EDITOR—Before the second world war no medicines existed to cure tuberculosis (TB). Only 50 years later, strains of tuberculosis that are resistant to all major drugs have emerged.1 Many areas of the former Soviet Union have been found to harbour high incidences of multidrug resistant tuberculosis.1 In many Western countries, an increasing number of cases of tuberculosis in foreign born residents has resulted in a change from the expected downward trend.2

Over the past years, increasing numbers of people have left the new states of the former Soviet Union. In neighbouring Scandinavian countries there is public concern that increased immigration may result in increased transmission of infectious diseases, such as multidrug resistant tuberculosis. More than 30 000 former Soviet citizens have arrived in Norway since 2001.3 Only four of these were diagnosed with multidrug resistant tuberculosis on arrival, and their infections were not transmitted to other people in Norway.4 5

Little evidence exists that increased immigration and imported tuberculosis threaten public health in the neighbouring countries of the former Soviet Union. Tuberculosis is rarely transmitted from immigrants,2 4 5 and, from a global point of view, it is far more threatening to the public health if epidemics are uncontrolled than it is to take part in controlling them. So long as tuberculosis remains a major health problem in some parts of the world, no country can expect to eliminate this disease.