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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

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The documents listed below are historical, archived information. The information contained in these documents, while accurate at the time of release, may not be the most current available.

Strategies and Action Steps

Domestic Federal Actions in Response to the Institute of Medicine Report on TB:
Ending Neglect: The Elimination of Tuberculosis in the United States

D. Global U.S. Actions in Response to the Institute of Medicine Report on TB: Ending Neglect: The Elimination of Tuberculosis in the United States.

This brief but important section has been developed by a smaller group that includes representation from the U.S. Agency for International Development, the National Institutes of Health, and the Centers for Disease Control and Prevention.

IOM Recommendation 6.1: “To decrease the number of foreign-born individuals with tuberculosis in the United States, to minimize the spread and impact of multidrug-resistant tuberculosis, and to improve global health...”

Strategies
Action Steps

1. In collaboration with the World Health Organization (WHO), develop models for diagnosis and treatment of MDR TB in countries with high MDR TB rates.

Lead Agencies: CDC, USAID

Collaborating Agency: NIH

Start Date: FY 2002

Completion Date: Ongoing

a) Implement and expand model directly observed treatment, short course (DOTS) programs to prevent further creation of MDR TB caused by improper treatment of new TB patients.

  • Leads: NCHHSTP, USAID
  • Collaborator: NIAID
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

b) Develop and implement pilot DOTS-Plus projects to treat existing MDR TB patients and prevent MDR TB.

  • Leads: NCHHSTP, NCID, USAID
  • Collaborator: None
  • Start Date: FY 2002
  • Completion Date: Ongoing

c) Assist in the development of "Centers of Excellence" to ensure that MDR TB is addressed, to build high- grade local capacity, and to serve as regional training centers for professionals from other countries.

  • Leads: NCHHSTP, USAID
  • Collaborators: NIOSH, NCID, PHPPO, NCID, NIAID, Fogarty International Center
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

d) Evaluate the cost effectiveness and appropriate use of rapid methods for diagnosis of MDR TB.

  • Leads: NCHHSTP, NIAID, USAID
  • Collaborator: None
  • Start Date: prior to FY 2002
  • Completion date: FY 2005

e) Conduct drug resistance surveillance to measure the extent of MDR TB and to determine
optimal approaches to treatment, specific to given locations.

  • Leads: NCHHSTP, USAID
  • Collaborator: NIAID
  • Start Date: prior to FY 2002
  • Completion date: Ongoing

2. Provide international technical and programmatic assistance aimed at reducing the impact of TB globally.

Lead Agencies: CDC, USAID, NIH

Start Date: FY 2002

Completion Date: Ongoing

a) Provide technical assistance to countries for TB surveillance.

  • Leads: NCHHSTP, GAP, USAID
  • Collaborators: NCID, PHPPO
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

b) Provide technical assistance to improve and enhance TB laboratory capabilities.

  • Leads: NIAID, NCHHSTP, PHPPO, USAID
  • Collaborators: Fogarty International Center, GAP, NCID
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

c) Develop and promote WHO/IUATLD/CDC national external quality assessment guidelines to monitor and improve the quality of AFB microscopy.

  • Lead: PHPPO
  • Collaborators: NCHHSTP, USAID
  • Start Date: FY 2002
  • Completion Date: Ongoing

d) Conduct operational research to improve diagnosis and treatment of HIV-associated TB.

  • Leads: NCHHSTP, GAP, USAID, NIAID
  • Collaborators: Fogarty International Center, NTCA, PHPPO
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

e) Conduct large-scale feasibility and cost-effectiveness studies of various regimens for the treatment of latent TB infection in HIV-infected persons.

  • Leads: NIAID, NCHHSTP, GAP, USAID
  • Collaborator: None
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

f) Provide technical assistance for developing and implementing institutional infection control strategies.

  • Leads: NCHHSTP, USAID
  • Collaborator: NCID
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

g) Provide onsite technical assistance to national TB control programs.

  • Leads: NCHHSTP, GAP, USAID
  • Collaborator: None
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

3. Strengthen TB research capability in high-burden countries to enhance ability to develop and test improved treatment, prevention, and control strategies.

Lead Agencies: CDC, NIH, USAID

Collaborating Agency: None

Start Date: FY 2002

Completion Date: Ongoing

a) Expand and conduct training and technology transfer in high-burden countries.

  • Leads: NCHHSTP-GAP, NIAID, USAID, Fogarty International Center, NHLBI
  • Collaborators: NCID, PHPPO
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

b) Enhance needed infrastructure, including laboratory facilities and Internet connectivity.

  • Leads: NCHHSTP-GAP, USAID, NIAID
  • Collaborators: GAP, NCID, PHPPO, Fogarty International Center
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing

c) Conduct clinical trials of novel therapeutic, diagnostic, and prevention strategies in
partnership with high-burden countries.

  • Leads: NIAID, NCHHSTP-GAP, USAID
  • Collaborator: None
  • Start Date: prior to FY 2002
  • Completion Date: Ongoing
 
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