CDC History of Tuberculosis Control - Medical and Public Health ...

amount in 1982 dollars. Throughout the 1980s
the ALA/ATS continued to advocate for
increased funding for the CDC, but it was not
until 1993, after the resurgence of TB in the
US had peaked, that funding increased dramatically.
The success in gaining increased funding for
TB was facilitated by having in place the
Advisory Council for the Elimination of
Tuberculosis (ACET), an advisory group to
the CDC that was specifically authorized by
Congress as a result of ALA/ATS lobbying
efforts. Among the first tasks of the ACET
was the development of the Strategic Plan for
the Elimination of Tuberculosis. This plan,
plus the newly-created National Coalition for
the Elimination of Tuberculosis (NCET),
provided new energy and focus for the advocacy
efforts, and funding levels grew to their
current level of approximately $120 million by
1995.
Notable Events in TB Control
The creation of NCET harkens back to the
early days of the ALA and its activities in
community organization. NCET was formed
at a time when TB cases were increasing and
there was rising concern about drug resistance,
yet public apathy and Congressional inaction
continued. The goals of ALA in fostering the
creation of NCET were nearly identical to the
goals of the NASPT almost 90 years earlier:
increasing public awareness of TB and advocating
for adequate public funding of control
programs. As noted above, NCET played an
important role in the intensified response to
the resurgence of TB in the 1990s. In 1998
NCET reevaluated its role and structure and is
focusing on advocacy at the state level for
funding and for ensuring an appropriate legal
framework for TB control, while not abandoning
it national activities.
Both the ALA and the ATS have concerns
with international, as well as domestic, TB
control — concerns that are consistent with
the traditions of the organizations, with
current epidemiologic realities, and with the
25
increasing international
focus of the
CDC. Soon after
its founding, the
NASPT became
involved in international
activities,
hosting the sixth
International
Congress on
Tuberculosis in
An illustration from Huber the Tuber, a book about tuberculosis
written and illustrated by H. A. Wilmer, MD, and published by
the National Tuberculosis Association in 1942.
1908. True to its origins, the ALA currently
is an important constituent of the International
Union Against Tuberculosis and Lung
Disease (IUATLD). Additionally, the ALA
and the ATS are founding partners of the Stop
TB Initiative, together with the CDC, the
World Health Organization, the World Bank,
the IUATLD, and the Royal Netherlands
Antituberculosis Association. The Initiative is
a global partnership to accelerate TB control
worldwide and in part is a product of the
successful efforts of the ALA/ATS in advocating
for funding of international TB control
through the US Agency for International
Development.
At the first annual meeting of NASPT in 1905,
two committee reports were read, “Early
Diagnosis” and “Clinical Nomenclature.”
These reports, which served to define the state
of the art on one hand and standard terminology
on the other, set the pattern for future
activities of both the NASPT and ASA. The
Society’s journal, the American Review of
Tuberculosis (subsequently the American
Review of Tuberculosis and Pulmonary Disease,
then the American Review of Respiratory
Disease, and now the American Journal of
Respiratory and Critical Care Medicine) was
first published in 1917. The first issue carried
an article, “The Classification of Pulmonary
Tuberculosis,” which was the first of an
ongoing series of statements entitled “Diagnos-