Our Centre was established to assist with the WHO global program in the area of non-communicable diseases. The Centre began in 1986, focusing on insulin-dependent diabetes mellitus (IDDM). We helped to develop and coordinate the WHO Multinational Project for Childhood Diabetes, known as Diabetes Mondiale (DiaMond), which involves 150 centres in 70 countries. The Project is designed to monitor the incidence of childhood diabetes world-wide to the year 2 000 with the establishment of population-based registries, and includes molecular epidemiology studies of the risk factors for IDDM, mortality and economic studies of the impact of childhood diabetes, and short and long-term training in diabetes epidemiol ogy. In
recent years the work has developed along two exciting, parallel, directions, that of global disease telemonitoring, directed by Dr. LaPorte, and molecular epidemiology and
DNA technology transfer, directed by Dr. Dorman.

Telecommunications and Disease Monitoring
Director: Ronald E. LaPorte, Ph.D.

Much of local and global health involves information transfer and the monitoring of local health conditions for allocation of health resources. Since 1990 we have been establishing a Global Health Network (GHNet). The GHNet consists of the establishment of interconnectivity among all public health people world wide, the development of a telecommunications backbone to a disease monitoring system which will assess the frequency both communicable and non-communicable diseases, the development of aglobal health network university (a meta university) and networking of all health related non-government organizations. The global health network system is being developed in conjunction with individuals from PAHO, WHO, NASA, the World Bank, US Foreign AID, IBM, Digital plus several other agencies. With the Global Health Network it will be possible for public health officials and researchers from even the remotest areas across the world to exchange information and data. The telecommunications system will permit almost daily updates of health at the local to global level, and students will be able to inexpensively take classes from leading teachers half a world away. We are beginning pilot studies of this effort in South Korea and Chile.

Molecular Epidemiology and DNA Technology Transfer
Director: Janice S. Dorman, Ph.D.

Molecular epidemiology has recently been defined as "a science that focuses on the contribution of potential genetic and environmental risk factors, identified at the molecular level, to the etiology, distribution and prevention of disease within families and across populations". This new field has recently emerged from the integration of molecular biology into traditional epidemiologic research. The objectives of molecular epidemiology include: 1) descriptive and analytical studies to evaluate host/environmental interactions in disease, 2) the development of prevention strategies for the control of bacterial, parasitic and viral disorders through molecular diagnosis, and 3) the prevention of non-communicable diseases and genetic disorders by assessing risk and identifying susceptible individuals through genetic screening.

As yet, few countries are involved in molecular epidemiology due to a lack of trained molecular epidemiologists and limited access to advanced biotechnology for epidemiology and public health practice. Thus the International Molecular Epidemiology Task Force (IMETAF) was recently established and is being coordinated at this WHO Collaborating Centre. Its mission is to: 1) facilitate the development and implementation of programs in molecular epidemiology in all regions of the world, and 2) promote advanced biotechnology transfer for scientific research and its integration into epidemiology, medicine and public health for disease prevention. Each participating country is establishing a National Scientific Committee with Government Advisors to assure that the activities related to the development of molecular epidemiology are integrated with other national health programs and contribute towards the establishment of appropriate health policy. Sci entific committees in Argentina, China, and Mexico have been formally established. Other countries in Africa, Asia, and Latin America are planning to join this initiative. Although each molecular epidemiology program is unique, common international objectives are addressed. These include an assessment of health problems which may be improved through molecular
epidemiology, an analyses of the nation's state-of-the-art in epidemiology and molecular biology, the development of multidisciplinary collaborative networks, tra ining programs, disease-specific projects, and the transfer of advanced biotechnology and epidemiology.

International Collaborative Efforts