GLOBAL PROGRESS IN INFECTIOUS-DISEASE CONTROL

There is both good news and bad news concerning infectious disease con trol globally. The good news is that smallpox has been eradicated, era dication of poliomyelitis and guinea worm disease is on track, and man y infectious diseases are under effective control in much of the world . The advances are primarily the results of improved sanitation, effec tive use of vaccines, and introduction and use of specific therapies ( whose impact has primarily been on mortality, rather than incidence). The bad news is that infectious diseases are still the leading cause o f death world-wide, new diseases are emerging, old diseases are re-eme rging, there are ominous interactions between diseases, and antibiotic resistance is emerging as a major problem. There are many promising d evelopments for the future, including new and improved vaccines, new s pecific therapies, and new strategies to deal with infectious disease. However, unless eradicated, infectious diseases remain a threat and r equire continuous efforts to be kept under control. Given the ability of infectious agents to evolve, it is certain that the future will als o hold new problems and new diseases. (C) 1998 Elsevier Science Ltd. A ll rights reserved.