Tuberculosis presents an ongoing community health challenge for King County, and reflects a local symptom of a continuing global epidemic. In 2008, 121 people were diagnosed with active tuberculosis (TB), a drop from the 30-year high of 161 cases reported in 2007. Over the past decade, reported TB cases have ranged between 121 and 161 cases annually. In response to funding challenges for 2009 and beyond, the TB Control Program has carefully reassessed its service delivery system for controlling TB in King County. Strategies to improve program efficiencies include: focused use of resources on cases posing the greatest public health significance and community partnerships for provision of care and management of non-infectious TB cases. Key findings from the 2008 Annual Report said that all non-white races continue to have disproportionately higher rates of TB than whites: Asian American (15.9 per 100,000). Also, 34 percent of people with active TB in King County came from East Africa, 21 percent of people from Southeast Asia and 15 percent from Central America.