: India has the highest number of tuberculosis cases of any country in the world, and many of these cases are MDR TB. A combination of contributing factors has led to the current public health crisis: a failing National Tuberculosis Programme, denial and lack of compliance on the part of patients, lack of regulation of doctors in private practice, governmental policy failure and corruption, social and economic problems, and a growing HIV epidemic. This situation must be combatted on several fronts, including promoting social change, increasing government funding, seeking global aid, implementing DOTS, non-DOTS, and NGO programs, integrating TB and HIV programs, funding research, enacting regulatory legislation, and establishing continuing medical education programs among private practitioners.