THE GLOBAL disparities are large, not only in the burden of tuberculosis, but also in the amount of available resources to tackle the problem. When he announced the new strategy of the World Health Organization (WHO) for tuberculosis control in 1991, Kochi compared epidemiologic indicators in low, middle-income, and industrialized countries and resources available. 1 Briefly, those with the worst problem have also the least amount of available resources.

This gradient invites collaboration, ranging from the efficient, to the well-meaning, to the selfish. In this paper, an attempt is made to delineate the different facets of international collaboration in the fight against tuberculosis, and how different approaches can lead to improvement, and, in some instances, to a deterioration of the problem. The International Union Against Tuberculosis and Lung Disease (IUATLD) bases its approach on the three pillars of technical collaboration, training and education, and research. These three pillars form the outline of the present exposé and are supplemented at the end by considerations about financing of projects in collaboration between affluent and lowincome countries.