TUBERCULOSIS PREVENTION AND CONTROL

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Section I. Introduction

As defined by the National Health and Welfare Act, Section 5, the duties, powers, and functions of the Minister extend to include all matters relating to the promotion and preservation of health of the people of Canada. As a directorate in the Health Protection Branch of Health Canada, the Laboratory Centre for Disease Control (LCDC) is subject to the provisions of the Act. There is a wide range of provincial, interdepartmental and international agreements that influence the LCDC Directorate.

The ultimate purpose of LCDC activities is disease prevention and control at the national level. To fulfil its mission, the Directorate carries out the following functions:

• national disease surveillance and disease control,
• diagnostic laboratory services,
• support of national and international public health networks,
• evaluation and standard setting,
• knowledge and technology development,
• knowledge and technology transfer and training,
• international collaboration and liaison,
• management and support of scientific organizations,
• facilitation of interjurisdictional communication and collaboration.

Rationale

For the last several years, LCDC has had insufficient resources to develop a comprehensive program in support of tuberculosis (TB) prevention and control. LCDC has become concerned because the 30-year downward trend in reported cases of TB that has now reached a plateau as well as the continued presence of pockets of disease in Canada that have stubbornly resisted some of our better interventions. An additional concern is the situation which has developed in the United States due to multi-drug-resistant (MDR) TB and the human immunodeficiency virus (HIV)/TB interaction that appears to occur in focal areas. The question arises: what should be the extent of the national investment in TB prevention and control, given that Canada has one of the lowest TB rates in the world, yet still has some focal areas of high rate? This question is directed at provincial, territorial, and federal levels. To define LCDC's role in a possibly renewed national strategy for TB prevention and control, LCDC organized a consultation on July 25-27, 1994.

These proceedings include presentations from all guest speakers, as well reports with recommendations from each of the five working groups. The list of participants can be found in Appendix I and II.

The five working groups were organized in the following manner:

• Policy and Guidelines: LCDC's Role in Support of TB,
• Surveillance: Case-finding,
• Surveillance: Case-holding,
• HIV/TB Surveillance and Research, and
• Reference Laboratory Services and Research.

Implementation of these recommendations will depend on multi-year operational funding (MYOP).

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