There is no generally acceptable definition for developing countries. On account of multiple demands of varying urgency on small resources, public health often receives lower priority than it deserves. To change the equilibrium between man and bacilli in the direction of positive health it would be necessary to invest resources on many key factors. Control of tuberculosis can only be a part of the effort to achieve the positive health. It is also now known that undue importance to quick conversion of sputum or early return of patients to work, need not be given. But the objective of TB programme for developing countries should be i) not to neglect service to actual sufferers and ii) to apply specific control measures in harmony with measures aiming at the overall improvement of socio economic conditions.

For developing countries domiciliary chemotherapy is the treatment of choice. Applying chemotherapy on a long term basis poses many problems, the main being the fall out of patients from treatment. The key factors are: a practical and economically feasible Case-finding and treatment programme, an adequate supply of anti TB drugs and effective executive cum supervisory organization. The District Tuberculosis Programme for a population of 1-1.5 million in each district, comprises one specialised district TB Centre which makes use of the area general health services for tuberculosis Case-finding and treatment. Several stages of development are envisaged and a start can be made from any stage, according to the facilities already available. The emphasis is on providing treatment for the patients nearest to their homes, along with effective supervision exercised by general health services staff under the guidance of the district centre. The choice of a drug regimen in the programme will depend upon efficacy of the regimen, availability of drugs, average cost of treatment, suitability for self administration and acceptability by patients/organisation. INH+PAS daily or supervised streptomycin containing intermittent regimen for smear positive cases, INH alone daily for sputum negative appear to be the regimens of choice for developing countries. It is unfortunate that a powerful regimen like S + H + PAS is very expensive and less acceptable. Thus a planned and systematic approach is needed to deal with the problem of TB. For running an organised and coordinated tuberculosis control programme, the national character of the Campaign should be recognised right at the start and maintained till the objective has been achieved.