This Monograph will discuss the main issues related to TB, with an innovative approach, beginning with a patient’s perspective [3]. The role of patients is very important, given the burden of the disease on healthcare systems globally. A chapter on the history of TB discusses recent advances in human and TB genetics and presents historical vignettes that are relevant to the current introduction of new treatments [4]. Social determinants are included in the chapter on epidemiology, so that the measures to control and eventually eliminate TB are more holistic [5]. Molecular biology has made significant advances since the last ERS Monograph on TB was published in 2012 [6], and clinically relevant material has been included in a number of chapters [4, 7–12]. The diagnostic aspects (clinical diagnosis, laboratory diagnosis, imaging, bronchoscopy and other invasive procedures) are reiterated and updated so that they are accessible to the physician in training [5, 9, 13, 14]. The treatment of drug-susceptible and drug-resistant cases, new and repurposed drugs, adverse events and the role of surgery are discussed, together with broad principles, so that physicians can apply these to the likely rapid changes in this area [15–18]. Specific patient groups (children, pregnant women and the elderly) are addressed [19]. Comorbidities have become an increasing problem in the management of TB, and diabetes, chronic renal impairment, liver disease and transplantation are addressed, in addition to coinfection with HIV [20]. The modern TB physician has to work with a team to manage homelessness, alcohol and opiate addictions, poverty and malnutrition and the disruptions caused by migration and fleeing war zones and persecutions [21]. A later chapter includes both treatment and therapeutic drug monitoring, noting that the latter will become increasingly important in personalised treatments regimens [22]. Rehabilitation after TB has become an important topic and receives its own chapter [23]. NTM have been included, as they are frequently diagnosed when TB is considered their increasing importance may merit an entire Monograph in the not-too-distant future [24]! Preventive issues have come to the fore, especially with the End TB Strategy and there are chapters on vaccines [10], infection control [25] and latent TB infection management [11]. Looking to the future, there is a chapter on research priorities [12], and one addressing the needs of the physician training [26]. Lastly, to emphasise the realities of managing TB, there are some clinical cases drawn from the experience of early career members with expertise in managing MDR-TB [27]. The developments and challenges over the last 6 years, since the publication of the first TB Monograph [6], have exceeded our expectations. We expect the recent pledges of world leaders to defeat TB will be met by a mixture of attention to patients’ needs and scientific advances, in addition to those we have outlined in this Monograph. We hope the Monograph will encourage TB physicians and basic scientists to see the gaps and fill these with their own excellent research for the next TB Monograph. References 1. World Health Organization. Global Tuberculosis report 2018. WHO/CDS/TB/2018.20. Geneva, World Health Organization, 2018. http://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng.pdf?ua=1 2. UNGA High Level Meeting on Tuberculosis, 26 September 2018. https://www.un.org/pga/73/event-detail/fight-to- end-tuberculosis/. https://doi.org/10.1183/2312508X.10031118 xv