The problems of compliance among TB patients are similar in developed and developing nations and the solutions are a little different. The reasons for non-compliance, the kind of patients in whom non-compliance is high, the problems in detecting compliance, patients’ attitudes which affect compliance and suggestions to overcome these attitude problems are presented. Ways to reduce non-compliance include such means as providing SCC, directly administered therapy, providing all treatment medications only once daily, providing a fixed-dose combination of treatment drugs and, treating the patients on an out-patient basis.

Measures known to improve adherence such as short course chemoprophylaxis and directly observed therapy can be enhanced to a significant extent by the use of incentives. Adherence to TB therapy is influenced by several factors, including the health care system, complexity of therapeutic regimens and patient’s characteristics. Individual factors that negatively influence patient’s adherence are the most difficult to counter. Preventive TB therapy is doubly challenging because the benefit of treatment is not felt, while toxicity from the medication, when it occurs, is experienced immediately. Ingenious incentives therefore have to make it worth the patient’s while. During a study on preventive regimens, a request for an incentive, Sustacal, was observed to help completion of preventive regimens. Components of individual TB programs may help in patient adherence; it is important for health care staff to identify these aspects and, if they are successful, utilize these as an incentive to complete treatment.