The behavioural aspects of TB control are a leading causal factor in the growing epidemic. Major obstacles to the control of TB worldwide include poor patient adherence to treatment, deficiencies in medical management and lack of governmental support. For an improved TB control programme, efforts must be made to improve physicians' knowledge, attitudes and practices in TB control management. Effective techniques for improving adherence include the use of DOT, incentives and enablers, fixed-dose combination pills or capsules of demonstrated bioequivalence, patient education, appointment reminders and comprehensive services.

Drug resistance, poverty, natural disasters, HIV and lack of government commitment have contributed to the resurgence of TB worldwide. However, even acknowledging these forces, there is little chance of controlling TB unless the behavioural barriers that allow the epidemic to progress are considered. Biomedical advances are essential but, alone, are insufficient for the control of TB - the human element remains critical. With adequate funding and programme changes, control of TB can be achieved, even under adverse conditions.