There is a dangerous and persistent interplay between tuberculosis (TB) and poverty. TB infection is transmitted more readily in the environmental conditions of poverty: overcrowding, inadequate ventilation and malnutrition. Having TB makes poor people, their relatives and communities poorer still by preventing gainful employment and worsening their social relationships. Yet it is the poor who use proportionally more of their income in accessing treatment for TB than the less poor. This year's World TB Day theme is therefore welcome in emphasising the needs of TB patients, especially poor TB patients, in balance to the needs of TB services and their targets.