Health sector reforms should retain vertical programmes like those for tuberculosis. While transferring health services to local communities is beneficial, the abrupt removal of vertical programmes, such as the WHO's DOTS tuberculosis programme, can lead to serious consequences. Central coordination, monitoring, and bulk drug purchasing are essential for effective tuberculosis control. The loss of these programmes can result in a lack of drugs and control measures, especially in countries like Zambia and Ethiopia. The World Health Organization has declared tuberculosis a global emergency, emphasizing the need for national control programmes to prevent multidrug resistance. Retaining central monitoring and gradually transferring responsibility to local communities is crucial. The UK's community development projects show that professionals are still needed to support local efforts. The article also addresses misconceptions about tuberculosis among immigrants, highlighting the importance of screening and follow-up. The US has implemented screening for immigrants and refugees, leading to a decline in tuberculosis cases. The article also discusses the ethical considerations of testing for tuberculosis, emphasizing the need for informed consent. The GMC advises that consent for tuberculosis testing should be obtained generally, not specifically naming the disease when the probability is low. The article also addresses the use of resistance testing for HIV, noting that while it may improve treatment, its current accuracy is limited. The use of tracker trials is suggested for evaluating new health technologies, but there are concerns about their implementation. The role of accident and emergency doctors should be expanded, with a focus on training and supervision. General practitioners are still essential for maintaining general medical skills. The need for a flexible approach in healthcare is emphasized, with a focus on patient needs and outcomes. The importance of good communication in education is highlighted, as well as the need for rigorous qualitative research. Antirealism in research is criticized as an excuse for sloppy work. The analysis of cost data in a study on inflammatory bowel disease is questioned due to the use of inappropriate statistical methods. The risk of cancer in patients with inflammatory bowel disease was not addressed in the study. The incidence of burns associated with photodynamic therapy is discussed, highlighting the need for awareness of rare but serious complications.Health sector reforms should retain vertical programmes like those for tuberculosis. While transferring health services to local communities is beneficial, the abrupt removal of vertical programmes, such as the WHO's DOTS tuberculosis programme, can lead to serious consequences. Central coordination, monitoring, and bulk drug purchasing are essential for effective tuberculosis control. The loss of these programmes can result in a lack of drugs and control measures, especially in countries like Zambia and Ethiopia. The World Health Organization has declared tuberculosis a global emergency, emphasizing the need for national control programmes to prevent multidrug resistance. Retaining central monitoring and gradually transferring responsibility to local communities is crucial. The UK's community development projects show that professionals are still needed to support local efforts. The article also addresses misconceptions about tuberculosis among immigrants, highlighting the importance of screening and follow-up. The US has implemented screening for immigrants and refugees, leading to a decline in tuberculosis cases. The article also discusses the ethical considerations of testing for tuberculosis, emphasizing the need for informed consent. The GMC advises that consent for tuberculosis testing should be obtained generally, not specifically naming the disease when the probability is low. The article also addresses the use of resistance testing for HIV, noting that while it may improve treatment, its current accuracy is limited. The use of tracker trials is suggested for evaluating new health technologies, but there are concerns about their implementation. The role of accident and emergency doctors should be expanded, with a focus on training and supervision. General practitioners are still essential for maintaining general medical skills. The need for a flexible approach in healthcare is emphasized, with a focus on patient needs and outcomes. The importance of good communication in education is highlighted, as well as the need for rigorous qualitative research. Antirealism in research is criticized as an excuse for sloppy work. The analysis of cost data in a study on inflammatory bowel disease is questioned due to the use of inappropriate statistical methods. The risk of cancer in patients with inflammatory bowel disease was not addressed in the study. The incidence of burns associated with photodynamic therapy is discussed, highlighting the need for awareness of rare but serious complications.