world requires funding for studying the factors involved in infectious
diseases and their spread, alleviating suffering, and preventing disease
where possible. Much of the money spent in the United States to fight
infectious diseases is Federal money, allocated through well-established
and closely monitored agencies and programs. Some of the money,
however, is private money, made available through the beneficence
of private foundations and individual donors.
Whether the money is public or private, someone, somewhere, has to decide
how to allocate it: to whom it will be given and why, and how it will be
spent and where and when. These decisions are not easy. Frequently, they
are made by carefully considering many competing requests for funds, and
the decisions reflect the degree to which, in the minds of reviewers, the
requests meet the funding criteria established for use of the money.
In this lesson, students consider three proposals for spending $5 million
that a private foundation has made available to combat infectious diseases.
Each proposal addresses a different infectious disease (AIDS; measles;
and vancomycin-resistant Staphylococcus aureus, or VRSA) and proposes
different actions. Students use three reference databases to learn about each
disease and evaluate the proposals on the basis of two criteria: magnitude
(how important it is that the situation described in the proposal be
addressed now) and effectiveness (how likely it is that the proposed project
will address the situation successfully). Finally, students recommend which
proposal to fund, provide reasons for their recommendations, and discuss
differences in their evaluations as a way to understand how complex such
decisions can be.
In Advance
Photocopies and Transparencies
Equipment and Materials
• 1 copy per student for the
• 1 overhead projector
print-based version only of
• (Optional) Computers with
Masters 5.1, 5.2, 5.3, 5.4
access to the Internet
• 1 copy per student of Masters
5.5 and 5.6
• 1 transparency of Master 5.7
102
1. Introduce the lesson by saying something like, “We’ve been studying
Procedure
infectious diseases and the reasons why ‘new’ diseases are emerging
and ‘old’ ones are re-emerging. What are some of those reasons? What
steps can we take to avoid disease emergence and re-emergence? How
can research contribute to better ways to control infectious diseases?”
Reasons for disease emergence and re-emergence developed in the
previous lessons include environmental changes, indiscriminate use
of antibiotics, and failure to vaccinate populations. Steps that can be
taken to avoid disease emergence and re-emergence include carefully
considering the impact of development in wilderness areas and being
This is an opportunity
alert to the possibility of pathogens having access to a new and/or
for students to review
larger host population, avoiding unnecessary uses of antibiotics, and
what they learned in the
increasing efforts to enforce vaccination. Research can help us develop
previous activities and
better ways to recognize and understand new pathogens, create new or
for you to assess their
improved antimicrobial drugs to prevent or treat infection, develop new
vaccines to protect individuals and the population, and discover new
understanding infor mally.
ways to prevent transmission of infection.
For a more formal
assessment of student
2. Continue the discussion by saying something like, “Fighting infectious understanding, ask diseases requires money as well as knowledge. There is a limit, though,
stu dents to write
to the money available for this. How do people decide where to invest
individ ual responses
money in fighting infectious diseases?” Entertain some answers, then
explain that in this activity, students will consider proposals to fight
to the questions.
three different diseases, investigate each of these diseases, and
recommend one proposal to fund. Indicate that their recommendations
will be based on two criteria, magnitude and effectiveness, which will
be described in the activity. Their recommendations must also include
reasons for funding one proposal but not the other two.
In the first scenario (see Step 3), the representative of the funding
agency explains that students’ recommendations are to be based on
the criteria of magnitude and effectiveness, and gives examples of
the questions that students must answer to determine the magnitude
of each situation and how effective the proposed plan is likely to be.
Those and additional questions related to magnitude and effectiveness
also appear on Master 5.5, Proposal Criteria Matrix.
You may want to indicate to students that there are valid reasons for
recommending each proposal. Explain that this activity is like “real
life” in that we frequently have to make difficult choices among several
“good” options (or among several “bad” options).
