Despite an increase in the total number of tuberculosis (TB) patients globally, positive trends in reduction of prevalence and mortality are observed. However, high numbers of drug-resistant cases are threatening this trend. Multidrug-resistant and extensively resistant cases constitute an increasing challenge in many parts of the world also within the European region - especially in former Sovjet Republic nations. Point-of-care test systems potentially replacing microscopy and urine antigen detection systems are currently launched in many TB-high endemic countries improving TB detection rates. However, the effect on key indicators like mortality is still waiting to break through.