Modeling has shown that eliminating TB is not possible without addressing LTBI. (9) Comorbidities associated with TB include cancer, diabetes mellitus, and HIV. People with these medical conditions and compromised immune systems are more likely to develop active TB disease and to have worse outcomes from TB. (10) Forms of active TB that do not show drug resistance are classified as drug-susceptible TB (referred to in this section as DS–TB ). Drug-resistant TB (referred to in this section as DR–TB ) is a rising threat to the public health of the United States. DR–TB that exhibits resistance to two or more first-line drugs is referred to as multi-drug resistant TB (referred to in this section as MDR–TB ). MDR–TB that also is resistant to at least one injectable second-line medication and at least one fluoroquinolone is classified as extensively drug-resistant TB (referred to in this section as XDR–TB ). (11) Approximately 78 people in the United States were diagnosed with MDR–TB in 2016. One person was diagnosed with XDR–TB in the same year. (12) In the United States, direct treatment costs average $17,000 to treat a patient with DS–TB, $150,000 to treat a patient with MDR–TB, and $482,000 to treat a patient with XDR–TB. When factoring in productivity losses during treatment, DS–TB averages $46,000, MDR–TB averages $294,000 and XDR–TB averages $694,000. Treatment is often difficult, with daily complex multi-pill regimens and injections, with side-effects ranging from hearing and vision loss to mental health issues. (13) Recognizing the public health, economic and societal costs to the threat of MDR–TB, the National Action Plan to Combat MDR–TB was developed by the White House to provide the United States with a comprehensive three-pronged strategy to address MDR–TB by strengthening domestic capacity to combat MDR–TB