CIA Transnational Health and Economic Activities - Intelligence Key Judgments On The Global Infectious Disease Threat

Intelligence Key Judgments On The Global Infectious Disease Threat

The IC determined that new and reemerging infectious diseases will pose a rising global health threat and will complicate U.S. and global security over the next 20 years. These diseases will endanger U.S. citizens at home and abroad, threaten U.S. armed forces deployed overseas, and exacerbate social and political instability in key countries and regions in which the United States has significant interests.

Infectious diseases are a leading cause of death, accounting for a quarter to a third of the estimated 54 million deaths worldwide in 1998. The spread of infectious diseases results as much from changes in human behavior—including lifestyles and land use patterns, increased trade and travel, and inappropriate use of antibiotic drugs—as from mutations in pathogens.

HIV prevalence will increase in five hard-hit countries, contributing to more instability:

• Twenty well-known diseases—including tuberculosis (TB), malaria, and cholera—have reemerged or spread geographically since 1973, often in more virulent and drug-resistant forms.
• At least 30 previously unknown disease agents have been identified since 1973, including human immunodeficiency virus (HIV), Ebola, hepatitis C, and Nipah virus, for which no cures are available.
• Of the seven biggest killers worldwide, TB, malaria, hepatitis, and, in particular, HIV/AIDS continue to surge, with HIV/AIDS and TB likely to account for the overwhelming majority of deaths from infectious diseases in developing countries by 2020.
• Acute lower respiratory infections—including pneumonia and influenza—as well as diarrheal diseases and measles, appear to have peaked at high incidence levels. There is, however, always the possibility of an influenza pandemic such as "Spanish flu" of 1918–1920, which actually appears to have originated in the U.S. By whatever name, that virus, of serotype H1N1 (i.e., different than the H5N1 "bird flu") killed between 40 and 50 million people. Its genome has been sequenced, there is a much better understanding of why it was so lethal, and there are some meaningful treatments. Those treatments, however, require, at the least, a robust pharmaceutical industry with appropriately fast drug distribution, and, at the higher levels of care, respiratory intensive care. Not even the most developed nations have adequate ICUs to handle a major epidemic; SARS was a warning in a city with the excellent medical facilities of Toronto