Before DOTS implementation, many countries used ineffective tuberculosis registration and reporting systems with little local benefit. Measurement of the effect of tuberculosis control was restricted to estimates based on a small cohort of surveys of tuberculosis prevalence, and on a range of quite low-cost yearly surveys of the risk of tuberculosis in school-aged children from settings with high prevalence of tuberculosis. Such surveys in children were stymied by high coverage of BCG vaccination which confounded results of tuberculosis testing. Unavailability of local or global estimates of mortality from tuberculosis led to gross estimation from a small cohort to countries with functioning vital registration systems. During 2000–07, only eight of the 22 high-burden countries had national surveys of disease prevalence, 12 undertook in-depth analysis of routine surveillance data, and four accomplished analysis of vital registration data for mortality.