In the fight against TB, a partnership exists among three important sectors: the public, the health professionals, and the government. This chapter will deal with two of these three partners: the public and the health professionals.

A simple relationship between a patient and the doctor as individuals through community-oriented national TB programmes is part of the global fight against TB. The responsibility for having a national programmme rests with the government; it is up to the health authorities to design, staff, implement, assess, and orient the programme. Although this is generally accepted and would seem fully logical today, it is remarkable that the first organized effort against TB (which in many instances led the way to other public health measures) originated from the voluntary combination of the energy of physicians and the public in an attempt to relieve suffering, prevent disease, and disseminate information. Thus were created at the end of the past century and the beginning of this century, voluntary associations that gather together lay individuals and professionals to develop the first elements for the concerted effort to fight TB. In most countries, even though governments have taken the responsibility for providing health services in relevant programmes, the success of any governmental programme continues to depend on the competence and attitudes of professionals who are delivering the programmes and on the active and understanding participation by the people in the measures offered them.

Voluntary NGO are the best means of ensuring high standards in the application of the professional and governmental measures and the widespread participation of the public in any control programme. This includes lobbying for improvements and acting as a “watchdog” for the programme.

This is a report of the "Health Sector Priorities Review" that the World Bank undertook with a number of collaborators, over two years. The core of this review is a series of studies on the public health significance of major clusters of diseases in the developing world and on the costs and effectiveness of currently available technologies for their prevention and case management. This analysis of TB, supported as a part of these studies, revealed the tremendous burden of TB and the existence of interventions of proven efficacy that were some of the most cost-effective in the international public health armamentarium.