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Key messages from this report are that even though tuberculosis is in decline, pressure to eliminate the disease needs to be increased or there will be a resurgence as there has been in the past. Issues to be addressed by the policy makers, as abstracted from the recommendations include:

  • Adequate funding needs to be maintained (categorical at the federal level) and adjusted for inflation.

  • State regulations mandating the completion of treatment need to be kept current.

  • Regionalizing activities and using contracts with the private sector where this will enhance delivery of services.

  • Providing educational resources to maintain excellence in tuberculosis services.

  • Increasing resources for the prevention of tuberculosis through programs of targeted screening and treatment of latent infection, including enhanced programs focused on contacts to infectious cases, newly arriving immigrants from countries with high rates of tuberculosis, and residents of correctional facilities and other congregate settings.

  • Increasing resources for research especially for the development of new diagnostic tools and treatments for latent infection and the development of a vaccine to prevent infection.

  • Increasing involvement in support of global tuberculosis control through multilateral and bilateral agreements.

As has been demonstrated in the past century of control efforts, social mobilization is critical to sustaining tuberculosis control programs. Moreover, the tuberculosis control community must pay as much attention to social mobilization efforts it pays to the technical, medical, and scientific issues.

REFERENCES

    Centers for Disease Control and Prevention . 1989 . A strategic plan for the elimination of tuberculosis in the United States . Morbid Mortal Weekly Rep 38(S-3) : 1–25 .

    Centers for Disease Control and Prevention . 1999 . Tuberculosis elimination revisited: Obstacles, opportunities and a renewed commitment . Morbid Mortal Weekly Rep 48(RR-9) : 1–13 .

    Shyrock, R.H. 1957 . National Tuberculosis Association: 1904–1954 . New York : National Tuberculosis Association .

    World Health Organization Global Tuberculosis Program . 1998 . Report of the ad hoc committee on the tuberculosis epidemic, 17–19 March, 1998, London .



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