federal agencies to formulate evidence‐based policies that improve the nation’s health • Collaborating with partner organizations to increase public health actions and advance policies that promote health • Educating the public about the interconnected efforts needed to prevent and control infectious diseases, empowering them to improve and protect their health and that of their families. The fulfillment of 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. October 2011 | 5 Box 3. Infectious disease issues of special concern Antimicrobial resistance Antimicrobials are critical, life‐saving tools, yet their use contributes to a significant challenge in infection control: drug‐resistant pathogens. Patients infected with drug‐resistant microbes are more likely to require hospitalization, remain in the hospital longer, and have a poor prognosis. In the United States, antibiotic‐resistant infections are responsible for an estimated $20 billion in excess healthcare costs, $35 billion in societal costs, and 8 million additional hospital days. Combating antimicrobial resistance requires a multi‐faceted approach involving the efforts of patients, healthcare providers, industry, policy makers, and the public. CDC provides expertise in monitoring the effectiveness of current antibiotics and the emergence of resistant strains and works to advance broad collaborations to ensure appropriate use of antimicrobials in communities and healthcare settings. These efforts include providing leadership in the development and implementation of the 2011 public health action plan to combat antimicrobial resistance, which coordinates the activities of federal agencies for more effective and efficient actions to address this emerging threat. Chronic viral hepatitis An estimated 1.4 million persons in the United States are chronically infected with hepatitis B virus and 2.7–3.9 million with hepatitis C virus. Many of these people have “silent” infections and do not know that they are infected, increasing their risk for cirrhosis or liver cancer and for unknowingly transmitting infection. In 2011, HHS released a viral hepatitis action plan designed to improve prevention, increase identification and linkage to care among infected persons, and improve coordination of federal and partner efforts to reduce viral hepatitis. CDC is helping to lead and advance many of the actions described in the plan, including expanded educational campaigns to increase awareness of viral hepatitis, of risk factors and the need for testing, and of new treatment advances. Food safety An estimated 48 million foodborne illnesses occur in the United States each year, resulting in 128,000 hospitalizations and 3,000 deaths, with factors such as today’s global food supply and mass processing contributing to these events. Among its prevention activities, CDC tracks and investigates foodborne diseases in collaboration with state and local health departments and other partners, working to rapidly identify their sources and contain their spread. Vital to these efforts are CDC‐supported national networks of federal, state, and local laboratories that can detect and identify clusters of foodborne illness. CDC is also working to help advance the 2011 Food Safety Modernization Act—important legislation calling for new safety standards, expanded inspections and compliance, improved import safety, and increased surveillance of foodborne illness. Healthcare-associated infections HAIs are a leading preventable cause of illness and death in the United States, affecting approximately 5% of all hospitalized patients and resulting in significant healthcare costs. Demonstrated successes by CDC and public health partners in using concerted infection control practices to reduce HAIs have contributed to a number of healthcare quality improvement efforts, including increased roles for state health departments in HAI prevention. An example of these successes is the approximate 58% decline in central line‐associated bloodstream infections from 2001–2009, which saved an estimated 27,000 lives and $1.8 billion in medical costs. CDC is working to sustain and advance these HAI prevention efforts and helping to change HAIs from inevitable aspects of healthcare to rare, unacceptable events. HIV/AIDS Despite major advances in prevention and treatment, HIV infection remains a significant national and global public health challenge. In the United States, more than 1 million persons are living with HIV. An estimated one‐fifth of these individuals are unaware of their infection, precluding access to life‐saving treatment and important 6 | CDC ID Framework October 2011 | 7 prevention information to protect their partners. HIV prevention saves lives and healthcare costs: from 1991– 2006, HIV prevention efforts averted an estimated 350,000 U.S. infections, saving $125 billion in medical care costs. CDC is committed to advancing the National HIV/AIDS Strategy for the United States, with primary goals of 1) reducing HIV incidence; 2) increasing access to care and improving health outcomes for persons with HIV infection; and 3) reducing HIV-related health disparities. Respiratory infections Acute