Dr Joseph Donovan, clinical researcher at OUCRU Vietnam and Associate Research Fellow at the University of Oxford, joins Dr Angus Lane, medical registrar to discuss the global burden and diagnostic challenges of tuberculosis meningitis (TBM). He outlines key findings from major trials in Vietnam and Indonesia, including the ACT HIV trial of adjunctive dexamethasone, discusses global practice guidelines, and highlights existing and emerging evidence on antiretroviral timing, aspirin, and rifampicin. Dr Donovan also reflects on the severe neurological complications of TBM and the need for evidence-based critical-care strategies worldwide.