Pathogens Determined to Attack Inside the United States.

In June 1996, President Clinton issued a Presidential Decision Directive calling for a more focused US policy on infectious diseases. The intelligence community of the United States is responsible for assessing threats to the United States and in 1999, as part of the US Government's effort in response to the Presidential Directive, produced a report entitled 'The Global Infectious Disease Threat and its Implications for the United States.'

It examines the most lethal diseases globally and by region; develops alternative scenarios about their future course; examines national and international capacities to deal with them; and assesses their national and global social, economic, political, and security impact. It then assesses the infectious disease threat from international sources to the United States; to US military personnel overseas; and to regions in which the United States has or may develop significant equities.

The report was produced by members of the Armed Forces Medical Intelligence Center, the National Intelligence Council and included conclusions from a conference on infectious diseases held jointly with the State Department's Bureau of Intelligence and Research.

You can find it at the CIA webpage as a pdf file but more easily accessible html versions are available.

The conclusions are not optimistic.