high‐burden diseases include the establishment of TB Regional Training and Medical Consultation Centers to optimize TB treatment and reduce the development of drug resistance. Additional strategies include advancing efforts to enable co‐treatment of frequently associated conditions such as HIV, STDs, and TB—approaches that can also help reduce health disparities. • Interventions to reduce disease transmitted by animals or insects Zoonotic and vectorborne diseases are the primary source of emerging infections, requiring multi‐disciplinary partnerships and innovative approaches for their prevention and control (see also Priority 3B, Promote One Health approaches . . .). Recent efforts include the development of promising human vaccines against dengue and malaria, expanded use of insecticide‐treated bed nets and indoor walls in malaria endemic areas, and the use of tick‐control interventions among deer carrying ticks that transmit Lyme disease. For vectorborne disease control, resistance to pesticides is an ongoing challenge affected by usage, vector biology, and environmental changes (14). Improved approaches to insect control are underway, including a new class of insecticides derived from the bark of the Alaskan yellow cedar tree. Potential applications include prevention of mosquito‐borne diseases like dengue fever and malaria; tickborne diseases like Lyme disease, ehrlichiosis, and Rocky Mountain Spotted Fever; and diseases caused by tickborne potential bioterror agents (e.g., babesiosis, tularemia, Q fever). New efforts designed to avoid pesticide resistance are also under October 2011 | 15 investigation, including altering the capacity of mosquitos to host malaria parasites or other human pathogens. Improved diagnostics (Priority 1B) are also essential for controlling zoonotic and vectorborne diseases. CDC is helping to develop and validate field‐friendly diagnostic tests that can rapidly identify zoonotic diseases in humans and animals (e.g., plague, tularemia, anthrax, and monkeypox), expediting the delivery of treatment and prevention interventions. Priority 2B. Use proven tools and interventions to reduce high-burden infectious diseases CDC has initiated a series of targeted efforts that use known, effective strategies to achieve measurable results within a short period of time against diseases and conditions with high population impact. Termed Winnable Battles, these efforts target select domestic and global infectious diseases along with known causes of major chronic diseases and other health concerns. For domestic infectious diseases, these efforts include strategies to reduce HIV infections, HAIs, and foodborne diseases. These Winnable Battle actions and other priority infectious disease activities (Boxes 3 and 3.1) involve national strategies and multi‐level partnerships to reduce illness and death from high‐burden diseases, taking advantage of proven tools, scientific expertise, and field experience. Examples of these efforts include the following: • Vaccine‐preventable diseases Vaccines are our most effective and cost‐ saving tools for disease prevention. For each annual U.S. birth cohort vaccinated against 13 diseases in accordance with the recommended schedule from the Advisory Committee on Immunization Practices (ACIP), approximately 42,000 lives are saved, 20 million cases of disease are prevented, $13.6 billion in direct costs are saved, and $68.9 billion in direct plus indirect (societal) costs are saved.‡ Advancing the use of vaccines—including helping to ensure broad coverage, monitoring the impact and safety of vaccines, and communicating their efficacy and public health significance—is an important component of CDC’s infectious disease prevention efforts. Box 3.1 Infectious disease issues of special concern • Antimicrobial resistance • Chronic viral hepatitis • Food safety • Healthcare‐associated infections • HIV/AIDS • Respiratory infections • Safe water • Vaccine‐preventable diseases • Zoonotic and vectorborne diseases ‡ Preliminary results of updated analysis from Zhou F, Santoli J, Messonnier M, Yusuf H, Shefer A, Chu S, Rodewald L, Harpaz R. Economic evaluation of the 7‐vaccine routine childhood immunization schedule in the United States, 2001. Arch Pediatr Adolesc Med 2005;159:1136‐1144. 16 | CDC ID Framework As part of these efforts, CDC oversees the Vaccines for Children (VFC) program, working with federal partners, industry, and state and local health departments to help enable access to recommended vaccines for financially vulnerable children. Ongoing efforts to modernize the national infrastructure for vaccine delivery are supported by the Prevention and Public Health Fund of the 2010 Affordable Care Act. Particular aims are to expand access to childhood vaccines, especially in medically underserved communities, and to expand access to vaccines recommended for adolescents and adults, including vaccines against seasonal influenza, pneumococcal infections, pertussis, human papillomavirus (HPV), hepatitis B virus, and bacterial meningitis. In addition, these funds are supporting efforts to evaluate the introduction of new vaccines on disease burden—a key factor in understanding return on public health investments. Other improvements include upgrading state‐level immunization registries to make them