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TB Notes 4, 2002

Dear Colleague:

As of this writing, Congress still has not approved the fiscal year 2003 federal agency appropriations. We have been operating under a continuing resolution since October 1, 2002. However, 36 congressmen have signed and forwarded a letter to the chairman of the subcommittee on labor, HHS, and education appropriations, urging an increase of at least $50 million for TB control at CDC. In another budgetary item, the consultants in the Field Services Branch (FSB) have finished conducting their reviews of the TB elimination cooperative agreement applications for FY 2003 and have made their funding recommendations to the CDC Procurement and Grants Office. We appreciate the hard work that goes into the preparation of these applications.

The November issue of CDCís peer-reviewed journal, Emerging Infectious Diseases, is now available online at, and should also be available for ordering by November 15. We will be sending copies to state TB controllers and others who routinely receive mail-outs from DTBE. As you know, this issue is devoted to TB. More specifically, it is dedicated to the research that was conducted through the National Tuberculosis Genotyping and Surveillance Network (NTGSN). In addition to the outstanding articles themselves, there is a remarkable essay on TB, entitled "At the Deathbed of Consumptive Art," by D.M. Morens. I strongly recommend this issue, and I applaud the hard work and dedication that went into it. Congratulations to all the NTGSN collaborators for a job well done!

On September 26, several members of the Advisory Council for the Elimination of Tuberculosis (ACET) met with Dr. Eve Slater, Assistant Secretary for Health of the Department of Health and Human Services, to present ACETís concerns about TB control in the United States. This meeting had originally been scheduled for last fall but was postponed after the events of September 11. The group traveling to Washington, DC, for the meeting consisted of Drs. Charles Nolan, Masae Kawamura, and Charles Wallace; I accompanied them, as did Dr. Harold Jaffe, Director of the National Center for HIV, STD, and TB Prevention (NCHSTP). Our goal was to bring four major issues to Dr. Slaterís attention: the gap in funding for TB prevention, control, and elimination; the high incidence of TB in the southeastern United States and in U.S.-born African Americans; the challenges faced in low-incidence states; and the need for new TB drugs and diagnostic tools. I am happy to report that Dr. Slater expressed interest in our presentation and comments, and that we achieved our goal of raising awareness about TB with Dr. Slater and her staff.

The 33rd International World Conference on Lung Health was held October 6-10, 2002, in Montreal, Canada. On October 5, before the opening of the World Conference, the Third Meeting of the Stop TB DOTS Expansion Working Group was held. The group met to review the status of TB control and DOTS expansion in the world, identify and discuss constraints, review the financial situation of TB control, and discuss specific program activities with representatives from the 22 high-burden countries. CDC staff participated in these key discussions. On October 6 the World Conference began, and included a wide variety of postgraduate courses, symposia, poster presentations, and plenary sessions for participants. On October 7, staff of the Prevention Effectiveness section of the DTBE Research and Evaluation Branch conducted a postgraduate course entitled "Using Logic Models for Program Planning and Evaluation." Based on evaluation principles described in the CDC Framework for Program Evaluation in Public Health, the course was coordinated by Noreen Qualls and team-taught by Maureen Wilce, Robin Shrestha-Kuwahara, Audrey Reichard, and Heather Joseph. The one-day training session taught the 36 participants to develop and use logic models (graphic representations of program needs, operations, and expected outcomes) in order to effectively plan and evaluate programs. Through interactive case study exercises, course participants developed logic models to describe programs and then used the logic models to prioritize issues for specific examination. CDC staff served as faculty for other postgraduate courses as well, including "Basic Laboratory Techniques for Tuberculosis Control Programs" and "TB Training Programme Evaluation Course." In addition, CDC staff gave symposia presentations such as "Emergence of HIV in Russia: Implications for Increasing Rates of MDRTB" and "Working with Private Physicians: The New York Story." CDC staff also coordinated a display of TB education and training materials throughout the conference, as well as a TB education and training materials discussion session. CDC was further represented by a number of staff who presented and discussed recent research findings through poster presentations in a variety of subject areas during the conference.

I am pleased to announce the availability of CDCís Response to Ending Neglect. This 62-page document identifies the specific goals, objectives, and action steps that CDC will be pursuing to make TB elimination a reality in the United States, and will serve as a guide for CDC in these efforts. This document is the result of an inclusive process of reflection, discussion, and collaboration between professional staff within NCHSTP, the National Center for Infectious Diseases (NCID), the Public Health Practice Program Office (PHPPO), the National Institute for Occupational Safety and Health (NIOSH), and the National TB Controllers Association (NTCA). It represents our shared vision of what should be accomplished, and what can be accomplished, in the important campaign to control and eliminate TB in the United States. The report is posted on the DTBE Web site,

I am also pleased to report the availability of Reported Tuberculosis in the United States, 2001, which provides data on U.S. TB cases for the year 2001. This is also available on the DTBE Web site at I would like to thank the staff of DTBEís Surveillance and Epidemiology Branch for their continued excellent work on this important annual publication.

In particular, I wish to congratulate Gloria Kelly, who has had primary responsibility for this report for the past several years and has brought it to its current outstanding and polished form. At the end of this year, Gloria will be retiring, with 34 years of service to CDC. We are also saying goodbye to Ken Shilkret, TB Controller for New Jersey, who retires this year as well. Ken has had 40 years of federal service, 38 as a public health advisor with CDC. For his unflagging commitment to TB control, he was recently given a "TB Icon" award (John Seggerson was the first recipient of this honor), in addition to the many other awards he has received. It has been a pleasure to know and work with two such dedicated and committed persons, and we wish Gloria and Ken all the best in their retirements.

Kenneth G. Castro, MD

NOTE: The use of trade names in this issue is for identification only and does not imply endorsement by the Public Health Service or the U.S. Department of Health and Human Services.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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