The Future of the Public Health Laboratory

The widely quoted Institute of Medicine (10M) report, "The Future of Public Health" (9), only refers to the functions of the public health laboratory indirectly or in an historical context. The current role of the laboratory is not described, nor does the word "laboratory" appear in the index. And, a review of recent strategic planning documents prepared by officials of state and local public health agencies did not mention the public health laboratory. These findings are not unusual. Today's laboratory is too often taken for granted, in stark contrast to the public health laboratory of the early twentieth century. Pasteur described laboratories as the "temples of the future" r see the accompanying article by Valdiserri (14)]. In 1914, Charles Chapin wrote that "". the diagnostic laboratory is the most essential part of the machinery for the control of communicable disease." Public health laboratories still are essential for the control of communicable (and environmental) diseases. But, times have changed . . Public health laboratories long ago demonstrated the importance of clean food and water. Environmental microbiology testing has become routine. Vaccines are available for many communicable diseases, and more vaccines are on the way. Many antibiotics are available, although clinicians usually shoot first and ask questions only in the event of failure. Today, many competent laboratories operated by hospitals, universities, group medical practices, and private corporations offer wide-ranging services. Medical and