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TUBERCULOSISMDR-TB & XDR-TB2011 PROGRESS REPORT
WHO REPORT: TOWARDS UNIVERSAL ACCESS TO DIAGNOSIS
AND TREATMENT OF MDR-TB & XDR-TB BY 2015
Globally, it isestimated that 3.3%of all new TB caseshad MDR-TB in 2009 Each year, about440,000 MDR-TBcases are estimated The 27to emerge, and high MDR-TB
and XDR-TB150,000 persons with burden
MDR-TB die countries*
"Progress is being made, but the response is far from sufficient and too slow given the MDR-TBthreat facing the world. This WHO report underlines the need for countries to implement allnecessary measures to address MDR-TB, otherwise the universal access target, setby the WorldHealth Assembly, will not be achieved by 2015, with the loss of hundreds of thousands of lives,"
Dr Mario Raviglione, Director, Stop TB Department, WHO
Treatment:KEY FINDINGS from the
Of the estimated 250,000 MDR-TB cases expected to occur among27 countries* with a high burden all TB patients notified in 2009 in the high MDR-TB/XDR-TB burden
countries, 24,511 were reported to have been enrolled on treatment.of MDR-TB and XDR-TB 13 countries with data on treatment outcomes for MDR-TB casesAction Plans: reported a success of 25%-82% among patients that started on
treatment in 2007. 26 countries have updated the MDR-TB component oftheir National TB Control plans. Drugs:Funding: Since 2008, the Global Drug Facility has more than doubled the
number of finished pharmaceutical products (FPP) for MDR-TB In 23 countries, funding for MDR-TB care and treatment
treatment from11 to 25, and also increased the number of eligiblehas increased from US$ 0.1b in 2009 to US$ 0.5b in
suppliers.
2011. The Global Plan to Stop TB estimates that US$0.9b is needed in 2011 to address MDR-TB worldwide. Infection Control:
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Only Estonia, Latvia, the Russian Fed. and South Africa, 14 countries have conducted a national situation assessment of TBare using domestic sources to provide most if not all of the infection control and 11 have developed national action plans.MDR-TB control funding. If domestic funding is not Surveillance Data:mobilized, the Global Fund may be the sole source of
The number ofnew drug resistance surveys under way or plannedfunding for second-line drugs and MDR-TB management
increased from1 in 2008, to 10 in 2011, while the number ofin Armenia, Bangladesh, Bulgaria, Georgia, Tajikistan,
countries withrepresentative drug resistance data increased from 19Kyrgyzstan and Uzbekistan. to 22.
Laboratories: The number ofhigh MDR-TB burden countries able to report high-
16 countries achieved by the end of 2009, the quality continuous surveillance data has increased from 4 in 2008, torecommended target of having at least one laboratory with 8 in 2010.capacity to perform culture per 5 million population, and Recent drug resistance surveys have identified high rates of MDR-one laboratory with capacity to perform drug susceptibility TB in southernAfrica. The proportion of MDR-TB among new TBtesting per 10 million population. cases has increased in Swaziland from 0.9% to 7.7% between 1995 11 countries are introducing the rapid MDR-TB Xpert and 2009, whilein Botswana the point estimates were 0.3% in 1996diagnostic test. and 2.5% in 2008.
* representing approximately over 85% of the world's estimated number of incident MDR-TB and XDR-TB cases: Armenia, Azerbaijan,Bangladesh, Belarus, Bulgaria, China, DR Congo, Estonia, Ethiopia, Georgia, India, Indonesia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania,Myanmar, Nigeria, Pakistan, Philippines, Rep of Moldova, Russian Fed, South Africa, Tajikistan, Ukraine, Uzbekistan and Viet Nam
World Health Organization 23 March 2011
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MDR-TB PROGRAMME MANAGEMENT CAPACITY
Est. MDR-TB Notified MDR-TB MDR-TB MDR-TB
DST labs Nat Ref SecondNational Approved Infection
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ASSEMBLY
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WHAT ARE MDR-TB & XDR-TB?
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r Drug-resistant TB is widespread and found in all countries surveyed. It emergesas a result of treatment mismanagement, and is
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bpassed from person to person in the same way as drug-sensitive TB.
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Multidrug-resistant TB (MDR-TB) is caused by bacteria that are resistant to themost effective anti-TB drugs (isoniazid andrifampicin). MDR-TB results from either primary infection or may develop in thecourse of a patient's treatment.
Extensively drug-resistant TB (XDR-TB) is a form of TB caused by bacteria that are resistant to isoniazid and rifampicin (i.e.MDR-TB) as well as any fluoroquinolone and any of the second-line anti-TB injectable drugs (amikacin, kanamycin or capreomycin).
These forms of TB do not respond to the standard six month treatment with first-line anti-TB drugs and can take two years or moreto treat with drugs that are less potent, more toxic and much more expensive.
**Argentina, Armenia, Australia, Austria, Azerbaijan, Bangladesh, Belgium, Botswana, Brazil, Burkina Faso, Bhutan, Cambodia, Canada, Chile,China, Colombia, Czech Rep, Ecuador, Egypt, Estonia, France, Georgia, Germany, Greece, India, Indonesia, Islamic Rep of Iran, Ireland, Israel,Italy, Japan, Kazakhstan, Kenya, Kyrgyzstan, Latvia, Lesotho, Lithuania, Mexico,
Mozambique, Myanmar, Namibia, Nepal, Netherlands, Norway,Pakistan, Peru, Philippines, Poland, Portugal, Qatar, Rep of Korea, Rep of Moldova, Romania, Russian Fed, Slovenia, South Africa, Spain,
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Swaziland, Sweden, Tajikistan, Thailand, Togo, Tunisia, Ukraine, UAE, UK, USA, Uzbekistan, Viet Nam
World Health Organization 23 March 2011
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