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CDC's reponse to Ending neglect: the elimination of tuberculosis from the United States
  • Published Date:
Filetype[PDF - 180.50 KB]

  • Corporate Authors:
    National Center for HIV, STD, and TB Prevention (U.S.), Division of Tuberculosis Elimination. ; Centers for Disease Control and Prevention (U.S.) ;
  • Document Type:
  • Description:
    Executive Summary -- -- Introduction -- Historical Perspective -- TB: A Preventable and Treatable Disease -- Cycles of Resurgence and Control -- Challenges to Elimination -- -- How to Eliminate TB? -- The IOM Report -- Maintain Control of TB -- Speed the Decline -- Develop New Tools -- Increase Involvement in Global Efforts -- Mobilize and Sustain Public Support -- Why Eliminate TB? -- Rationale for Elimination -- -- Who Will Lead? -- CDC's Response -- -- The Plan -- Goal I: Maintain control of TB -- Goal II: Accelerate the decline -- Goal III: Create new tools -- Goal IV: Reduce the global burden of TB -- Goal V: Summon and sustain support -- Goal VI: Track progress -- References

    "This document is CDC's response to the IOM's TB elimination challenge [as found in the 2000 Institute of Medicine report: Ending neglect: the elimination of tuberculosis in the United States." -- p. 6.

    "In collaboration with divisions in the National Center for Infectious Diseases, the Public Health Practice Program Office, and the National Institute for Occupational Safety and Health, the Division of Tuberculosis (TB) Elimination of the National Center for HIV, STD, and TB Prevention (NCHSTP), Centers for Disease Control and Prevention (CDC), is the functional equivalent of a national TB program in the United States. As such, CDC is the federal government's lead agency for TB prevention, control, and elimination. In 1989, CDC published A Strategic Plan for the Elimination of Tuberculosis in the United States. This plan had been developed by the Advisory Council for the Elimination of Tuberculosis (ACET) and proposed a national strategy for TB elimination by 2010. The implementation of this plan was set back by the TB resurgence that occurred in the late 1980s and early 1990s. This rekindling of TB disease was fueled by the onset of the human immunodeficiency virus (HIV) epidemic, increases in TB cases among foreign-born persons, outbreaks in congregate settings, and the appearance and transmission of deadly multidrugresistant (MDR) TB strains. These occurred at a time when decades of cuts in TB funding had resulted in the deterioration of TB control programs, and TB control officials had very few resources with which to fight back. CDC published the National Action Plan to Combat Multidrug-Resistant Tuberculosis in 1992 to complement the 1989 TB elimination document. A renewed downturn in TB incidence since 1993 points to the successful implementation of these national plans over the past decade. Unprecedented low rates of TB disease now provide a historic opportunity to accelerate the decline in TB morbidity and the drive toward elimination. This opportunity is threatened, however, by several converging factors: 1) the retreat of TB into high-risk populations at the margins of society where it can resist detection, 2) the persistence and growth of the global TB epidemic, 3) the limitations of current control measures and recognition of the need for new tests and treatments, plus an improved vaccine, and 4) changes in the health care system that make the current context for TB elimination very different from that of a decade ago. Given this altered landscape, in late 1998 CDC commissioned the Institute of Medicine (IOM) of the National Academy of Sciences to conduct a study and determine if TB elimination is still feasible as a national goal and, if so, to provide recommendations on how to make that goal a reality. The resulting report, Ending Neglect: The Elimination of Tuberculosis in the United States, concluded that TB elimination in the United States is indeed feasible but will require 'aggressive and decisive action beyond what is now in effect.' To break the 'cycle of neglect' that has characterized U.S. tuberculosis control efforts, the report recommended an aggressive strategy to 1) maintain control of TB, 2) speed the decline in TB incidence, 3) develop new tools for TB diagnosis, treatment, and prevention, 4) increase U.S. efforts to help fight the global epidemic, and 5) mobilize and sustain public support for TB elimination and track progress." - p. 5

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