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 author presents a few selected topics for discussion expected to assist in the future formulation of strategies against the spread of TB. One such topic is demographic changes. In most developing countries, with constant age-specific rates, increasing population and a relative increase of the older age groups are expected to lead to an increase in the absolute number of TB cases, as illustrated with a simulation. The consequences of the fact that TB services are reflections of the health services which, in turn, reflect the general public services in the community and, that TB is closely related to the prevailing socio-economic conditions are discussed in detail. Also, it is suggested that the immediate and impressive successes of the reductionistic medicine led to an underestimation of the importance of the general living conditions in the generation of health.