**GAO-09-58**                      Published: Oct 14, 2008. Publicly Released: Nov 13, 2008.                  

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## Highlights

In spring 2007, the Department of Health and Human Services (HHS), the Department of Homeland Security (DHS), and state and local health officials worked together to interdict two individuals with drug-resistant infectious tuberculosis (TB) from crossing U.S. borders and direct them to treatment. Concerns arose that HHS's and DHS's responses to the incidents were delayed and ineffective. GAO was asked to examine (1) the factors that affected HHS's and DHS's responses to the incidents, (2) the extent to which HHS and DHS made changes to response procedures as a result of the incidents, and (3) HHS's and DHS's efforts to assess the effectiveness of changes made as a result of the incidents. GAO reviewed agency documents and interviewed officials about the procedures in place at the time of the incidents and changes made since.

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## Topics

Homeland Security

Border controlBorder securityDisease controlDisease detection or diagnosisDisease surveillanceDiseasesEmergency responseEmergency response plansEmergency response proceduresEmerging infectious diseasesHealth hazardsHomeland securityInfectious diseasesInteragency relationsInternal controlsPolicy evaluationProgram evaluationPublic healthRespiratory diseasesRisk managementTuberculosisPolicies and proceduresProgram goals or objectivesPublic health emergencies