Expanding the Frontiers of Tuberculosis Prevention: Moving from Targeted Preventive Therapy to Integrated Public...

Tuberculosis (TB) remains a leading cause of infectious disease-related mortality worldwide despite major advances in diagnostics, treatment, and programmatic control. Achieving the goals of the World Health Organization End TB Strategy requires a greater emphasis on prevention alongside improvements in diagnosis and treatment. This viewpoint examines evolving priorities in TB prevention and highlights key insights from studies included in the Special Issue 'New Perspectives in Tuberculosis Prevention and Control'. The articles published in the Special Issue highlight the importance of identifying populations at increased risk of infection, disease transmission, and disease progression; strengthening the implementation of tuberculosis preventive treatment among household contacts and people living with HIV; and addressing the behavioral, social, and structural determinants that influence access to TB prevention and care. They also demonstrate persistent challenges related to medicine availability, healthcare worker capacity, patient initiation and follow-up, program monitoring, and the implementation of preventive interventions in resource-constrained settings. Emerging developments in diagnostics, biomarkers, vaccines, and digital health may contribute to the longer-term TB prevention agenda but require further evaluation of their feasibility, affordability, and programmatic relevance. Collectively, the evidence indicates that effective TB prevention extends beyond individual biomedical interventions and requires coordinated approaches involving healthcare systems, communities, surveillance systems, and social support mechanisms. Continued investment in implementation research, health-system strengthening, program management, economic evaluation, and multisectoral action will be critical to translate existing evidence into sustainable, equitable, and context-specific strategies for reducing the global burden of TB.