Country responses to the governance challenge have varied. The Bangladeshi Ministry of Health supports stewardship of service delivery through an integrated essential services package, including tuberculosis care, implemented through the public health system in partnership with non-governmental organisations (NGOs). In Cambodia, decentralization of tuberculosis care to primary care and community structures occurred as part of a national health strategy focused on rebuilding primary health care and a detailed national DOTS expansion plan. A coherent support structure at all levels of the Indian Government enabled rapid implementation of the world’s largest DOTS programme, the Revised National Tuberculosis Control Programme (RNTCP), through primary health care.