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Dermot Maher

, Marcos Espinal

, and Mario Raviglione

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date: 16 May 2022

We begin the chapter by describing the natural history of Mycobacterium tuberculosis infection. This underpins our understanding of tuberculosis epidemiology and the principles of tuberculosis control, for which the main stratagems are then briefly discussed. We continue with an historical account of the global tuberculosis epidemic as the necessary background to a description of the current burden of tuberculosis and recent trends. A brief account of tuberculosis control in the era of anti-tuberculosis chemotherapy serves as the backdrop to the development and implementation of the World Health Organization (WHO) strategy for tuberculosis control known as DOTS (a brand name derived from Directly Observed Treatment, Short-Course) and its adaptations. The next section reviews the basic principles in tuberculosis care which underpin the public health approach to tuberculosis control. We provide an assessment of the progress made towards the international targets for tuberculosis control for 2005, and then outline recent events in the evolving international response to the challenge of tuberculosis, including the development of the Stop TB Strategy and the Global Plan to implement it. We conclude with an assessment of the prospects for tuberculosis control in the future, looking forward to 2015 (the target year for the United Nations’ Millennium Development Goals) and then beyond to 2050 (the target year for the elimination of tuberculosis as a global public health problem).

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