Magnitude of the problem and effectiveness of the proposed approach
are two criteria that are typically applied in making decisions about a
plan to address a societal problem. With regard to infectious disease,
magnitude refers to the current burden of illness, as well as the potential
for this burden to increase in the future. Effectiveness refers to how well
the proposal will alleviate the serious consequences of the disease.
103
Student Lesson 5
Emerging and Re-emerging Infectious Diseases
A third criterion—means—is often used to make decisions about
plans to address societal problems. Means refers to how well we can
accomplish the actions described in the plan. For example, proposing
that we spend money to distribute a “cure” for AIDS is not realistic
because no cure is available at this time. In this activity, students
consider means as part of their evaluation of the second criterion,
effectiveness. That is, if a group judges a proposed project to have
high “effectiveness,” the group believes there are means available to
accomplish it.
Most funding agencies have an established review process and
evaluation criteria for proposals submitted to them. NIH uses a peer-
review system, that is, external scientists familiar with the health
Basic research has
issues, tech niques, and research models in the proposals review and
make recommendations about the scientific merit of the proposals.
con tributed to the public
NIH specifies five major criteria for evaluation of proposals: significance
health management of all
(similar to the criterion of magnitude in the activity), approach (similar
three of these dis eases.
to effectiveness), innovation, experience of the principal investigator(s),
Research on the measles
and institutional support for the project.
virus in the 1950s and
1960s led to the
Step 3 for classes with access to the Internet
development of a vaccine
3. Organize students into their groups and direct them
to prevent the disease.
to watch the video segments “Foundation Officer”,
Research into HIV
“Proposal 1”, “Proposal 2”, and “Proposal 3” on the Web site
replication revealed
( http://science.education.nih.gov/diseases/activities/lesson5). Then, have vulnerable points in its
them begin their research using the databases on the Web site. Tell
infectious cycle, leading
the groups that they have 30 minutes to complete their work.
to the proteases now
used to increase both the
Step 3 for classes without access to the Internet
quality and the length
3. Organize students into their groups. Give each student
of life for those who are
one copy of Master 5.1, The Proposals. Give each group
HIV-positive. Research
one copy each of Masters 5.2, 5.3, and 5.4, Reference Databases.
demonstrating that
Direct them to read Master 5.1 and then proceed directly into their
antimicrobial-resistance
research using the information provided in the reference databases.
genes can be passed from
Tell the groups that they have 30 minutes to complete their work.
one bacterial species to
4. Distribute Master 5.5, Proposal Criteria Matrix, and Master 5.6,
another alerted health
Proposal Summary Matrix, as students begin their work. Tell them
officials to the need for
that at the end of the 30 minutes, each group should be prepared to
increased surveillance for
announce its recommendation and explain its rationale to the class.
resistant pathogens and
rein forced the need to use
While the student groups are conducting their research, move among
antimicrobials prudently
them to make sure they understand each situation and the questions
and to conduct research
they are to answer. For example, ask them what each group of
applicants proposes to do (AIDS applicants: produce and distribute
to develop new, more
drugs to HIV-positive individuals; measles applicants: produce and
effective drugs.
distribute vaccine to susceptible people around the world; VRSA
applicants: develop new drug therapies against Staphylococcus aureus).
104
5. Ask each group to identify a spokesperson to tell the class which
proposal the group recommends and the reason it selected that
proposal. As the groups report their decisions, tally the number
recommending each proposal.
6. Invite students to look at the results of the tally and ask them if
they can explain the differences, considering that each group
worked with the same information.
Students may respond with comments such as, “We thought that, even
if the plan had problems, AIDS is so terrible that we should support
any plan that could possibly help,” or “We thought that the measles
plan had a pretty sure chance of working, whereas the others weren’t
as likely to be effective.” Encourage this kind of discussion and point
out that some groups gave more weight to the magnitude criterion and
others gave more weight to the effectiveness criterion.
