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.