Public health officials and organizations around the world remain on high alert because of increasing concerns about the prospect of an influenza pandemic, which many experts believe to be inevitable. Moreover, recent problems with the availability and strain-specificity of vaccine for annual flu epidemics in some countries and the rise of pandemic strains of avian flu in disparate geographic regions have alarmed experts about the world's ability to prevent or contain a human pandemic. The workshop summary, The Threat of Pandemic Influenza: Are We Ready? addresses these urgent concerns. The report describes what steps the United States and other countries have taken thus far to prepare for the next outbreak of "killer flu." It also looks at gaps in readiness, including hospitals' inability to absorb a surge of patients and many nations' incapacity to monitor and detect flu outbreaks. The report points to the need for international agreements to share flu vaccine and antiviral stockpiles to ensure that the 88 percent of nations that cannot manufacture or stockpile these products have access to them. It chronicles the toll of the H5N1 strain of avian flu currently circulating among poultry in many parts of Asia, which now accounts for the culling of millions of birds and the death of at least 50 persons. And it compares the costs of preparations with the costs of illness and death that could arise during an outbreak. Table of Contents Front Matter Summary and Assessment 1 The Story of Influenza 2 Today 3 Toward Preparedness: Opportunities and Obstacles 4 Strategies for Controlling Avian Influenza Birds and Mammals 5 Emerging Technical Tools 6 Beyond Biomedical Response Appendix A: Pandemic Influenza: Assessing Capabilities for Prevention and Response Appendix B: Selected Bibliography Appendix C: The Critical Path to New Medical Products Appendix D: Forum Members, Speakers, and Staff Biographies

Globalization is by no means a new phenomenon; transcontinental trade and the movement of people date back at least 2,000 years, to the era of the ancient Silk Road trade route. The global spread of infectious disease has followed a parallel course. Indeed, the emergence and spread of infectious disease are, in a sense, the epitome of globalization. Although some experts mark the fall of the Berlin Wall as the beginning of this new era of globalization, others argue that it is not so new. The future of globalization is still in the making. Despite the successful attempts of the developed world during the course of the last century to control many infectious diseases and even to eradicate some deadly afflictions, 13 million people worldwide still die from such diseases every year. On April 16 and 17, 2002, the Forum on Emerging Infections held a working group discussion on the influence of globalization on the emergence and control of infectious diseases. The contents of the unattributed sections are based on the presentations and discussions that took place during the workshop. The Impact of Globalization on Infectious Disease Emergence and Control report summarizes the presentations and discussions related to the increasing cross-border and cross-continental movements of people and how this could exacerbate the emergence and global spread of infectious diseases. This report also summarizes the means by which sovereign states and nations must adopt a global public health mind-set and develop a new organizational framework to maximize the opportunities and overcome the challenges created by globalization and build the necessary capacity to respond effectively to emerging infectious disease threats. Table of Contents Front Matter Summary and Assessment 1 A World in Motion: The Global Movement of People, Products, Pathogens, and Power 2 Examining the Consequences: A Changing Landscape 3 The Global Application of Knowledge, Tools, and Technology: Opportunities and Obstacles 4 Creating a Framework for Progress Appendix A Agenda Appendix B International Law, Infectious Diseases, and Globalization Appendix C Changing Vector Ecologies: Political Geographic Perspectives Appendix D Social Aspects of Public Health Challenges in Period of Globalization: The Case of Russia