanta, GA: Centers for Disease Control and
Prevention, 1994.
Arnold S. Monto
School of Public Health, University of Michigan, Ann
Arbor, MI 48109-2029
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The recognition of emerging and reemerging infections as
neglected threats to public health was documented by the
publication of an Institute of Medicine report on the subject
in 1992 (1). Since that time, there has been increasing attention paid to the problem, both in studies and in funding of
specific activities. More recently, the potential relation
between emerging infections and the bioterrorist threat has
generated increased financial support for components of the
public health infrastructure, such as local health departments, which had been poorly funded for many years.
The volume entitled The Global Threat of New and
Reemerging Infectious Diseases (2) is the product of a study
sponsored by the RAND Corporation. It attempts to provide
background information on emerging infections to persons
whose work involves national security and policy considerations. From my standpoint, the review of emerging infectious diseases in the book is rather superficial. This is not to
say that it is inadequate for readers who are more interested
in the policy areas. More importantly, I found little that was
new in other aspects covered.
In chapter 3, the authors use the impact of acquired immunodeficiency syndrome (AIDS) in South Africa as a case
study. They interviewed persons directly affected by the
pandemic in various parts of the country. This chapter
contains some first-hand information and documents the
devastating effect that human immunodeficiency virus
(HIV) infection is having. The overall issues raised are not
new to anyone familiar with the epidemiology of AIDS in
this region. However, they may be of interest to policymakers deciding on fiscal appropriations for control of HIV
infection in Africa.
The book was first published in 2002, but there is little
reference to the immense change in the US political land-