1. ACET March 20-21, 2007 DTBE Director’s Report Kenneth G. Castro, M.D. Assistant Surgeon General, USPHS Director, Division of Tuberculosis Elimination National Center for HIV, Hepatitis, STD, and TB Prevention* Coordinating Center for Infectious Diseases * Proposed

2. Recent Activities (Not Covered by ACET Agenda) Mar 6, 7 OGAC meeting Mar 7 XDR TB briefing requested by 5 Senators (Durbin, Brown) Mar 15,16BSC subcommittee (XDR TB) Mar 21CDC testimony (Dr. JLG) to House Foreign Affairs Comm. Next weeksWhite House interagency team on XDR TB

3. World TB Day 2007 WHO/IUATLD theme “TB anywhere is TB everywhere” MMWR March 23 rd box, 3 articles First TB Awareness Walk March 24, Atlanta’s Grant Park (~ 450 registrants) http://www.cdc.gov/

4. National TB Case Rate, 2005-2006 YearIncidence/100,000 pop. 20054.8 2006 † 4.6 † Data provisional and embargoed until March 22 3.2% decline

5. †Data provisional and embaroed until March 22

6. Figure 2. Number of persons with and rate* of tuberculosis (TB), by origin of birth and year ─ U.S., 1993–2006 † * Per 100,000 population. † Data for 2006 are provisional and embargoed until March 22.

7. MDR TB*: 2004–2005 § 2004 (n=11,132) 2005 † (n=10,662) No. (%) MDR Cases129 (1.2)124 (1.2) US born31 (24.0)22 (17.7) Foreign born98 (76.0)101 (81.5) * Denominators based on culture confirmed cases with ISUS to INH and RIF † Missing origin of birth for one MDR case in 2005 § 2005 is the latest year with complete drug susceptibility test results

8. 1993–1999 (N MDR = 2005) 2000–2006 † (N MDR = 922) No. (%) XDR Cases (% of MDR)32 (1.6)17 (1.8) US born19 (59.4)4 (23.5) Foreign born12 (40.6)13 (76.5) Characteristics of Extensively Drug- Resistant (XDR) Tuberculosis Cases, 1993–1999 vs. 2000–2006 †Data provisional and embargoed until March 22

9. FSEB Branch Chief Announcement: 3/14/07, closes 3/27/07 HHS-CDC-D3-2007-0236, Medical Officer (PH), GS-602-15, NCHSTP, DTBE, FSEB (External) HHS-CCD-T3-2007-0784, Medical Officer (PH), GS-602-15, NCHSTP, DTBE, FSEB (Internal) HHS-CDC-D3-2007-0233, Supervisory Health Scientist, GS-601-15, NCHSTP, DTBE, FSEB (External) HHS-CDC-T3-2007-0785, Supervisory Health Scientist, GS-601-15, NCHSTP, DTBE, FSEB (Internal) Medical Officer: Must submit copy of medical school transcript, copy of medical license, or copy of medical diploma. Supervisory Health Scientist: Must submit copy of official college transcript with the application. Link to the CDC jobs website: http://www.cdc.gov/employment/findcareer.htm http://www.cdc.gov/employment/findcareer.htm

10. NEDSS TB PAM Update NEDSS PAM Platform (NPP), containing TB PAM, no longer supported by CDC. PHIN/NEDSS standards and Base System will be supported by CDC DTBE response TIMS and its import utility continued to support national TB surveillance system (short-term) Collaborate with NCPHI/NEDSS Program to: speed enhanced NEDSS TB message development (for reporting areas already developing their own systems) explore adding TB module to existing NEDSS Base System (for reporting areas needing CDC data entry tool) survey availability TB software applications developed by private vendors Communication to NTCA, TB Program Directors and TB Surveillance Coordinators and conference call/webinar (Mar 23) to agree on action plan

11. Remaining TB Program Challenges Reductions in TB control program funds Improve efficiency and accountability Decline in cases/ increase in complexity Loss of expertise

12. CDC TB Cooperative Agreement Funds FY2001-FY2006 USD $ in Millions Year

13. TB CoAg Fund Redistribution Plans Second phase redistribution FY2008 – 20% redistributed in FY 2005 – 35% to be redistributed NTCA/CDC workgroup Scheduled discussions allow for adjustments based on new factors Strategic planning for future policies

14. Mycobacteriology Lab Branch NLTN last mycobacteriology course Apr/03 (1-2 hr audio conferences since) Lab course Summer 2007 – 30+ applicants; can only take 16 – If successful, repeat Course to be held in the new CDC training labs/classroom facility

15. Probable Receipt of FY 2007 CDC Emerging Infections Funds One-time funding ~ $2 million Support laboratory enhancements Support active outbreak response Implement BSC recommendations