The report, "Anti-Tuberculosis Drug Resistance in the World," is based on data collected between 2002 and 2006 on 90 000 TB patients in 81 countries. It found that extensively drug-resistant tuberculosis (XDR-TB), a virtually untreatable form of the respiratory disease, has been recorded in 45 countries.
The report also found a link between HIV infection and MDR-TB. Surveys in
Based on the analysis of the survey data, the World Health Organization (WHO) estimates there are nearly half a million new cases of MDR-TB a year, which is about 5 percent of 9 million new TB cases of all types. The highest rate was recorded in
Proportions of MDR-TB among new TB cases were 19.4 percent in
"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."
For the first time, the global survey includes analysis of XDR-TB. However, because few countries are currently equipped to diagnose it, limited data were available for this report.
The report also points to some successes. Thirteen years ago,
The true scale of the problem also remains unknown in some pockets of the world. Only six countries in
"Without these data, it is difficult to estimate the true burden and trends of MDR-TB and XDR-TB in the region. It is likely there are outbreaks of drug resistance going unnoticed and undetected," said WHO TB expert Abigail Wright, the principal author of the report.
WHO estimates that $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. But there is a total finance gap of $2.5 billion, including a $500 million gap for MDR-TB and XDR-TB.
"The threat created by TB drug resistance demands that we fill these gaps, as laid out in the Global Plan to Stop TB, a roadmap for halving TB prevalence and deaths compared with 1990 levels by 2015," said Dr. Marcos Espinal, executive secretary of the Stop TB Partnership. "The plan also calls for another imperative -- sufficient resources for research to find new diagnostics, new drugs effective against resistant strains and an effective TB vaccine."
Source: World Health Organization