The present decade has seen a reawakening of tuberculosis (TB) drug research and development (R&D), spurred on by an urgent need to stem the tide of the disease globally and develop new, more effective treatments against drugsensitive and resistant strains. As a result, there are now seven products in clinical development and the largest pipeline of early-stage projects and compounds in history. The primary goals of this resurgent activity are to shorten and simplify the treatment of active TB, provide safer and more efficacious treatments for drug-resistant TB, simplify treatment of TBHIV coinfections by eliminating troublesome drug-drug interactions, and shorten treatment for latent TB infection. Successful development of new, safe and effective TB therapies faces a number of challenges, some unique to TB drug R&D, many with implications for other therapeutic indications.