Background:  TB basic science research has enjoyed a 15-year “renaissance” since the early 1990s when funding agencies recognized the gravity of TB as a public health threat. Now, well into the post-genomic era, primary mechanisms of pathogenesis by Mycobacterium tuberculosis are coming into focus. These include the identification virulence effector molecules and specialized delivery systems for these effector molecules, which together lead to a blockade of intracellular signaling in macrophages and the subsequent pathways of antigen presentation and acquired immunity. Genomic and proteomic tools have fostered high-throughput approaches to characterizing bacterial and host genes involved in this interplay. Additionally, advances have been made in understanding the pathogenesis of granulomatous lesions and the establishment of persistent infections.

Conclusions:  The progress in basic science offers routes for innovation in the fields of diagnostics, therapeutics, and vaccine development for tuberculosis.