The global control of tuberculosis: What are the prospects?

Tuberculosis (TB) still imposes a huge burden of ill health, premature deat h and emotional suffering on the developing world. Over the past 30 y it ha s been greatly neglected by those concerned about international public heal th and there are now nearly 8 million new cases annually and 1.86 million d eaths. An epidemic of HIV-associated TB is now affecting Africa and threate ning parts of Asia. Multidrug-resistant TB has emerged as a huge threat in Russia and its former satellites. However, with the advent of the directly observed treatment, short-course (DOTS) strategy in 1995, high-burden count ries have started to seriously address the problem. Recent political commit ment on the part of the rich nations, together with significant increases i n funding from private foundations and great scientific advances in our und erstanding of Mycobacterium tuberculosis, give rise to cautious optimism th at TB will be controlled during this century.