On any day worldwide about 10 million people are incarcerated, in prisons, remand centres, police stations, jails, detention centres for asylum seekers, penal colonies, and prisoner of war camps. There is an increasing recognition that the high risk of tuberculosis in these settings poses a problem for those imprisoned and for the wider society. The issue now is what to do about what was until very recently “a forgotten plague.”1 The important general measures for tuberculosis control in prisons are improvement of prison conditions, particularly a reduction in overcrowding, improvement of nutrition and hygiene, and guaranteed access to improved prison health services.

Knowledge of the epidemiology of tuberculosis in prisons, appreciation of what makes control different from control in other settings, and understanding of the principles of tuberculosis control are all necessary for governmental and other agencies to contribute to the implementation of effective tuberculosis control programmes in prisons. We have focused here on countries with a high prevalence of tuberculosis, where the problem is most severe and the need for action most pressing, and on the specific measures necessary in the implementation of an effective prison tuberculosis programme.