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Arms Race -- Getting Ahead of Killer Microbes

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The SARS epidemic a decade ago showed the world's continued vulnerability to infectious disease outbreaks. SARS started in China but spread worldwide quickly. In just weeks, it killed hundreds, sickened thousands, and cost over $30 billion to global business and travel.

At the time, China was slow to recognize, respond to, and report the new disease. Ineffective global tracking and cooperation dramatically slowed our international response. Eventually, SARS was stopped because we were able to identify the virus and apply infection control measures. We were also lucky -- the virus helped by fading away before things got worse.

The Centers for Disease Control and Prevention (CDC) and the world have made progress since SARS. We continue to hunt 24/7 for disease threats, and global collaboration to stop diseases from spreading has improved. In the decade since SARS, CDC and China have worked together closely. China is now better prepared to track, test for, sequence the genome of, and respond to the new H7N9 influenza strain.

More recently, it took just weeks for the global health community to recognize, do the molecular sequencing, and develop a test for the SARS-like coronavirus that emerged recently in Saudi Arabia and other countries. We can now track the disease better and find cases earlier.

No one can predict with certainty whether the new coronavirus or the H7N9 influenza outbreak in China will go global. But we, along with the World Health Organization, are closely monitoring the situation.

But I can tell you that CDC's best scientists are concerned -- very concerned -- and so am I, about H7N9 and the new coronavirus, which could cause a devastating pandemic if they mutate to spread easily from one person to another.

We can be certain of one thing: we now face a perfect storm of four threats that makes us vulnerable to infectious disease outbreaks. The growing threats of new microbes, more drug-resistant germs, increased global travel and trade, and potential bioterrorism agents all combine to push the limits of acceptable risk. And while we are more prepared today than ever, we need new tools to solve health mysteries faster and more accurately.

The basic tools of disease tracking and data analysis -- which CDC's disease detectives and others relied on to eradicate smallpox, identify Legionnaires' disease, and stop SARS -- remain essential. But they are no longer enough.

When cholera hit Haiti after the 2010 earthquake, CDC labs rapidly sequenced the organism's genome, a critical first step to understand the outbreak. However, we had to send the data to a lab outside the U.S. for interpretation, because CDC didn't have the tools. While grateful for our global partners, I was ashamed we had to outsource our nation's ability to respond to threats.

Cracking the DNA code of an infectious disease creates massive amounts of information in hours. Powerful new computing tools can help put the puzzle together quickly. New technology can revolutionize how CDC investigates and controls outbreaks, and also serve as a launch pad for other exciting life-saving breakthroughs. But unless we pursue these scientific advances, killer microbes will continue to have the advantage.

CDC's current capacities to use next-generation tools have not kept pace. Budget cuts such as the $580 million cut from CDC's budget this year further erode our ability to find answers quickly. If CDC falls behind, we leave the U.S. and the world vulnerable.

A decade ago we did good work to stop SARS -- and we also got lucky. With today's perfect storm of threats, it would be irresponsible to hope for another lucky break. The shame will be hard to bear if we are not ready to respond.

Dr. Tom Frieden, MD, MPH is Director of the Centers for Disease Control and Prevention