Tuberculosis

The failure to control tuberculosis (TB) in recent times stems, at least in part, from complacency towards TB control in the 1970s and 1980s and the subsequent devastating impact of the HIV-1 pandemic, the rising emergence of drug resistance as well as the growing disparity in disease burden between developed and developing countries. Progress has also been hindered by the slow development of more effective tools such as point-of-care diagnostics and treatments for active and latent disease, preventive vaccines, and laboratory assays of disease progression, immune protection, and cure. This lack of progress is, in turn, related to a poor understanding of the fundamental relationship between Mycobacterium tuberculosis and the human host and especially the nature of what is referred to as ‘latent TB infection’. An increased focus on understanding the mechanics and drivers of transmission together with a concerted effort to translate research findings into policy and practice contextualized to local needs and resources is required. This chapter reviews recent advances in tackling tuberculosis, highlighting key unmet needs and strategies for an accelerated effort to achieve control.