Incorporating appropriate technology into North American schools of public health.

The major discoveries in bacteriology during the last half of the 19th century and the promise of their application to sanitation and public health practice helped to stimulate the founding of the first generation of schools of public health in North America (1, 2). Sometimes referred to as the " West Points of Public Health, " these schools at Johns Hopkins, Harvard, Columbia, Yale, Michigan, and Toronto shared an important mission: to apply new advances in laboratory sciences towards the development of new technologies for disease control (1, 2). The activities of these schools during the 20th century resulted in a number of landmark achievements, including the discovery of vitamins A and D, which led to the elimination of rickets and other pediatric diseases, a reliable formula for chlorinating water to make it safe to drink, tissue culture technology for the development of rubella and other vaccines, the isolation of human immunodeficiency viruses HIV-1 and HIV-2, cytomegalovirus and numerous arboviruses, and the clinical evaluation of inactivated polio vaccine (3, 4). Over the last two decades, however, the schools of public health in the United States have increasingly moved away from technology, particularly as it relates to infectious disease control and prevention in developing countries. With the exception of the University at Albany (State University of New York), none of the U.S. schools of public health that have come into existence after 1980 have departments grounded in microbiology or related laboratory sciences (1, 5). Instead, these new schools of public health focus heavily on areas that interface with the social sciences, such as health services policy and management, health promotion , occupational health, communication sciences, and exercise sciences. Only eight of the 33 accredited schools of public health in the United States host departments of microbiology or infectious diseases , and all but six of these departments are housed in schools founded before 1950 (1, 5). Ironically , these reductions in microbiology training opportunities in public health schools coincided with the emergence or re-emergence of polio, severe acute respiratory syndrome (SARS), West Nile virus, and other infections.