CDC Tuberculosis Protocols and Adoptions

A number of national media outlets reported last week on the implementation of recent Center for Disease Control (CDC)  protocols that are having a drastic impact on some adoptive families, particularly from China and Ethiopia.  See this NPR report for more.   According to the CDC, the new TB protocols are intended to reduce the likelihood of tuberculosis being spread in the U.S.  But some TB experts and a number of adoption advocacy organizations have challenged the CDC, arguing that the protocols make things much harder on adopted children than medically necessary to prevent the spread of TB.  One of the organizations that has been engaging in this issue for some time is the group Equality for Adopted Children (EACH).   The President of EACH, McLane Layton, shared this update with us recently:

We have finally been able to get the CDC’s attention on this issue, due to a family adopting a four year old girl from China who had to leave her behind because of the new TB protocol.  It engendered some national media attention and the CDC finally allowed a waiver for this little girl to come home but that doesn’t fix the problem for those coming behind.  However, a number of adoption organizations including EACH were able to participate on a conference call with the CDC a few weeks ago (prior to the waiver being issued for the little girl) to discuss the problem and how it impacts adopted children of American citizens. We had the top pediatric TB specialist on the phone and he was able to provide specific medical information to the CDC that indicates that the protocol as applied to children is medically inappropriate.  Since the conference call, the CDC has established a new “unit” at the CDC to review current and future protocols and their impact on adopted children and coordinate with the adoption community.  This is a positive step in the right direction.  However, the issues with the new TB protocols need to be resolved now to avoid additional major problems for children in the adoption process.

In the media reports, the CDC says it doesn’t have the authority to exempt one class of immigrants from the TB protocol.  I would beg to differ with them since the CDC created the protocol (it was not done due to a statutory mandate), they can change it.  A few of the organizations here in Washington, including NCFA and JCICS and EACH are going to work for a legislative fix in the event we cannot get a satisfactory resolution from the CDC.  However, we are hoping to be able to resolve this issue without the need for legislation, but the CDC really needs to focus on a quick fix to this issue, not discuss and debate it for a year or so while adopted children of American citizens suffer. It is our understanding that very positive discussions are going on within the CDC regarding possible changes to address the concerns of American adoptive families and this is encouraging.  However, we would prefer for the CDC to suspend the implementation of the 2007 TB guidelines for adopted children until a mutually satisfactory approach can be agreed upon – one that satisfies public health concerns and one that won’t leave children sitting in orphanages any longer than necessary when they have American families waiting for them to care for them.