Retooling the Uniformed US Public Health Service for the 21st Century

Donahue and Camona comments on the retooling of the uniformed public health services. The history of public health in the US is marked by great advances interspersed with periods of benign neglect--eras of maintaining the status quo ended by a significant epidemiological event. Cholera, tuberculosis, plague, polio, and malaria have catalyzed significant advances in public health. These problems are now largely banished from the US landscape, but not from the global perspective. In developing countries, millions of individuals die annually from largely preventable or treatable diseases. Some of these diseases could be transported to developed countries in a new form. New diseases are emerging at an unprecedented rate, prompting the World Health Organization to identify this issue as a global threat.' Even as medicine continues to find effective treatments for specific diseases, nature continues to adapt and cause illness with Legionnaire disease, Lyme disease, AIDS, Hantavirus, severe acute respiratory syndrome (SARS), and the Ebola and Marburg viruses, among others. Multiple drug-resistant tuberculosis and methicillin- resistant Staphylococcus aureus organisms are but 2 recent examples of evolving infections.