Accountability
Forest Preserves
Public Safety
Cook County Budget
Forest Pres. Budget
Property Tax Appeal
Cook County Health & Hospitals System
Policy Resolutions

For almost 100 years, the American Lung Association of Metropolitan Chicago has been an advocate for the prevention and control of tuberculosis in Chicago and Cook County. During that time, we have learned many important lessons about tuberculosis and its transmission. Some of those lessons are: *The prevention and control of tuberculosis is complex, requiring coordinated services in medicine and public health. Because tuberculosis is airborne and can be contagious, it is particularly important that cases be monitored carefully within an infrastructure that is capable of responding quickly to varying types of outbreaks. *Although cases of tuberculosis among U.S.-born residents have been steadily decreasing, tuberculosis remains a significant threat worldwide. Because of the higher rates of TB among foreign-born populations, urban centers with large foreign-born populations such as the Chicago metropolitan area require comprehensive and effective TB prevention and control programs. *Over the last 20 years, whenever public health officials have relaxed funding for TB prevention and control, the disease has come back, not infrequently in drug-resistant strains. In the 1980s, for example, following budget cutbacks in New York City, there was a new outbreak of hundreds of cases of multi-drug resistant tuberculosis that cost New York City almost $1 billion to bring under control. Notwithstanding the debate over the fate of the Cook County Tuberculosis Sanitarium District, even the district's detractors admit the district is succeeding in controlling this public health risk. Indeed, the district now has an effective program that uses patient-centered directly observed therapy. The Illinois representative for the Centers for Disease Control and Prevention recently commended the district for its knowledge and understanding of the needs in higher-risk communities. Every indication is that the current structure is controlling TB and doing a good job of it. We believe a prudent next step in the decision whether to maintain the current district is to assemble a panel of tuberculosis experts to study the problem and make recommendations for potential reforms that might reduce costs without exposing Cook County residents (or all Illinoisians) to an increased TB risk. A misstep in the resolution of the dispute over TB control in suburban Cook County could have serious and unintended side effects for Cook County and the rest of Illinois. Joel J. Africk, chief executive officer, American Lung Association of Metropolitan Chicago