The project narrative outlines a comprehensive strategy by the North Dakota Department of Health and Human Services (NDDHHS) to combat tuberculosis (TB), a critical public health issue. The initiative aims to reduce TB incidence by focusing on early identification and treatment of both active TB cases and latent TB infections (LTBI). Key strategies include collaboration with partners like the Mayo Clinic Center for Tuberculosis and the North Dakota Department of Corrections and Rehabilitation, enhancing diagnostic techniques like Nucleic Acid Amplification Testing (NAAT), and ensuring timely and effective treatment regimens. The project targets high-risk populations, such as non-U.S.-born individuals, those with HIV, and people in congregate settings, while addressing health disparities through culturally-sensitive care. Expected outcomes include increased testing, treatment initiation, and completion rates, with long-term goals of reducing TB incidence and improving health equity. The project also emphasizes robust evaluation and performance measurement to guide continuous improvement and ensure that interventions are effective and appropriately targeted.