ProMED global monitoring of emerging diseases: design for a demonstration program.

The emergence and reemergence of infectious diseases, as the result of recent and ongoing social and environmental changes, urgently calls for a global surveillance system, so that unusual outbreaks can be recognized and controlled at an early stage. ProMED, an international non-governmental group of infectious disease experts, was organized by the Federation of American Scientists to promote the establishment of a global Program to Monitor Emerging Diseases. ProMED proposes the establishment of a demonstration program by prioritizing a small number of strategically-located institutions in the developing world, mainly those least in need of upgrading, for development as sentinel centers. In this way a functional, although limited, network with capabilities for monitoring both endemic and emerging diseases could be rapidly established at minimal cost. The network would serve as an experimental model for future expansion. Initially, each center would develop its own local/regional network with which it would exchange information and assistance, and through which it would collect clinical data and specimens for monitoring the emergence of a limited number of defined syndromes. A central program office would provide protocols, assistance, training, quality assurance, communications, etc. and would coordinate fundraising and program activities. If successful, the syndromes monitored would be expanded and additional institutions strengthened to become new network centers.