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Recommendation 3.5 To promote a well-trained medical (in a broad sense) workforce and educated public, the committee recommends that

  • The Strategic Plan for Tuberculosis Training and Education, which contains the blueprint that addresses the training and educational needs for tuberculosis control, be fully funded.

  • Programs for the education of patients with tuberculosis be developed and funded.

  • Funding be provided for government, academic, and nongovernmental agencies to work in collaboration with international partners to develop training and educational materials.

BACKGROUND

The future of tuberculosis in the United States is dependent on not one but two competing races to elimination. The first is the race to reduce the incidence of tuberculosis by implementing measures to stop both transmission and reactivation of the disease. As the number of tuberculosis cases declines, however, only the very optimistic could believe that resources for tuberculosis control will, as a matter of course, be protected. Instead, a second race seems likely—one of elimination of local, state, and federal public health tuberculosis control resources by reallocation of those resources to competing priorities. Tuberculosis elimination is dependent on the results of this second race, with the best outcome being that it is never run. Strategies to that end include not only aggressive promotion of the vision of tuberculosis elimination but also continual adaptation and evolution of the tuberculosis control program response to an increasingly uncommon disease.

What factors should be considered to make this evolution of programs as productive as possible?

The key goals of a successful tuberculosis control program are not controversial. They have been well articulated by the Advisory Council for the Elimination of Tuberculosis and consist of the following:

1. Identify and treat individuals with active tuberculosis.

2. Find and test individuals who have had contact with tuberculosis patients to determine whether they are infected. If they are, provide appropriate treatment.

3. Screen populations at risk for infection to detect infected individuals and provide therapy to prevent progression.



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