Believing that TB was almost eliminated, industrialized countries relaxed / dismantled their TB control network to a greater / lesser extent. The almost simultaneous appearance of the HIV epidemic has made the situation worse. TB has made a come back, while increased drug resistance has led to emergence of MDR-TB.

In the USA, a sharp increase of new TB cases has been reported, including MDR-TB.

In developing countries, TB has always remained a leading cause of death, in spite of help programs from industrialized countries. De HIV epidemic is responsible for much morbidity and mortality in sub-Saharan Africa and South East Asia. Immigrants and asylum seekers from these countries going to industrialized countries carry this burden with them. An illegal status (fugitives) complicates matters, in that they escape detection and treatment. The possibility of a 3^rd epidemic with MDR-TB calls for effective measures.