Attending the CDC TBESC Meeting

Three weeks ago I was invited to the CDC’s 3rd semiannual Tuberculosis Epidemiologic Studies Consortium in Atlanta, GA. This is where TBESC research sites and the CDC Division of Tuberculosis Elimination meet to assess their current standing with their research goals, evaluate potential substudies of interest, and identify needs to be addressed. I, of course, jumped at the chance to participate and immediately planned my stay.

I made the trip up to Atlanta on Tuesday the 5th so I would have a day to get settled in, accompanied by my boyfriend Nguyen. The meeting was held at the Crowne Plaza Ravinia, an amazing hotel with elegant gardens and an indoor river flowing from the lobby to the dining area a floor down. In attendance were some of the biggest names in TB research, with representatives from Emory University, Duke University, McGill University, the University of North Texas, the University of Florida (of course); the Departments of Health from California, Denver, Hawaii, Maryland, King County, and Maricopa County; the Treatment and Action Group for TB advocacy; the TBESC Board of Advisors; and the Centers for Disease Control and Prevention itself. Even with so many participants (roughly 80 altogether), it was an intimate gathering. Nearly everyone in attendance knew each other well.

I came to this meeting with full expectations of a conference-style event; hundreds of attendees, multiple talks per time slot, solely informative with a dash of what is next for the TB Epi world. Instead I was surprised by an agenda that was reminiscent of staff meetings, albeit quite expansive. It was essentailly an opportunity to update all agencies of their current progress towards the original study aims. Pilot outcomes and accomplishments were celebrated, sources of vulnerability were identified and solutions voiced, enhancements for the data management system planned, and a new biobanking initiative discussed. I was slightly taken aback by the informality of proceedings; each topic had extensive brainstorming sessions where the greatest minds in TB bounced ideas back and forth on where and how improvements could be made. I was greatly impressed. This consortium is in it’s infancy, but as a group they are being keenly proactive and maintaining vigilant watch over the preliminary results and setbacks. The TBESC meeting proved that active surveillance is being done. The TBESC discussions affirmed that thoughtful improvements to protocols were being identified and implemented in a timely manner.

TBESC is a huge endeavor, following 40,000 TB patients and coordinating multiple analyses (currently involving 21 separate research studies). I gained many insights during the two days of presentations and discussion, but one key impression left the greatest impact. If you are going to put your money into a public health program, don’t wait around until it is over to find the weaknesses in the protocol and identify improvements. When this happens hopes are that the next project will learn from this one’s oversights. So many things are wrong with this; namely that these flaws in your program had consequences on the outcome observed. Potentially more worrisome is the chance that a similar program might never again be funded or your suggestions fall on deaf ears. If you are going to do something, do it right the first time because it might be the only time. It is a simple investment requiring only time and active scrutiny, but the return can be enormous.

Realizing how important this is, and seeing firsthand how ardently the CDC works to assure this quality in their studies made me fall in love with them all over again. I met many impassioned professionals and had my first big-time introduction to public health studies on the national level. As I told my family and Nguyen, I arrived inquisitive and I left inspired.

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