Defending the Public's Health Against Tuberculosis

Twelve years have passed since the unprecedented resurgence of tuberculosis (TB) in the United States. From 1985 to 1992 TB cases increased almost 20% nationally²and increased more than 35% in children,³along with dramatic changes in the nature and magnitude of the disease.⁴Despite many contributing factors, including the acquired immunodeficiency syndrome (AIDS) epidemic, increases in substance abuse and homelessness, increased immigration, and lack of patient compliance, concerned observers felt that the TB resurgence was directly due to policymaker neglect of appropriate TB control mandates, which led to the dismantling of programs that had kept TB under control.⁵,⁶ See also pp 833, 838, and 843. The societal response was an unprecedented initiative, a veritable "war" against TB. A multiagency governmental task force was organized to coordinate the effort⁷; huge increases in congressional appropriations for direct support were obtained⁶; major research efforts by government