The Coming Plague: Newly Emerging Diseases in a World Out of Balance

The CDC (an acronym originally standing for “Communicable Disease Center”) is a branch of the US Public Health Service based in Atlanta, Georgia. Initially tasked with treating and controlling malaria, its oversight gradually expanded to include nearly all major areas of public health within the US and operating in a leading role for global health issues. In addition to acting as the US agency for health oversight, one of its chief missions is detecting emerging disease threats and responding rapidly to such situations.

The CDC’s work as the agency tasked with assessing emerging threats puts it at the center of most of the outbreaks covered in The Coming Plague. Although many of the outbreaks were far removed from US soil, the CDC took a leading role in sending scientists to the affected areas, equipping mobile labs, raising funding, and conducting research on samples sent back from the field.

As a government agency, the CDC could sometimes get caught up in a bureaucracy that hampered its efficiency, and it was also limited at times in its ability to respond to emerging threats when the government was not forthcoming with the necessary funding. On the whole, it represented the most capable agency in responding to the emerging threats detailed in The Coming Plague. Despite its imperfections, some scientists considered it the only viable solution for a centralized response to global health crises. Garrett quotes D. A. Henderson as saying, “I therefore see no option but to acknowledge CDC as an international resource, to fund it appropriately, and to acknowledge its mandate in legislation” (604).

The World Health Organization is the global health agency that operates under the aegis of the United Nations. Based in Geneva, Switzerland, it is tasked with promoting medical and social practices to raise global health standards for all people. Like the CDC, it also monitors and responds to emerging health threats worldwide.

Unlike the CDC, however, WHO is presented in The Coming Plague as less effective and restricted by international politics and diplomacy issues. As an agency of the United Nations, it requires an official invitation from a host country to pursue a course of action, and in contexts where disease outbreaks form just one factor of larger socio-political upheavals, such invitations are not always forthcoming. In the outbreaks detailed in the book, WHO seems to work better as a global forum for scientific minds than as an active response unit. One major exception was in its organization of the global push to eradicate smallpox, but the program’s success was due as much to the head agents’ willingness to break WHO’s rules as it was to WHO’s organizational prowess. In the final analysis of the scientists quoted in The Coming Plague’s closing chapter, WHO was not adequate for the role of providing a central response to global health crises.