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Federal Tuberculosis Task Force Plan in Response to the Institute of Medicine Report, Ending Neglect: The Elimination of Tuberculosis in the United States

Chronology in the Development of This Report

In responding to the IOM report, members of the Federal TB Task Force met to develop a coordinated federal action plan. Two meetings were convened in Bethesda, Maryland (on December 6-7, 2000, and February 8-9, 2001), to initiate the development of this plan. At the December 6-7 TB Task Force meeting, each agency provided a summary of its TB-associated activities as they relate to the IOM reportís recommendations. Then, using facilitated breakout workgroups made up of scientific and program experts, the participants drafted action steps to be included in a federal action plan response to the IOM recommendations. Participants agreed to initially focus on the first three (of five) broad recommendations of the IOM report that were considered amenable to federal activity:

  1. Maintaining control of TB
  2. Accelerating the TB decline
  3. Developing new tools

Three breakout groups were organized according to participant areas of interest and expertise: 1) services, financing, and quality; 2) targeted testing and treatment of latent TB infection; and 3) needed research. The groups considered topics in the context of the three IOM recommendations and the following related issues: 1) defining the necessary federal activities related to these areas; 2) determining which agencies should take the lead in developing and implementing the identified activities; and 3) determining which agencies should be involved as collaborators in developing and implementing these activities. The breakout groups developed a comprehensive series of recommended activities for the federal government to undertake. At the February 8-9 meeting, the TB Task Force representatives further developed the recommended activities, and assigned a priority to each of them. A consensus was reached in determining the lead agencies and collaborating agencies for each activity. Common activities and themes became obvious in many of the recommendations of the separate breakout groups. Following the meeting, individual recommendations revolving around common activities were consolidated, and a consensus was reached on the resulting list by circulating drafts to the entire task force.

In the next step, lead individuals were identified for the lead agencies. These persons worked with named co-leads and collaborating agencies to further develop the strategies by adding additional action steps where they were deemed necessary to implement the strategies. Subsequent drafts of the entire document were shared with the Federal TB Task Force participants who provided comments, where appropriate, for the next draft. The final draft was discussed at a Federal TB Task Force conference call in late August 2001, during which remaining issues were resolved. This was followed by a series of additional participant reviews accomplished by circulation of the drafts to participants. Because of the unusual multiagency nature of this document, it went through high-level multiagency clearance before publication.

The names of participating representatives of TB Task Force federal agencies and organizations are included in the fourth chapter of this report. The agencies represented include (1) agencies of the Department of Health and Human Services: the Office of Minority Health of the Public Health Service (OMH/PHS), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Health Care Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the National Institutes of Health (NIH), Regional Health Administrators (RHAs), and the Substance Abuse and Mental Health Services Administration (SAMHSA); (2) other Federal agencies: the Department of Veterans Affairs (VA), the Federal Bureau of Prisons (FBOP), the U.S. Marshals Service, the Office of HIV/AIDS Housing in the Department of Housing and Urban Development (HUD); the Office of Occupational Medicine, Occupational Safety and Health Administration (OSHA), the U.S. Agency for International Development (USAID); the Immigration and Naturalization Service (INS),1 the Department of State (DOS); the CDC Advisory Council for the Elimination of Tuberculosis (ACET); and (3) the American Lung Association and the National TB Controllers Association (NTCA).

This report is organized with reference to the major IOM recommendation areas with acknowledgment of potential overlap in the impact of some activities (e.g., improved education to health care providers and to patients will both improve control of the current TB burden and accelerate the decline of the disease).

Note: The following outline lists the specific IOM recommendations followed by the related proposed strategies and action steps, as well as the lead and collaborating agencies.

1 INS functions are now subsumed by the Department of Homeland Security, Directorate of Border and Transportation Security, Bureau of Immigration and Customs Enforcement.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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