Professor Graham Rook presents a plenary presentation giving a broad overview of TB immunology and the potential for TB immunotherapy as a countermeasure to the long and complex courses of antibiotic treatment, at 'The Challenge of TB: UCL's Contribution' held on 24th March 2010. He explains the careful balance between cytokines that are thought to be important for driving the progression or resolution of latent TB infection. Promising data for the potential of manipulating these cytokine responses to improve the outcome of TB infection are described in mouse models and progress is also being made to investigate these findings in humans, with discussions ongoing with pharmaceutical companies about possible roll out to full clinical studies. Two other new vaccines, the Hsp-65 DNA vaccine and vaccination with the saprophytic mycobacterium M. vaccae, are also discussed. The Hsp-65 vaccine is moving into human studies in Brazil and Japan, whilst a recent study of M. vaccae vaccination in BCG-primed HIV positive patients with TB showed promising results. Professor Rook discusses the possibility of targeting those patients that are failing treatment for XDR TB with vaccine treatments.