Tuberculosis Elimination and Laboratory Cooperative Agreement - Tuberculosis (TB) remains a public health threat around the world, across the United States, and in the Commonwealth of Virginia. The mission of the Virginia Department of Health (VDH) TB Program is to control, prevent, and eventually eliminate TB from Virginia. The VDH TB Program aims to detect every case of TB in Virginia, assure that each case is adequately and completely treated, and prevent transmission of TB in communities through management of active TB cases and screening, testing, and treatment of contacts of TB cases with latent tuberculosis infection (LTBI). Through the strategies and activities described in this grant application, the VDH TB Program strives to: (1) diagnose and treat persons with active TB disease, (2) conduct contact investigations for infectious TB cases, (3) test and treat populations at higher risk for TB and LTBI, (4) conduct program planning, monitoring, evaluation and improvement efforts for public health TB program activities, (5) ensure robust surveillance systems are in place for TB and LTBI, (6) strengthen capacity of the VDH TB program through human resource development (HRD) and partnerships, and (7) ensure the availability of high quality and timely core laboratory services for TB. The VDH TB Program is applying for funding under the Tuberculosis Elimination and Laboratory Cooperative Agreement CDC-RFA-PS-25-0003 to assist with addressing the strategies and implementing the activities identified in this application. Funding for Prevention and Control (P&C), Human Resource Development (HRD), and Laboratory Strengthening will allow for continued and new activities that will be measured by evaluation of progress toward short-term and intermediate outcomes outlined in the funding announcement. Progress toward these short-term and intermediate outcomes will lead to a decreased TB incidence overall and among those populations at higher risk and those disproportionately affected by TB disease and TB infection.