to help integrate clinical infectious disease preventive practices into U.S. healthcare; increase community and individual engagement in disease prevention efforts; strengthen global capacity to detect and respond to outbreaks with the potential to cross borders; address microbial drug resistance; and promote “One Health” approaches to prevent emergence and spread of zoonotic diseases Partnerships and implementation Achieving CDC’s vision of a strong, vigilant U.S. public health system—ready and able to prevent and control endemic diseases and respond to new and emerging threats— requires the sustained, coordinated, and complementary efforts of many individuals and groups. The ID Framework is designed to advance these efforts, optimally used in multiple capacities such as • Working with state and local health departments to sustain and upgrade public health fundamentals and address priority infectious disease issues • Coordinating with public health, healthcare, and other partners to increase actions and to formulate and advance policies that improve the nation’s health • Helping community leaders and businesses to improve local response readiness • Educating the public about the interconnected efforts needed to prevent and control infectious diseases and their role in protecting health INTRODUCTION Infectious diseases are a leading cause of illness and death throughout the world. The enormous diversity of microbes combined with their ability to evolve and adapt to changing populations, environments, practices, and technologies creates ongoing threats to health and continually challenges our ability to prevent and control disease. In low‐income countries, the impact of infectious diseases is often devastating— decreasing survival rates, particularly among children, and impeding opportunities for economic growth and development. In more developed countries, infectious diseases also continue to present significant health and economic concerns. In the United States, examples of major infectious disease challenges include human immunodeficiency virus (HIV), which continues to newly infect approximately 50,000 Americans (and millions globally) each year; healthcare‐ associated infections (HAIs), a leading preventable cause of death; chronic viral infections, causing cancers of the liver and cervix; and drug‐resistant pathogens, a major cause of severe and untreatable infections. Additional concerns include the emergence of new diseases such as the novel 2009 H1N1 influenza virus, the resurgence of “old” diseases in new locations, and local and multi‐ state outbreaks of foodborne diseases. Other recent examples include a resurgence of local dengue fever in Florida, a resurgence of pertussis in California that sickened infants too young to be vaccinated, and an outbreak of diarrheal disease caused by Salmonella‐ infected eggs sold throughout the country. These disease problems—endemic, new, and resurgent—cause immense suffering and death and impose enormous financial burdens on society. A CDC Framework for Preventing Infectious Diseases: Sustaining the Essentials and Innovating for the Future—CDC’s ID Framework—was developed to provide a roadmap for improving our ability to prevent known infectious diseases and to recognize and control rare, highly dangerous, and newly emerging threats, through a strengthened, adaptable, and multi‐purpose U.S. public health system. The document was prepared by CDC’s Office of Infectious Diseases, Influenza Coordination Unit (ICU), and infectious disease national centers,* with assistance from other CDC organizational units† and input from other public and private sector experts and partner organizations. Although its primary purpose is to guide CDC’s infectious disease activities, the document is also designed to guide collective public health action at a time of resource constraints and difficult decisions, while advancing opportunities to improve the nation’s health through new ideas, partnerships, technical innovations, validated tools, and evidence‐based policies. Meeting challenges and pursuing opportunities in a new public health environment Today’s infectious disease challenges are broader and more complex than they were in 1998, when CDC last issued a comprehensive * The National Center for Emerging and Zoonotic Infectious Diseases; the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; and the National Center for Immunization and Respiratory Diseases. † The Center for Global Health; the Office of Science, Epidemiology and Laboratory Services; the Office for State, Tribal, Local and Territorial Support; and the National Institute for Occupational Safety and Health. October 2011 | 1 Box 1. Examples of infectious disease threats, unusual health events, and newly discovered pathogens, worldwide, 2000–2011 2000 Outbreak of Rift Valley fever in Saudi Arabia and Yemen, representing the first reported cases of the disease outside the African continent 2000 First detection of carbapenem resistance among the common gram‐negative bacteria Enterobacteriaceae (Klebsiella pneumoniae) 2001 Intentionally caused anthrax in the United States 2001 Identification in the Netherlands of a new virus, human metapneumovirus, among children with