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The Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) have conducted an increasingly broad range of research and educational activities related to Lyme disease. CDC has instituted a system for the surveillance of Lyme disease, helped to standardize diagnostic testing, conducted and funded basic research on Lyme disease and on its prevention, and developed patient and practitioner educational materials. CDC has initiated most activities recommended by external reviewers and congressional appropriations committees regarding changes to its programs. NIH has conducted and funded basic research on Lyme disease and on its etiology, diagnosis, treatment, and prevention. In addition, NIH research is addressing two topics of particular interest to patient advocates--chronic Lyme disease and the occurrence of other tick-borne infections in Lyme disease patients. NIH has also responded to most expert recommendations and congressional recommendations. During the last 10 years, allocations for Lyme disease have increased slightly at CDC, and obligations for Lyme disease have increased significantly at NIH. CDC allocations for Lyme disease research and education have increased seven percent, from $6.9 million to $7.4 million in inflation-adjusted dollars from fiscal years 1991 through 2000. In contrast, the NIH increase in obligations for Lyme disease has been steady and relatively large, at 99 percent.

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