Emerging infectious diseases: a 10-year perspective from the National Institute of Allergy and Infectious Diseases

Abstract

Although optimists once imagined that serious infectious disease threats would by now be conquered, newly emerging (e.g., severe acute respiratory syndrome [SARS]), reemerging (e.g., West Nile virus), and even deliberately disseminated infectious diseases (e.g., anthrax bioterrorism) continue to appear throughout the world. Over the past decade, the global effort to identify and characterize infectious agents, decipher the underlying pathways by which they cause disease, and develop preventive measures and treatments for many of the world's most dangerous pathogens has resulted in considerable progress. Intramural and extramural investigators supported by the National Institute of Allergy and Infectious Diseases (NIAID) have contributed substantially to this effort. This overview highlights selected NIAID-sponsored research advances over the past decade, with a focus on progress in combating HIV/AIDS, malaria, tuberculosis, influenza, SARS, West Nile virus, and potential bioterror agents. Many basic research discoveries have been translated into novel diagnostics, antiviral and antimicrobial compounds, and vaccines, often with extraordinary speed.

Figure 1

Leading causes of death worldwide (estimates for 2002). Nearly 15 million (>25%) of the 57 million annual deaths worldwide are caused by infectious disease (6).

Figure 2

Leading causes of disability-adjusted life years (DALYs) due to infectious and parasitic diseases (2002 estimates). Lower respiratory infections, HIV/AIDS, diarrheal diseases, and malaria are among the infectious diseases that contribute to the most DALYs each year throughout the world (6).

Figure 3

Budget of the National Institute for Allergy and Infectious Disease (NIAID), FY1994–2005. The overall NIAID budget rose from $1.06 billion in FY1994 to $4.4 billion (estimated) in FY2005. Funding for emerging infectious diseases rose from $47.2 million in FY1994 to $1.74 billion in FY2005 (est.).

Figure 4

AIDS cases, AIDS deaths, and persons living with AIDS in the United States, 1981–2003. Over the past decade, the number of new AIDS cases and deaths due to AIDS has decreased, while the number of people living with the disease has increased, due in large part to improvements in diagnosis and treatment. Estimates adjusted for reporting delays. Source: CDC (8).