If all groups recommended the same proposal, tell them that other
evaluators may well have recommended different proposals. Give them
some possible rationales for those recommendations and ask them what
explanation they can give for the different choices.
7. Display a transparency made from Master 5.7, Reflection Questions,
and ask each group to work together to list as many responses to
each question as they can. Conclude the lesson by asking each
group to give one of its answers and list it on the transparency.
Step 7 addresses
Question 1. How did understanding the biology of infectious dis eases
the activity’s major
help you make your decision?
concept. Students
should under stand that
Students may indicate that understanding how natural selection leads
making policy decisions
to the evolution of antibiotic-resistant bacteria helped them evaluate
about spend ing money
the likelihood of the emergence of VRSA, or that under standing herd
immunity helped them assess the effectiveness of a vaccination program to combat infectious to eliminate measles.
diseases is complex and
there is typically no one
Question 2. What else did you consider in making your decisions?
“right” decision. Students
also should recognize
Students may say that they felt it was important to consider the num ber
that understanding the
of people affected by the disease, or the impact the disease would have
on the families of the victims (for example, “AIDS orphans”) or on the
biol ogy underlying such
countries where the victims live (for example, the loss of pro ductivity
dis eases can help inform
due to illness and death of AIDS victims in their prime working years).
the decisions that
ultimately are made.
105
Student Lesson 5
Emerging and Re-emerging Infectious Diseases
Lesson 5 Organizer
What the Teacher Does
Procedure
Reference
Tell students, “We’ve been studying infectious diseases and the
Page 103
reasons why ‘new’ diseases are emerging and ‘old’ ones are
Step 1
re-emerging.” Ask the class
• What are some of those reasons?
• What steps can we take to avoid disease emergence and
re-emergence?
• How can research contribute to better ways to control infectious
diseases?
Say something like this: “Fighting infectious diseases requires
Page 103
money as well as knowledge. There is a limit, though, to the money Step 2
available for this. How do people decide where to invest money in
fighting infectious diseases?”
Explain that students will now
Page 103
• consider proposals to fight three different diseases,
Step 2
• investigate the three diseases, and
• recommend one proposal to fund.
Tell them to base their choice on two criteria—magnitude and
effectiveness—and to include reasons for their choice (compared
with the other two proposals).
For classes with Internet access (preferred) Step 3
Page 104
Organize students into groups and have them watch these videos
Web
on the Web site: Foundation Officer, Proposal 1, Proposal 2, and
Step 3
Proposal 3. After that, have them use the databases on the Web site
to do their research.
For classes without Internet access, Step 3
Page 104
Organize students into groups. Give each student a copy of
Master 5.1 and each group one copy each of Masters 5.2, 5.3, and
Step 3
5.4, Reference Databases. Ask them to read Master 5.1 and then start their research using the reference databases.
Give each student one copy each of Masters 5.5 and 5.6. Tell them
Page 104
to be prepared to share their group’s recommendation and rationale Step 4
with the class.
106
What the Teacher Does
Procedure
Reference
Ask groups to pick a spokesperson to tell the class which proposal
Page 105
they are recommending and why. Tally the number of groups
Step 5
recommending each proposal.
Ask the class if they can explain why groups may have reached
Page 105
different decisions about the proposals even though they were all
Step 6
using the same information.
Display Master 5.7 and ask students to work with their groups to
Page 105
list as many responses as they can. Conclude the lesson by asking
Step 7
each group to give one of their answers. Write responses on the
transparency.
Note: Shaded text highlights the steps for classes with access to the Internet.
= For classes without access to the Internet.
= Involves copying a master.
= Involves making a transparency.
= Involves using the Internet.
