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RECOMMENDATIONS

Recommendation 5.1 To advance the development of tuberculosis vaccines the committee recommends that the plans outlined in the Blueprint for Tuberculosis Vaccine Development, published by the National Institutes of Health (NIH) in 1998, be fully implemented.

Recommendation 5.2 To advance the development of diagnostic tests and new drugs for both latent infection and active disease, action plans should be developed and implemented. The Centers for Disease Control and Prevention (CDC) should then exploit its expertise in population-based research to evaluate and define the role of promising products.

Recommendation 5.3 To promote better understanding of patient and provider nonadherence with tuberculosis recommendations and guidelines a plan for a behavioral and social science research agenda should be developed and implemented.

Recommendation 5.4 To encourage private-sector product development, the global market for tuberculosis diagnostic tests, drugs, and vaccines should be better characterized and access to these markets for these new products should be facilitated.

Recommendation 5.5 To define the applicability of any new tools to the international arena and facilitate their development, the U.S. Agency for International Development (AID), NIH, and CDC should build upon international relationships and expertise to conduct research.

BACKGROUND AND INTRODUCTION

In 1989, the CDC Advisory Council for the Elimination of Tuberculosis (ACET) called for the development and evaluation of new technologies for tuberculosis diagnosis, treatment, and prevention and the rapid transfer of newly developed technologies into clinical and public health practice. The International Task Force echoed this sentiment for disease eradication and concluded in 1993 (Centers for Disease Control and Prevention, 1993) that tuberculosis could not be eradicated without better tests, treatments, case findings, and vaccines. In the years that have passed since these pronouncements, progress has been made on all of these fronts, but much remains to be done. This chapter reviews the current status and



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