The Arden House Conference on Tuberculosis, Revisited: Perspectives for Tuberculosis Elimination in the United States

In 1959, the Arden House Conference on Tuberculosis inaugurated modern tuberculosis control strategy by declaring that curative treatment of tuberculosis is a public health obligation. In the decades after the conference, tuberculosis rates decreased more slowly than forecast, perhaps because chemotherapy had less impact than anticipated, or because the conference's recommendations were not implemented fully until 30 years later, when an epidemic resurgence jolted the country out of complacency. Since 1959, several broad issues have gained prominence after being overlooked or unexpected at the time of the Arden House Conference. These include tuberculosis outbreaks, contact investigations, treatment of latent Mycobacterium tuberculosis infection, briefer treatment regimens, human immunodeficiency virus infection, bacteriology laboratory capabilities, and transnational migration. Trends and experience have shown that tuberculosis elimination in the United States will be unfeasible until both technological advances and social justice allow control systems to be applied throughout the world.

KEYWORDS

Tuberculosis epidemiology - tuberculosis treatment - tuberculosis prevention - tuberculosis funding - medical history

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1 In their report, the Arden House members alternatively wrote of “eradication” and “elimination.” Apparently they did not observe current conventions, which define the first term as the abolition of all TB and the second as an indefinite suppression of TB to a predetermined minimal frequency.

2 Precursor of the American Lung Association.

3 See previous footnote.

4 The use of trade names is for information purposes only and does not constitute an endorsement by the United States Public Health Service or the Department of Health and Human Services.

5 “Active” and “inactive” radiographic cases; not distinguished in the reports.