After treptomycin, which heralded the era of antibacterial chemotherapy for tuberculosis (TB),
many important advances have made available treatment regimens that are almost 100 per cent
curative. Randomised clinical trials by the Tuberculosis Research Centre, in Chennai and British
Medical Research Council in East Africa and in the Far East have helped to establish many of the
principles of antituberculosis chemotherapy. With successes have also come fresh challenges.
Mycobacterium tuberculosis becomes rapidly resistant to the drugs used against it and in the last
decade, the HIV epidemic has had an adverse impact on the global epidemiology of tuberculosis,
with many countries in Sub-Saharan Africa experiencing a 2-3 fold increase in their TB burden.
While the currently recommended treatment regimens are very effective, they have failed to control
the burden of TB in the developing countries due to less than satisfactory implementation of the
control programmes. Faced with the dual threat of multidrug resistant TB and the HIV/facilitated
increase in TB, the WHO has instituted a Global TB Control Programme based on the directly
observed treatment shortcourse (DOTS) strategy. Much of the principles of this strategy have
come out of research in India. As part of this strategy, the Government of India is implementing
a Revised National Tuberculosis Control Programme (RNTCP). Under the RNTCP standardized
treatment regimens are prescribed for different treatment categories. Already more than 80 per
cent of the population is covered by this Programme and full coverage is slated for 2005.
Meanwhile, fresh research is ongoing to shorten treatment duration, a measure that should
greatly aid TB control
