A Strategic plan for the elimination of tuberculosis in the United States
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A Strategic plan for the elimination of tuberculosis in the United States

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    In 1987, the Secretary of the U.S. Department of Health and Human Services established an Advisory Committee for Elimination of Tuberculosis to provide recommendations for developing new technology, applying prevention and control methods, and managing state and local tuberculosis programs targeted at eliminating tuberculosis as a public health problem. After review and feedback from numerous interested people and organizations, this plan was completed. The committee urges the nation to establish the goal of tuberculosis elimination (a case rate of less than one per million population) by the year 2010, with an interim target of a case rate of 3.5 per 100,000 population by the year 2000. The U.S. case rate for 1987 was 9.3 per 100,000. Three factors make this a realistic goal: 1) tuberculosis is retreating into geographically and demographically defined pockets; 2) biotechnology now has the potential for generating better diagnostic, treatment, and prevention modalities; and 3) computer, telecommunications, and other technologies can enhance technology transfer. Therefore, a three-step plan of action was developed: more effective use of existing prevention and control methods, especially in high-risk populations; the development and evaluation of new technologies for treatment, diagnosis, and prevention; the rapid assessment and transfer of newly developed technologies into clinical and public health practice. The committee brings this plan to the attention of the medical community and the public to stimulate positive, constructive discussion and action, to increase the public's level of awareness of tuberculosis, and to encourage a commitment to the elimination of tuberculosis. In the past, the United States has spent hundreds of millions of dollars annually on tuberculosis treatment and control activities. Unless alternative action is taken, large and unnecessary expenditures will continue indefinitely. Expenditures on tuberculosis treatment may increase over the next few years because of high morbidity rates among people infected with the human immunodeficiency virus (HIV), the homeless, the foreign-born, the elderly, and various minority groups. Furthermore, tuberculosis has the potential for spreading more widely in the community. The mission of all tuberculosis control programs should now be to eliminate this disease by the year 2010. Strategies for eliminating tuberculosis are set out in this document. These strategies are based on the needs and responsibilites of the various groups of people involved in this effort (Appendix). The committee realizes the task will not be an easy one; it will require considerable commitment at all levels. The challenge to carry out this plan is a test of our willingness and ability as a society to respond to a very serious health problem that disproportionately affects its disenfranchised members. A great nation such as ours can carry out this plan. It is time to commit to a tuberculosis-free society!
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    Includes bibliographical references (p. 20-21).
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    2495432
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