The burden of tuberculosis in New Zealand peaked during the Second World War with 2603 cases recorded in 1943. Control measures legislated for in the Tuberculosis
Act of 1948 played a significant role in bringing down the national incidence rate from over 150 cases per 100,000 to below 10 per 100,000 by the 1990s. Today, New Zealand is considered to be a low TB incidence country;
however, this designation can mask disparities in the burden of TB within the population. The Asian ethnic group exhibits rates of TB that are approximately
50 times greater than in the European or other ethnic groups. Furthermore, among New Zealand-born individuals, Māori experience a higher burden of TB compared to their Pākehā compatriots. In this chapter, factors involved in contributing to the risk of TB in New Zealand are examined. Data from molecular typing studies are explored to gain an insight into the transmission of the illness in the population. In terms of further measures to reduce the incidence of TB in New Zealand, newer technologies that specifically detect latent TB infection are required for pre-immigration screening from high TB burden countries. Greater utilisation of prophylactic therapy of latent TB infection in individuals at risk of developing TB could assist in preventing reactivated cases. And early detection and treatment of active TB cases combined with enhanced contact tracing would help minimise the emergence of epidemiological clusters of the disease.