G lobally, every year, almost 9 million people develop tuberculosis and 3 million people die from the disease. More people aredying of tuberculosis today than ever before. Almost one third of the global total of infectious cases is detected in the Western PacificRegion, where the number of cases has almost doubled in the last decadeto 900 000 cases. About half a million people die from tuberculosis each year in theRegion. The tuberculosis burden is even heavier in the small Pacificisland countries, where, in 1998, the average notification rate in 17 ofthese countries was 73 per 100 000 population, which is much higherthan the regional average. If the control mechanisms are maintained at the current levels, it isprojected that the number of tuberculosis cases and related deaths willincrease considerably in the next few years. However, this trend can bereversed if the WHO recommended tuberculosis control strategy, thedirectly observed treatment short course (DOTS), is implemented. TheDOTS strategy has been shown to be highly effective in all settings, evenduring conflicts. A full course of anti-TB drugs, sufficient to cure onepatient, costs less than US$40, making the DOTS strategy one of themost cost-effective health interventions. Therefore, the potential tosignificantly reduce the size of the tuberculosis epidemic already exists,if governments are committed to providing continuous political andfinancial support.