[Which strategies for eradication of tuberculosis?]

Eradication of tuberculosis is biologically feasible because infectious tuberculosis is relatively easy to identify, is treatable and curable, with cure rates approaching 100% when modern short-course therapy is used. Early diagnosis and effective treatment reduce transmission. Infected persons at increased risk of developing infectious tuberculosis can be identified through tuberculin screening of high-risk populations and tuberculosis is, at least partly, preventable by the administration of preventive therapy (chemoprophylaxis) and BCG vaccination. Humans are the primary reservoir of the tubercle bacillus. In industrialized countries, tuberculin testing of dairy cattle and slaughter of infected animals and pasteurization of milk have virtually eliminated the problem. In industrialized countries, tuberculosis has retreated into focal pockets that can be targeted for intensified control efforts. Elimination of tuberculosis in these countries depends in part on global elimination because of imported cases. In developing countries, the immediate task is to control tuberculosis, and DOTS is the key detection and treatment strategy. Joint efforts should address the issue of the global implementation of DOTS strategy and of the research needs for effective vaccine, new drugs and new delivery services.