Four themes have dominated the evolving public health landscape, each providing a blend of pride and apprehension. Scientific advances continue to astound while human failings continue to confound.
The first evolving theme is the field of infectious disease. Infectious disease control was once synonymous with public health. The decreasing role it played as chronic disease and environmental and occupational health problems were expanding is being reversed. New tools, advances, and abilities must be weighed against worrisome setbacks. The advances are momentous. A second disease is nearing eradication, with dracunculiasis cases decreasing from an estimated 3.5 million in 1986 to 150 000 in 1994, a decrease of 95%.1 This hemisphere has gone 3 years without a case of polio caused by wild virus strains, China is on the brink of polio eradication, and global eradication will occur before the end of the decade, making it the third human disease to
Foege W. Preventive Medicine and Public Health. JAMA. 1995;273(21):1712-1713. doi:10.1001/jama.1995.03520450082043