How can we overcome the barriers to treating drug-resistant TB?
Almost 1 in 20 cases of tuberculosis worldwide is resistant to multiple drugs (known as multidrug-resistant TB or MDR-TB) and the World Health Organization has called for a massive scale up in public health efforts to tackle these cases. In this week’s PLoS Medicine, a group of MDR-TB experts outlines its recommendations on conducting research that would help in the scale up. MDR-TB can be effectively treated using second-line TB drugs, though these drugs are more expensive, less potent, and less well tolerated than first-line drugs. Fewer than 2% of all patients with MDR-TB are receiving appropriate second-line treatment. The WHO has therefore called for a dramatic scale up of MDR-TB treatment as a routine component of TB control, setting a target of treating 1.6 million patients with MDR-TB by 2015. Pilot projects of MDR-TB management (known as “programmatic management of drug-resistant TB” or PMDT) in five low income settings showed treatment success rates of 59%-83%. Frank Cobelens
