Tuberculosis Control in New York City ? A Changing Landscape
Michelle Macaraig, Dr.P.H., M.P.H., Joseph Burzynski, M.D., M.P.H., and Jay K. Varma, M.D.
N Engl J Med 2014; 370:2362-2365June 19, 2014DOI: 10.1056/NEJMp1402147
Since the introduction of chemotherapy for treating tuberculosis, political commitment and stable, sufficient funding have been the primary predictors of success for tuberculosis-control programs, and their absence has resulted in tuberculosis epidemics. Over the past decade, the federal funding for tuberculosis-control programs in the United States has decreased by more than 15%, even without adjusting for inflation, according to the Centers for Disease Control and Prevention. The incidence of tuberculosis continues to decline nationally, but in recent years the rate of decline has slowed, and some jurisdictions have seen increases in incidence. In New York City, which was the epicenter of the country's tuberculosis epidemic in the 1990s, overall funding for tuberculosis control has been cut by more than 50%, and in 2014 the city reported its first increase in cases after a decade of continuous reductions in annual tuberculosis incidence. Are we condemned to repeat history by reliving what has been called the ?U-shaped curve of concern??1...
