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