107
Student Lesson 5
Masters
Lesson 1, Deadly Disease among Us
Master 1.1, Causes of Death Quiz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . transparency Master 1.2, Disease Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . classroom set Master 1.3, Disease Classifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . transparency Lesson 2, Disease Detectives
Master 2.1, Three Mysterious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 2.2, Documents from Physician’s Investigation File . . . . . . . . . . . . . . . . . . . . . . . classroom sets Master 2.3, Documents from Laboratory Scientist’s Investigation File. . . . . . . . . . . . . . . classroom sets Master 2.4, Documents from Field Researcher’s Investigation File. . . . . . . . . . . . . . . . . . classroom sets Master 2.5, Notes from the Physician’s Investigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .group copies Master 2.6, Notes from the Laboratory Scientist’s Investigation . . . . . . . . . . . . . . . . . . . . .group copies Master 2.7, Notes from the Field Researcher’s Investigation. . . . . . . . . . . . . . . . . . . . . . . . .group copies Master 2.8, Mystery Disease 1 Final Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .group copies Master 2.9, Mystery Disease 2 Final Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .group copies Master 2.10, Mystery Disease 3 Final Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .group copies Master 2.11, Mystery Diseases Summary Table . . . . . . . . . . . . . . . . .student copies and transparency Lesson 3, Superbugs: An Evolving Concern
Master 3.1, Bacterial Growth Experiment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 3.2, Discussion Questions for the Bacterial Growth Experiment . . . . . . . . . . . . . student copies Master 3.3, Debi’s Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies (print version only) Master 3.4, Debi’s Story: Explaining What Happened . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 3.5, Antibiotic Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .group copies Lesson 4, Protecting the Herd
Master 4.1, Measles Outbreak at Western High. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 4.2, A Little Sleuthing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 4.3, Following an Epidemic. . . . . . . . . . . . . . . . . . . . . . . . . student copies and transparencies Master 4.4, Disease-Transmission-Simulation Record . . . . . . . . . . . . . . . . . . .student copies (optional) Master 4.5, Characteristics of Smallpox, Polio, and Measles . . . . . . . . . . . . . . . transparency (optional) Master 4.6, Cases of Smallpox in Niger and Bangladesh . . . . . . . . . . . . . . . . . . transparency (optional) Lesson 5, Making Hard Decisions
Master 5.1, The Proposals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies (print version only) Master 5.2, Reference Database—AIDS . . . . . . . . . . . . . . . . . . . . . student copies (print version only) Master 5.3, Reference Database—Measles . . . . . . . . . . . . . . . . . . . student copies (print version only) Master 5.4, Reference Database—VRSA . . . . . . . . . . . . . . . . . . . . . student copies (print version only) Master 5.5, Proposal Criteria Matrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 5.6, Proposal Summary Matrix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . student copies Master 5.7, Reflection Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . transparency 109
Causes of Death Quiz
1. Which of the following diseases has been recognized since antiquity?
a. AIDS
b. Ebola hemorrhagic fever
c. guinea worm disease
d. Legionnaire’s disease
2. In the 1700s and 1800s, a terrible, wasting disease killed thousands of European and American city dwellers. What disease was this?
a. AIDS
b. lung cancer
c. polio
d. tuberculosis
3. What infectious disease causing severe fever and chills plagued settlers in the
Southern and Midwestern United States during the 1800s and early 1900s?
a. Legionnaire’s disease
b. Lyme disease
c. malaria
d. schistosomiasis
4. Most deaths among U.S. servicemen in 1918 were due to what cause?
a. automobile accidents
b. flu
c. injuries sustained on the battlefields of World War I
d. plague
5. In 1994, a terrible disease nearly killed an 18-year-old high school student in
California. Which of the following diseases was it?
a. AIDS
b. breast cancer
c. cystic fibrosis
d. tuberculosis
6. According to the World Health Organization, which of the following diseases caused
the most deaths in 2008?
a. AIDS
b. diabetes
c. heart disease
d. pneumonia
Master 1.1a
Copyright © 1999 by BSCS and Videodiscovery, Inc. Permission granted for classroom use. Updated 2012.
Disease Cards
Acquired Immunodeficiency Syndrome (AIDS)
Infectious Agent: