One third of the world's population has latent tuberculosis, and nine million new cases of active tuberculosis emerge annually, which results in up to three million deaths. In a clinical review, Chan and Iseman (p1282) discuss the challenges associated with treating tuberculosis. Patients' non-adherence is the most common cause of treatment failure and acquired drug resistance, but predicting non-compliance is difficult. The immediate challenges for the control of tuberculosis are developing treatment regimens that are shorter or less frequent for patients. Long term prospects include improved vaccines.