This Step Up for TB 2020 report by the Stop TB Partnership and Médecins Sans Frontières (MSF) summarises findings from the 4th survey of national TB policies in the Step Up for TB series. This edition presents data on 37 high-burden countries (representing 77% of the global estimated TB incident cases), assessing the extent to which national policies align with international best practices based on WHO guidelines and the latest scientific research. It also reports on some of the barriers to policy adoption and implementation identified by NTPs, although it does not attempt to portray the level of implementation across all policies featured. It offers an insight into the ambitions of governments around the world regarding the care they aim to provide. These ambitions are considered in the context of countries’ global commitments and progress in implementation, as reported by WHO.