Clinical detection and treatment of tuberculosis are still cumbersome, and new effective vaccines are not yet available. However, basic science is contributing significant new insights that can improve patient care and may ultimately control the pandemic. This symposium will foster interactions between basic and clinician scientists to focus research on the most prominent clinical needs and reciprocally to translate key findings into novel preventive, care and control strategies. Discussions will specifically focus on the heterogeneity of the host-pathogen interactions that underlie disease and represent a fundamental challenge to achieving this vision. By considering the full spectrum of disease, diversity of the host and pathogen, and environmental factors influencing immune control, we will refocus interventional strategies on those that will be most effective in the real world. Ultimately these insights should lead to the rational design and testing of vaccines that can prevent infection and disease in the global population, preventing not only acute disease but also post-TB sequelae.