ABSTRACT

As tuberculosis rages out of control in New York City—with one third of the cases resistant to treatment—the press and government officials are placing the blame on patient "non-compliance." In the late 1960s the New York City Tuberculosis Program spent forty million dollars annually on twenty-eight clinics and provided over 1,000 hospital beds for TB patients. But just as TB started to come under control, the city faced a budget crisis and cut health programs across the board. Funding for TB remained flat through the 1980s despite signs that, fanned by AIDS and homelessness, the disease was spreading rapidly. Just nine TB treatment clinics remain open. There are zero hospital beds for long-term TB care in the entire public system. As a result, treatment has increasingly fallen to general practitioners. The government's approach is to seek to control patients rather than to serve them. City officials throw up their hands saying they can't do more without a federal bail-out.