Tuberculosis Elimination and Laboratory Cooperative Agreement - The 2023 surge of tuberculosis (TB) disease cases in Massachusetts has underscored the pressing need for targeted interventions to address the specific challenges faced within the state, particularly among racial and ethnic minority groups and non-U.S.-born individuals. In response, a five-year project has been proposed to prevent, control, and alleviate the burden of TB among at-risk populations in Massachusetts. Securing funding from the Centers for Disease Control and Prevention (CDC) is integral to the success of the Massachusetts TB Elimination Plan. The Massachusetts Department of Public Health, Bureau of Infectious Disease, Division of Global Populations and Infectious Disease Prevention is committed to reducing the TB burden in the state through various core strategies and activities. These include diagnosis and treatment of TB cases, contact investigation, targeted testing and treatment of latent TB infection in high-risk populations, program planning, evaluation, improvement, epidemiologic surveillance and response, and human resource development. The Massachusetts Public Health Laboratory provides essential laboratory services for TB. The project places emphasis on a comprehensive approach to achieve outcomes through short-term, intermediate, and long-term strategies such as increased TB response capacity among public health providers and communities, decreased barriers to accessing TB care and treatment, increased treatment completion rates, reduced TB transmission, decreased acquired drug resistance, improved surveillance, increased dissemination of best practices, and improved health equity related to TB testing and treatment. Additionally, the project aims to improve access to medical and social services through partnerships, enhance surveillance, develop human resources, and strengthen laboratory capabilities, in line with CDC guidance and funded under the Tuberculosis Elimination and Laboratory Cooperative Agreement CDC-RFA-PS-25-0003. These combined efforts ultimately seek to reduce the overall incidence of TB and specifically target populations at higher risk, addressing the disproportionate impact of TB on affected communities and aligning with the goal of TB elimination in Massachusetts.