The article is an adaptation of a speech made by Dr. Mahler, Director-General of WHO on Sept. 8, 1976 in Kampala, Uganda and on 11th October in Karachi, Pakistan. The main focus of the speech is the need for a social revolution in public health to attain an acceptable level of health uniformly distributed throughout the world's population. The meaning of a social revolution in this context is to take a new approach to the solution of community health problems. Four key factors to adopt when taking this new approach are described in detail: 1) determination of social health goals, 2) identification of the health technologies that subserve the stated goals, 3) selection of sound and affordable health technologies and, 4) manifestation of the political will to determine health policies and appropriate health care systems. It is suggested that these four factors could also serve as a guide for collaboration between Member States, both within and between Regions and certain measures to meet the social challenge in implementation of the policies are offered.

The problem of TB in a developing country such as India must be considered in the overall social and economic context. Massive investment of money and resources to eradicate TB may interfere with other measures more important for the country`s progress. But a limited investment in a suitably oriented TB programme could hasten the decline of the disease. Social planners thus face a special challenge in such countries. The problems are almost overwhelming, while the resources available are extremely limited; scientists will have to formulate programmes which will ensure that these resources are utilised to give a maximal return from the investment. Thus, in considering TB as a problem of social planning in developing countries it will have to be dealt with at three different levels:

(a) Recognising the implications of factors other than a specific TB programme on the incidence of the disease; (b) developing methods that could offer the best possible returns from the available resources, both at any given point of time as well as at different time intervals; and (c) determining priority for allocating resources in a socially applicable TB programme. The NTI, Bangalore has used operational approach for formulating a nationally applicable and acceptable TB programme for India. The sequence of steps that led to the formulation of TB programme in India can as well be applied to develop a similar programme in any developing country.

The new approach to the role of socio-economic factors in TB control demands that social planning in respect of TB has to be in consonance with the overall development of the community. A rational allocation of existing resources in the context of this process of social change can be achieved only through a comprehensive and integrated approach. One of the important principles of social planning is the tailoring of a programme to the felt-need of the community. The intervention becomes more readily acceptable, less costly and allows the due share to the other felt-needs of the community. The overall development of the community and providing basic facilities leads to the better public participation in the TB control programme. Improved nutrition status of the people specially by feeding young, will help in preventing the breakdown of the disease. Since TB is equally prevalent in rural and urban areas, planning of the whole area by involving the existing facilities and development of effective rural TB services will bring the services within reach of every person. Regular and continuous training and supervision of the general staff to carry out TB activities is one of the prerequisite. A continuous anti-TB drug supply for treating about 4 million cases per year for a very long period of 20-30 years can be achieved with the help of international assistance.

Even if the programme is fairly effective, it is visualised that the control programme and social planning should be on long term basis for several decades.