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Commissioner's Remarks for Corona Clinic Opening, March 20, 2002

Tuberculosis control has been one of New York City's most dramatic successes in recent decades. In the early 1990s, the City was the epicenter of the tuberculosis and multidrug-resistant tuberculosis epidemic of the country. By 1995, because of the dedication and hard work of public health staff, the city became a global model for effective tuberculosis control. Cases of tuberculosis have declined by more than two-thirds, and cases of multidrug-resistant tuberculosis have been reduced by nearly 95%. In 2001, there were 1,261 new cases of tuberculosis in New York City. This is the lowest number of TB cases in a single year ever in New York City. The previous low was in 1978, with 1,307 cases. This represents a decrease of more than 5% from 2000, and a 67% decrease from 1992, the peak year of the recent epidemic. There were 25 cases of multidrug-resistant tuberculosis in 2001, down nearly 95% from the 1992 peak of 441 cases.

While the current downward trend of TB cases in New York City over the past nine years is encouraging, TB continues to disproportionately affect parts of the City and too many of our fellow New Yorkers. For this reason, it is essential that we continue intensive, targeted efforts to prevent and treat TB.

In the 1980s, faced with declining case rates, the City dismantled its tuberculosis control infrastructure. The result was a resurgence of tuberculosis, which cost the City more than 1 billion dollars, much of which could have been avoided. We will not repeat that costly mistake.

I would like to quote from a classic history of public health in New York City, written 35 years ago:

"Encountering apathy, ignorance, and avarice is the lot of all conscientious health officers. As preventive measures in the health area are more successful, the public is less inclined to support the programs which ensure this success." (John Duffy, A History of Public Health in New York City)

Now is not the time to relax our efforts to stop tuberculosis. Rather, it is the time to intensify and better target our activities. This clinic represents an enormous amount of work and we are deeply grateful to the Department of Design and Construction (DDC) for its efforts. I had the pleasure of working with the DDC on the design of the clinic in my previous role as Director of Tuberculosis Control. I was greatly impressed by their professionalism and expertise in the design of this clinic, and I thank them for all of their hard work.

Over the past few years, the face of tuberculosis has changed in New York City. Before 1997, the majority of tuberculosis cases were among persons born within the United States. Presently nearly two-thirds of tuberculosis cases are among non-U.S. born persons. Queens, which is one of the most wonderfully diverse communities in the world, now accounts for 1 in 3 tuberculosis cases citywide, compared with just 1 in 5 just a few years ago. The area in which the Corona Chest Center is located has the highest tuberculosis case rate in New York City for 2001: 35.6 cases per 100,000 people. During 2001, more than 10,000 patients visited the Corona Chest Center for a total of nearly 40,000 visits. The Corona Chest Center ranks third in reporting new TB patients in New York City, after Elmhurst Hospital and Bellevue Hospital. This clinic is well-prepared to provide state-of-the-art services to this population. I don't think there is a tuberculosis clinic anywhere in the world that has a safer, more appropriate design than this clinic. This and the other DOH chest centers provide outreach and treatment to a large medically-underserved population in the city.

TB control in New York City is still a challenge. New York City still has the highest tuberculosis case rate of any large metropolitan area in the nation. TB rates are 10 to 20 times the national average in many immigrant communities. Successful TB control shows that public health in New York City can control epidemics and save lives.

Public health is an integral part of the public safety. Direct observation of treatment, which is the mainstay of our strategy, builds a human bond between the patient and the healthcare worker. This bond is what ensures a cure and keeps all of our air safe. New York City's success in controlling tuberculosis became a global model and inspiration. Ten million TB patients have now been treated using this strategy, saving more than a million lives.

TB reminds us that we are integrally a part of the global community. Our successful efforts to begin the path toward elimination of tuberculosis are greatly strengthened by today's progress in establishing this state-of-the-art clinic.

Mayor Michael R. Bloomberg Re-Opens Tuberculosis Chest Center in Queens (March 20, 2002)