Since the publication of the Tuberculosis handbook by the World Health Organization in 1998, important changes have taken place in the global context in which control of tuberculosis (TB) is carried out. Firstly, the DOTS strategy has been adopted by virtually all countries during the past decade, although with varying quality, and full-scale DOTS implementation has not yet been achieved. At the same time, efforts to control the disease have become increasingly patient-centred and directed towards universal access to care for all.