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TB Notes 1, 2000
Field Services Activities
by Patricia M. Simone, MD
Chief, Field Services Branch
In the early 1960s, with the initiation of categorical project
grants, the Tuberculosis Branch moved to Atlanta to join CDC, called
then the Communicable Disease Center. In 1974, the Tuberculosis
Branch became the Division of Tuberculosis Control with two branches:
the Program Services Branch (which also contained training and surveillance)
and the Research Branch. In 1986, surveillance became a separate
branch. The Program Services Branch was reorganized into two sections:
the Program Operations Section and the Program Support Section.
The Program Operations Section was responsible for providing technical
assistance and administering cooperative agreement funding to the
state and local TB programs. A team of program consultants served
as project officers for the project sites, and field staff were
assigned to various state and local TB programs to assist with program
implementation. The Program Support Section was responsible for
training and educational activities as well as program evaluation
through information collected in the Program Management Reports.
Image 1: Logo promoting U.S. TB control staff: CDC DTBE field staff
- making a difference.
In 1991, the name of the division changed to the Division of Tuberculosis
Elimination. In 1996, the Division of Tuberculosis Elimination was
reorganized. The Program Services Branch became the Field Services
Branch (FSB). The Program Support Section of the Program Services
Branch became the Communications and Education Branch, although
the program evaluation activities remained in FSB. The Program Operations
Section became two sections, Field Operations Sections I and II,
with approximately one half of the project sites covered by each.
A medical officer was assigned to each of the new sections to work
closely with the program consultants to enhance technical assistance
and program evaluation capacity. A third medical officer conducts
studies and other activities centered around program evaluation
and program operations.
The number of field staff positions grew from a low of 25 in 1980
to over 60 by 1996. In addition to assigning more Public Health
Advisors to the project sites for enhanced capacity building, FSB
has hired several field medical officers serving as medical epidemiologists
and medical directors in various TB project sites. These positions
also serve as key training positions to develop TB clinical and
programmatic expertise as older TB experts retire. In order to better
meet the needs of the larger field staff, the Field Staff Working
Group was established to enhance communication between headquarters
and the field, and a field staff training and career development
coordinator was added to the headquarters staff of FSB.
The last group of persons hired in the Public Health Advisor (PHA)
series were recruited in 1993. Through attrition and promotion,
the pool of PHAs has continued to diminish without being replenished
with new recruits, yet the demand for Public Health Advisors to
be assigned to the TB project areas continues. FSB is in the process
of completing work on a recruitment and training program for junior-level
field staff to be assigned to state and local TB programs.
FSB is looking to the future by continuing to emphasize core TB
prevention and control activities, enhancing program evaluation
activities to help ensure that programs are as efficient and productive
as possible, and working toward TB elimination.