Recent WHO Global Tuberculosis Reports highlight a growing concern for the burden of undiagnosed TB on a global scale. Research by the Zambia Aids-Related TB Project (ZAMBART) supports the need for intensified TB casefinding in high HIV prevalence settings where existing health systems are over-burdened and limited resources are over-stretched, to ensure early detection and prompt and effective diagnosis and treatment. Research outlined in this briefing illustrates that many TB patients in Zambia remain undiagnosed and that TB suspects with a chronic cough do not seek care at their local health facility, spreading infection within communities where TB is becoming harder to control. Despite the availability of diagnostic tools and treatment for TB, these are inefficient and can be ineffective, and many patients are failing to access them. ZAMBART research aims to address the worrying gap between existing health services and the communities they aim to serve.