Pakistan ranks four among countries with high incident cases of multi-drug resistant Tuberculosis (TB). Pakistan has the dubious distinction of being the country with the fifth-highest burden of TB in the world, following India, China, Indonesia and the Philippines — all resulting from poverty, overcrowding and malnutrition. According to WHO, 50,000 new cases are added each year to the existing pool of 550,000 cases in Pakistan, of which 15,000 are drug-resistant. Thirty-five thousand die annually. In most countries more men have TB, but in Pakistan, more women of childbearing age are affected, often with severe and advanced disease as a result of multiple pregnancies, poor nutrition and restricted approach to healthcare. Symptoms include a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody, weight loss, night sweats, fever, loss of appetite, swelling in the neck, tiredness and fatigue. Doctors claim that while it is a serious condition, it can be cured if treated properly with antibiotics. Common symptoms of active lung TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats. Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB. Trained laboratory technicians look at sputum samples under a microscope to see if TB bacteria are present. Microscopy detects only half the number of TB cases and cannot detect drug-resistance. Diagnosis can be made within 2 hours and the test is now recommended by WHO as the initial diagnostic test in all persons with signs and symptoms of TB. poor living conditions — for example, overcrowding, lack of ventilation, inadequate or low-quality food — play a big role in determining who gets to acquire TB. Rightfully, they argue that it can only stop TB if we deal with its social determinants. While acknowledging that “practical ideas for action are scarce”, these voices nonetheless underscore the need to provide social and economic support to urban poor communities in the region, amid the continuing rapid pace of urban migration and rising inequity. Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable. TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected. People infected with TB bacteria have a 5–15% lifetime risk of falling ill with TB. Persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill. When a person develops active TB disease, the symptoms (such as cough, fever, night sweats, or weight loss) may be mild for many months. This can lead to delays in seeking care and results in the transmission of the bacteria to others. People with active TB can infect 5–15 other people through close contact over the course of a year Control of any disease is best achieved through awareness building to erase myths and stigmas. Information-flows at the grassroots about disease source, transmission, early diagnosis, treatment and outcome are essential for cure. Patients should be counseled about healthy nutrition and the completion of the prescribed course of treatment. Coupled with professional counseling and liaison with the treating doctor, this will achieve a complete cure in a majority of patients. Prevention of spread to others will ultimately lead to TB control. Tuberculosis is a disease of poverty and poor, malnourished, diabetic patients using corticosteroid drugs, drug addicts, smokers, elderly, HIV-infected patients, alcoholics and people living in an overcrowded institution like a prison. A large number of people infected with the tuberculosis bacilli are not diagnosed either because of poverty or because of a lack of awareness about the seriousness of the disease. The delay in diagnosis along with unsupervised, inappropriate and inadequate drug regimens, poor follow up and lack of social support programs for high-risk population, are some of the reasons for not reaching the target rates and emergence of a drug-resistant form of tuberculosis. Tuberculosis is a treatable disease with six months course of antibiotics. However, prevention is better than cure. It can be prevented by BCG vaccination and by awareness-raising campaigns on a mass scale. If somebody has the symptoms of tuberculosis, one should report to the nearest health care centers to get their sputum tested free of cost. Tuberculosis patients should not be stigmatised and must receive full support from family and community. To reduce the burden of the disease in Pakistan there is a dire need to increase awareness among the public and especially among the youth through mass media. The writer hails from Umerkot Sindh. He can be reached at anrahimoo@gmail.com