MDR-TB At Highest Level Yet in 20 Countries

The fourth report of the WHO/International Union Against TB and Lung Disease Global Project on Anti-Tuberculosis Drug Resistance Surveillance found 20 locales where multi-drug resistant TB is at its highest level yet. The earlier studies were done in 1997, 2000, and 2004; 14 of the locales are former Soviet countries, while four others are in China, WHO reported yesterday. Multi-drug resistant TB (MDR-TB) means TB that is resistant to the two most powerful first-line drugs, isoniazid and rifampicin. The 142-page report is available at www.who.int/tb/publications/2008/drs_report4_26feb08.pdf.

The report is based on data collected between 2002 and 2006 on 90,000 TB patients in 81 countries. It says extensively drug-resistant tuberculosis (XDR-TB), which is virtually untreatable, has been recorded in 45 countries but warns that few countries are currently equipped to diagnose XDR-TB, so limited data on cases were available for the report. WHO now estimates there are nearly 500,000 new MDR-TB cases per year -- about 5 percent of 9 million new TB cases of all types. The highest rate was recorded in Baku, the capital of Azerbaijan, where 22.3 percent of all new TB cases were reported as multi-drug resistant.

"TB drug resistance needs a frontal assault. If countries and the international community fail to address it aggressively now, we will lose this battle," said Dr. Mario Raviglione, director of the WHO Stop TB Department. "In addition to specifically confronting drug-resistant TB and saving lives, programs worldwide must immediately improve their performance in diagnosing all TB cases rapidly and treating them until cured, which is the best way to prevent the development of drug resistance."

WHO estimates $4.8 billion is needed for overall TB control in low- and middle-income countries in 2008, with $1 billion for MDR-TB and XDR-TB. Only about half of the needed funding is in place, however.

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