Australia has maintained an overall low incidence of active tuberculosis cases over the past half century due to strong political committment, appropriate monitoring and timely treatment of this disease.  Unfortunately due to a combination of the development of acquired drug resistant strains and recent suboptimal policital policy the future of tuberculosis in Australia is starting to decline and we are now in a threatened position; as multi-drug resistant tuberculosis has emerged in the Australian population.  In order to maintain biovigilance; policy makers will need to take on a visonary approach to prevent and control an increasing number of drug resistant cases.