Tuberculosis, a reemergent disease

Tuberculosis, an ancestral human disease, remains the most widespread infec tious disease in the world. Tuberculosis remains in constant expansion and the number of new cases is projected to continue to rise, especially in low -income countries in spite of all efforts made for its eradication and the existing efficacious treatment, known for more than 30 years. About one thi rd of the world population (2 billions) is already infected with Mycobacter ium tuberculosis. The annual number of new cases of tuberculosis is estimat ed to about 8 millions of patients, with 2 millions of deaths. At the end o f the XXth century, tuberculosis remains a disease closely related to pover ty and is dramatically more marked in countries or regions where the tuberc ulosis-control programs are absent or poorly functionning. More than 95% of all tuberculosis cases are present in the low-income countries. Within thi s pandemic context, the emergence of multidrug resistant strains, on the on e hand, arising mostly after inadequate treatment and follow-up, and on the other hand, the HIV coinfection that increases considerably the number of tuberculosis infected individuals moving rapidly to contagious tuberculosis disease, create new conditions where all the constituants are assembled fo r the occurrence of outbreaks of severe tuberculosis unmanageable by curren t antimycobacterial antibiotics, joint efforts should address the issue of the global implantation of the World Health Organisation recommendations to control tuberculosis and of research needs For developing new effective va ccine and new drugs based upon new knowledge on molecular and cellular phys iopa-thological mechanisms of tubercle bacillus in the host.