Support for core public health capacity is diminishing; outbreaks of microbial threats are not. In 2012 there were a number of high-profile threats (see the box on the right) that demanded public health intervention to protect the public. It is well understood that the role of a physician in responding to patients during these outbreaks can save lives one at a time. The impact of a well-trained, well-equipped public health system can multiply that benefit exponentially through prevention, early detection, and response to microbial threats. That impact, however, depends on a strong public health foundation.
State health agencies’ ability to quickly detect and respond to infectious diseases depends on having strong capabilities, as outlined in the recent Institute of Medicine (IOM) report entitled For the Public’s Health: Investing in a Healthier Future (2012). These core capacities, sometimes referred to as the “public health infrastructure,” are essential for planning, delivering, and evaluating public health. State health agencies require effective and efficient systems for preventing infectious disease morbidity and mortality, ensuring control of outbreaks and vigilance against existing diseases, and preventing and responding to emerging and reemerging infectious disease threats.