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Competing Interests: All authors are WHO staff members. The authors alone are responsible for the views expressed in this Comment and do not necessarily represent the views, decisions, or policies of WHO or other institutions with which they are affiliated. WHO receives funding from a diversified portfolio of donors (including the US Agency for International Development, The Bill & Melinda Gates Foundation, the US Centers for Disease Control and Prevention, European Respiratory Society, and Unitaid) to support meetings and other activities.

The provision of tuberculosis preventive treatment is one of the critical interventions to reduce tuberculosis incidence and ultimately eliminate the disease, yet we still miss appropriate tools for an impactful intervention and treatment coverage remains low. We used recent data, epidemiological estimates, and research findings to analyze the challenges of each step of the cascade of tuberculosis prevention that currently delay the strategy implementation. We addressed research gaps and implementation bottlenecks that withhold key actions in tuberculosis case finding, testing for tuberculosis infection, provision of preventive treatment with safer, shorter regimens and supporting people to complete their treatment. Empowering communities to generate demand for preventive therapy and other prevention services in a holistic manner and providing adequate financial support to sustain implementation are essential requirements. The adoption of an effective, universal monitoring and evaluation system is a prerequisite to provide general and granular insight, and to steer progress of the tuberculosis infection strategy at global and local level., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Matteelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)