DS-TB (including high-dose rifapentine and moxifloxacin) [23]. 8 weeks of daily treatment with high-dose rifapentine (1200 mg), isoniazid, pyrazinamide and moxifloxacin, followed by 9 weeks of daily treatment with high-dose rifapentine, isoniazid and moxifloxacin was shown to be non-inferior to the standard 6-month regimen [23]. These results show that shorter, efficacious and safe treatments are possible and thus, further late-stage trials, including new and repurposed drugs, are warranted. Similarly, recent studies have shown that shorter MDR-TB oral regimens can achieve high cure rates. Combinations of 6 weeks of bedaquiline, pretomanid and linezolid (with or without moxifloxacin) have shown favourable outcomes and an improved safety profile compared with the previous standard of care [24, 25]. Importantly, results have immediately translated into policy and the new 6-month MDR-TB treatment regimens are already recommended by the WHO [26]. Shorter regimens are likely to improve patient adherence and reduce adverse events they may also decrease overall treatment costs in the long term. Current priorities of TB research focus not only on the development of new tools but also on the factors associated with their successful implementation and on improving our understanding of the natural history of TB, especially the early stages of the spectrum infection–disease. Several studies suggest that asymptomatic TB disease, also referred to as subclinical TB, might be associated with a large proportion of global TB transmission [27, 28]. (See chapter 2 of this Monograph [29]). Large prevalence surveys in both African and Asian countries report that ∼50% of TB patients in whom Mycobacterium tuberculosis was isolated in sputum, were subclinical [30]. There is therefore a need to understand and measure its contribution to global TB transmission, given its immediate implications for control and research. Re-prioritisation of control strategies Globally, challenges remain in reducing the burden of disease. Specifically, DR-TB and TB-associated HIV co-infection continue to cause premature mortality in many world regions. Future threats include emerging and re-emerging pandemics, and disruption as a result of war and climate change. The recent COVID-19 pandemic eroded gains toward TB control and target achievement. The shift in focus towards public health interventions to control COVID-19 contributed to service disruptions and barriers in accessing TB care, significantly reducing both the number of people notified with TB, those enrolled to treatment – especially for MDR/RR-TB – and those put on TPT, worldwide. Wars (such as those ongoing in the Middle East, Africa and Europe in 2023) can trigger humanitarian crises, worsen the broader determinants of TB, and have a damaging impact on TB control, thereby reducing progress towards TB targets. Re-prioritisation is essential for future impact on the TB epidemic. On the eve of the second UNHLM political declaration on TB in 2023, it is hoped that member states will steady and increase their resolve to eliminate TB by re-committing to the End TB Strategy pillars, setting bold disease burden targets and closing the funding gap. Patient and provider-centred care is crucial to realising the desired declines in TB incidence, which can only be achieved if both patients and providers are made central to policies. This involves early diagnosis of TB with relevant tests, prompt treatment (for both DS-TB and DR-TB), investigation and appropriate evaluation, treatment of contacts of people with infectious TB disease, and prevention of further transmission through infection control. https://doi.org/10.1183/2312508X.10025822 xv