Tuberculosis 2000-2010: Control, but Not Elimination

The main task of global tuberculosis (TB) control over the next decade is to dramatically reduce TB deaths, the average duration of illness, and incidence--in that order. The best possible application of chemotherapy has the potential to cut the TB burden by more than 50% in 10 years. Mass screening for active TB has not generally been recommended, but the costs and benefits of targeted active case finding deserve further investigation. Among potential new tools for TB control, the biggest prize would be a high-efficacy vaccine that can produce long-lasting immunity. Now that good control programmes are becoming more widespread, new methods and indicators are needed to evaluate epidemiological impact. Even if morbidity and mortality are significantly reduced before 2010, tuberculosis infection will persist for much longer, acting as a sensitive indicator of public health, and as a marker of the quality of health services.