The understanding of tuberculosis (TB) requires effective links to be made between advances in biomedical knowledge and the wider social and economic dynamics of disease epidemiology. This review highlights some recent advances in contemporary TB research with particular emphasis on the spread of multidrug-resistant tuberculosis (MDR-TB); the prevalence of TB in prisons, urban ghettoes, and the marginalized communities of the South; and the relation between TB control and general developments in public policy making. The article also draws attention to the significance of new historical insights into the epidemiological transition of the twentieth century and the implications of new and emerging diseases for the future of public health. It is concluded that the real obstacles to the effective control of TB are political rather than scientific.