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federal health agencies with activities in this area. The Secretary needs to charge these agencies to develop and implement the public sector components of the proposed national system and to provide these agencies with sufficient resources to do so. From a technical expertise and program implementation perspective, the CDC is the appropriate agency to provide national leadership in many aspects of STD prevention. The leadership of the Department of Health and Human Services, especially the CDC, must give higher priority to STD prevention programs. For example, in its fiscal year 1997 budget proposal to Congress,2 the administration requested reduced funding for STD prevention at a time when the CDC lacks the capacity to adequately provide technical assistance to states. Other health agencies, such as the National Institutes of Health, the Health Resources and Services Administration, the Health Care Financing Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Health Care Policy and Research, the Food and Drug Administration, and the Indian Health Service, also need to assume leadership roles in their areas of responsibility. The Department of Health and Human Services needs to ensure that the agencies within its purview collaboratively provide bold innovative standards, guidance, technical assistance, and resources to state and local health departments and appropriate community-based organizations.
Therefore, the committee makes the following recommendation:
Federal government efforts in STD prevention, under the leadership of the Secretary of Health and Human Services, should:
provide guidance for STD-related clinical services and provide guidance and financial and technical assistance to states and local communities for STD prevention programs;
develop scientifically based standards for STD-related services, including clinical services, such as screening and counseling, diagnosis and treatment, laboratory services, and prevention programs; such standards should be sufficiently flexible and applicable to all states and communities and to all types of practitioners and programs that provide STD-related care;
develop and coordinate a comprehensive national surveillance system that collects STD-related data from public, private, and community-based providers and programs;
ensure that high-quality STD-related services, including all supporting disease prevention activities, and effective community-based prevention programs are coordinated and integrated as appropriate and are available and accessible to every person, regardless of insurance status, income, state of residence, or urban or rural location;
The Budget of the United States Government Fiscal Year 1997.