Summary: The Center for Disease Control (CDC) has the primary responsibility for the Federal role in the venereal disease prevention and control program and has expended an average of about $32 million annually since 1972. With these funds, CDC conducts research, develops program guidelines and performance standards, provides technical assistance to State and local governments, and supports educational activities. CDC uses reported syphilis and gonorrhea cases as its primary indicator of actual disease trends and program effects. Monitoring reported cases and cases identified through casefinding provides CDC with insufficient information to demonstrate: the effectiveness of current control strategies; the relative benefits of each control program component; and the optimal level of Federal, State, and local support for venereal disease control. Reported case trends are susceptible to influence by factors other than actual disease trends, such as changes in private physician reporting habits, the extent of public casefinding, public clinic availability, and disease diagnostic practices. Regardless of the accuracy of reported case trends as indicators of actual disease trends, actual disease incidence is the product of various interacting factors. Consequently, even declines in actual disease trends cannot be solely attributed to CDC-supported activities. CDC should conduct a study to develop a methodology for improving the reliability of reported data on identified and treated cases and to determine the numbers of people who comprise the venereal disease problem. CDC should use the resultant data to assess the impact of its efforts in controlling the incidence of venereal disease.
