Leadership will play a major role in the management of tuberculosis in
the future. Many populations, such as immunocompromised patients and
immigrants from countries with a higher prevalence of tuberculosis, cr
eate a challenge for care and diagnosis. Mycobacterial laboratory test
ing has undergone many changes in the past 10 years with the advent of
nucleic acid probes for identification of Mycobacterium tuberculosis,
and more recently nucleic acid amplification and beyond where compute
r technology meets molecular biology. In the past, changes for tubercu
losis testing were not incorporated rapidly, sometimes taking 20 years
or more to be fully implemented. The dynamics of acceptance of change
and more rapid implementation need to be understood. With the use of
such programs as Fast Track for Tuberculosis Testing, this can be acco
mplished more readily. New technologies can be provided to all users o
f such a network within a short amount of time and health care provide
rs can equally benefit from this novel approach. The tuberculosis labo
ratory cannot stand alone. It must work together with other players, i
n order to eliminate tuberculosis.