消灭结核病之类的公共卫生威胁通常是一个很吸引人的课题。但这种想法现实吗?选择消灭结核病作为奋斗目标需要作出承诺、明确挑战并开展批评性评价。有数不清的挑战在等着我们,包括大量的潜性感染、潜伏期长、现有控制手段和策略不力、贫穷及其与结核病的关系、对每况愈下卫生服务的依赖、人类免疫缺陷病毒感染的负面影响以及现有方法所需要的长期承诺等。虽然结核病会导致死亡和疾病慢性化,但消灭结核病的目标却一定要定位于预防感染,保证下一代不被感染上来。消灭病原体所需要的敏锐反应,仅以减少死亡率或提高健康水平为目标是不够的;这只能通过预防和消灭感染来实现。即使国际上对结核病控制策略达成共识,我们也一定要记住这还是不够。我们必须改进现有策略并发展新的手段,以此为基础制定新策略以实现消灭结核病的目标。实现这个目标需要保证现有策略的实施,保证以任何可能的方式改进该策略,并以新的头脑和思维来面对结核病控制的新方法。 Public health threats such as the eradication of tuberculosis are often an attractive topic. But does this idea be realistic? Choosing to eliminate tuberculosis as a goal requires a commitment to clearly challenge and critically evaluate it. Countless challenges are waiting for us, including a large number of latent infections, long latency, poor controls and strategies, poverty and its link with tuberculosis, dependence on deteriorating health services, and negative aspects of human immunodeficiency virus infection Impact and the long-term commitment needed for existing approaches. Although tuberculosis causes death and chronic disease, the goal of eradicating tuberculosis must be targeted at preventing infection and ensuring that the next generation is not infected. The acute reaction required to eradicate pathogens is not enough to reduce mortality or improve health; this can only be done by preventing and eradicating the infection. Even if the international consensus on tuberculosis control strategies is reached, we must also remember that this is not enough. We must improve our existing strategies and develop new ones as a basis for developing new strategies to achieve the goal of eliminating tuberculosis. Achieving this goal will require ensuring the implementation of existing strategies, ensuring that the strategy is improved in any way possible and that new approaches to tuberculosis control can be confronted with new minds and thinking.