F.

Influenza, Acute Respiratory Diseases and Viral Repatitis

The Centers for Disease Control (CDC) has participated in the joint scientific activities under the auspices of the U.S.U.S.S.R. Agreement for Cooperation in the Field of Medical Science and Public Health since 1974 when the area of "Influenza and Acute Respiratory Diseases (ARD)" was added to the collaborative program during the Third Meeting of the U.S.-U.S.S.R. Joint Committee for Health Cooperation. Dr. David J. Sencer (the then Director of CDC) was designated the Coordinator for the United States and CDC assumed the Lead Agency responsibility for the coordination of joint activities.

The scope of collaboration was expanded in 1978 by adding Viral Hepatitis to this scientific area.

To date, approximately 125 exchange visits took place among the scientists from the United States and the Soviet Union in the area of Influenza, ARD, and Viral Hepatitis. Contacts have been established with the following scientific institutions in the Soviet Union:

In Moscow:

In Leningrad:

Ivanovsky Institute of Virology

Moscow Research Institute of Viral Preparations
Tarasevich State Institute of Standardization
and Control of Medical and Biological
Preparations

Gamaleya Institute of Epidemiology and

Microbiology

Institute of Poliomyelitis and Viral
Encephalitis

All-Union Institute for Influenza Research
Institute of Experimental Medicine

Pasteur Institute of Epidemiology and

Microbiology

Domestically, CDC coordinated joint activities in cooperation with the following U.S. Government and private institutions:

National Institute of Allergy and Infectious Diseases,
Office of Biologic Research and Review, FDA

University of Michigan/Ann Arbor

University of Virginia/Charlottesville

Mount Sinai School of Medicine/New York

Baylor College of Medicine/Houston
University of Wisconsin/Madison

St. Jude Children's Research Hospital/Memphis

In the scientific area of Influenza, ARD, and Viral

Hepatitis, the collaborative activities were conducted in the
following interrelated sub-areas (also known as Problem
Areas) :

G.

1.

H.

Influenza

Etiology

Immunoprophylaxis and Vaccine Development
Epidemiology

Ecology

Chemotherapy/Chemoprophylaxis
Basic Properties of Viruses

The following research subjects have been studied in the
joint projects conducted in this scientific area:

Evaluation of exchanged attenuated strains of influenza virus for consideration as potential candidates for vaccine strains

Comparison of the U.S. and U.S.S.R. methods of
attenuation

• Modeling and prediction of epidemics

Evaluation of the side effects and efficacy of Amantadine and Rimantadine in the prevention of infection with H1N1 influenza

New viral agent responsible for non-A/non-B hepatitis

Control and prevention of hepatitis B in hospitals

Mental Health

(Coordinated by the National Institute of Mental Health).
This area has been politically sensitive due to the reported
Soviet treatment of dissidents as mental cases. U.S.
coordinators would like to resume collaboration with the
Soviets focusing on mental health problems of the aged.
Eye Disease

Coordinators: National Eye Institute;

All-Union Research Institute of Eye Diseases

Collaborative clinical trials to assess the use of short-
pulsed lasers in the treatment of anterior segment disease
and joint efforts to determine the earliest defects in optic
nerve functions in ocular hypertension and glaucoma.
The Soviets provided NEI with the technology to build the
first Q-switch laser in the U.S. This laser, which was
developed in the USSR by a Nobel laureate in physics for use
in vision disorders, is considered to be a better clinical
tool than the argon laser pioneered in this country.

I. Biomedical Communication

Coordinators:

National Library of Medicine;
Ministry of Health

Cooperation on exchange of books and journals, personnel, interlibrary loans, MEDLARS computer data base tapes and toxicological information.

J. Health Scientist Exchange Program

The intent of this program, which is jointly supported by the U.S. Public Health Service and the USSR Ministry of Health, is to foster collaboration in areas not covered under this agreement. Because U.S. scientists were reluctant to participate in the program following the invasion of Afghanistan, an imbalance was created in the numbers of U.S. and Soviet scientists exchanged. A moratorium was imposed by the U.S. in 1982, which was lifted in 1983 and the program continues at a reduced level. PHS is now prepared to propose an increase in the exchange quota.

ASSESSMENT OF BENEFITS AND PROGRAM CONTINUATION

Assessment of Benefits

The most active and productive area of exchanges has been in the field of Cardiovascular Research. Soviet scientists have contributed their expertise and data on selected populations with cardiovascular disease, and shared autopsy material on patients who have just died from cardiovascular disease. This has contributed substantially to our epidemiological information on various risk factors associated with cardiovascular disease. In addition, the Soviets have made available information on newly developed drugs for treating abnormal cardiac rhythms and on their biobehavioral approaches to the control of hypertension as well as allowing U.S. scientists access to a very large primate research center.

In the area of Influenza, Acute Respiratory Diseases, and Viral Hepatitis, there have been approximately 120 exchange visits over the past 12 years. These exchanges have allowed scientists from the U.S. Centers for Disease Control to rapidly share information, viral strains, and data, with their Soviet counterparts to increase mutual understanding of the epidemiology and the means to control the epidemic activity of influenza viruses and other infectious diseases.

In the area of Research on Eye Diseases, the Soviets developed a "Q-switched" or quick pulse laser for treating glaucoma. Glaucoma happens to be the second leading cause of blindness in the U.S. The Soviets provided assistance to the National Eye Institute so that we could build a similar instrument. This soon led to clinical trials and now pulsed lasers are in widespread use in the U.S. for treating glaucoma.

In other areas, the benefits, as well as the PHS level of effort may have been more modest. However, because no funds are specifically set aside for this cooperation, and instead activities must be justified and compete with other domestic and foreign research opportunities, we can say that nearly all the exchanges are undertaken with the clear expectation of benefit to the participating PHS components and to U.S. public health. Our general perception is that the costs of the exchanges and research have been, more or less, shared equally and the benefits to the health of both countries are also roughly comparable.

Program Continuation

The Department of Health and Human Services is fully prepared to continue the collaborative research and exchanges under its Health Agreements. With the resumption of high-level visits and Joint Committee meetings, we would expect to be able to identify new areas of mutual interest and benefit. Our level of effort is likely to remain approximately the same as in recent years.

No. Number of Scientists.

Man/Mo.- Person Months