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based on level funding. This is actually an effective reduction in funding, due to inflation, and a real reduction in funding, since many of the program areas have relied on carry-over funds from previous years to maintain their level of funding. The cooperative agreement funding has been divided into funding for core activities (surveillance, laboratory, completion of therapy for active cases, and contact investigation) and funding for elimination activities (e.g., targeted tuberculin testing and treatment of latent infection). Five percent of the funding is reserved for the elimination activities and is dependent on the performance in the core activities.
The branch has 48 field staff positions assigned to State and local tuberculosis programs. Currently there are 33 public health advisors and 5 medical officers assigned and 12 vacancies. The medical officer assignments are considered a priority to provide additional public health physicians in the future with training and experience in tuberculosis. The large number of vacancies is a result of a CDC decision in 1994 to suspend hiring of new public health advisors through the STD and TB programs. The tuberculosis division has received approval to hire entry level public health advisors and plans to bring on 8–10 new hires.
Addressing elimination issues, the branch staff commented that level funding will clearly be inadequate. Regionalization of services and expertise will also be in important issue. Public Health Prevention Service
The decision to suspend hiring in the public health advisor series was followed by the creation of a training program called the Public Health Prevention Service. This is three-year program consisting of one year of three-month rotations through different programs in Atlanta and two years of working in a State and local program with a CDC and local mentor advising them. Candidates for the program all have Master's degrees in a field related to public health, the third class of 25 has recently begun training, and the first class will graduate next year. This program will provide a program designed in consultation with the State and local programs for highly trained staff to assist with program planning, implementation, and evaluation. Laboratory
Laboratory issues were addressed by staff from the Division of Laboratory Services in PHPPO and from the Tuberculosis and Mycobacterial Laboratory Branch in the Division of HIV/AIDS, STD and Tuberculosis Laboratories. The Division of Laboratory Services is involved in a variety of training and laboratory assessment activities. A major issue is main