TUBERCULOSIS IN NEW-YORK-CITY - THE CONSEQUENCES AND LESSONS OF FAILURE - COMMENTARY

The resurgent tuberculosis epidemic represents-especially in New York City-a failure to maintain a public health infrastructure that was foc used on preventing active disease in high-risk populations (i.e., indi viduals with the human immunodeficiency virus [HIV]) and on treating a ctive tuberculosis patients until cured. Although the tuberculosis pro blem in New York City and other localities is worsened by homelessness , poverty, and substance abuse, it is possible to bring tuberculosis u nder control by directing public health resources into targeted progra ms that enhance compliance with tuberculosis treatment regimen and exp and chemoprophylaxis efforts among HIV-infected individuals. These two avenues will decrease, respectively, the number of cases of multidrug -resistant tuberculosis and the total number of new cases.