WHO launches US$2.15 billion plan to contain drug-resistant tuberculosis
3 July 2007
Geneva. The World Health Organization (WHO) and the Stop TB
Partnership have launched a US$2.15 billion action plan to help prevent
hundreds of thousands of cases of drug-resistant tuberculosis (TB) and save
up to 134 000 lives. It calls for urgent investment worldwide to boost the
ability to contain the threat.
The Global MDR-TB and XDR-TB Response
sets out measures needed now to prevent, treat and control extensively
drug-resistant TB (XDR-TB) and multidrug-resistant TB (MDR-TB) (see
The plan also sets in motion actions to reach a 2015 goal of providing
access to drugs and diagnostic tests to all MDR-TB and XDR-TB patients,
saving the lives of up to 1.2 million patients.
"XDR-TB is a threat to the
security and stability of global health. This response plan identifies
costs, milestones and priorities for health services that will continue to
have an impact beyond its two-year time line," said WHO Director-General Dr
Urgent need to boost investment
emphasizes the urgent need to boost basic TB control and target investment
in key areas, including:
- strengthening programmes to treat drug-resistant TB;
- building capacity in diagnostic laboratories;
- expanding infection control and surveillance; and
- funding research into new and improved diagnostics, drugs and
The plan lays out a strategy for sufficiently increasing the number
of fully-equipped TB laboratories in countries with high levels of TB to
achieve a ten-fold increase in detection of MDR-TB cases. If fully
implemented, the plan will also increase by ten-fold the number of
MDR-TB and XDR-TB patients being treated and cured under WHO guidelines.
"We have sounded the alarm on the potential for an untreatable XDR-TB
epidemic. Today we issue our response on behalf of all patients and
communities whose lives are most at risk. It is an ambitious plan that must
be fully supported if we are to keep a stranglehold on drug-resistant TB,"
said Dr Mario Raviglione, Director of the WHO Stop TB Department.
world first became aware of XDR-TB in March 2006 after researchers reported
on an emerging global threat of highly resistant TB strains. Concerns were
heightened six months later by a cluster of 'virtually untreatable' XDR-TB
cases in an area of South Africa with high prevalence of HIV. All but one of
the 53 patients died in an average of 25 days after samples were taken for
drug resistance tests.
In May 2007, the case of an air passenger from the
United States infected with XDR-TB also focused attention on the need to
address the TB epidemic as an immediate international priority.
Need for quality drugs
"A highly important element of the plan is
a steady supply of quality drugs to treat MDR-TB and XDR-TB in underserved
countries," said Dr Marcos Espinal, Executive Secretary of the Stop TB
Partnership. "The Partnership's Global Drug Facility is ensuring supply of
these drugs to a growing number of countries, after our Green Light
Committee has verified that applicant countries meet its technical standards
and will use the drugs correctly."
The Global MDR-TB and XDR-TB Response
Plan 2007-2008 details activities to be carried out in all six WHO regions.
Its eight main objectives are those recommended by the WHO Global Task Force
on XDR-TB, which met in October 2006.
The total budget for the two-year
plan is US$ 2.15 billion, of which 80% is for country-specific needs. US$
102 million is for essential support functions to fight TB drug resistance
by international partners, including WHO and the Stop TB Partnership, at
global, regional and national levels.
MDR-TB is a form of TB that does not respond to the standard treatments and
is defined as TB resistant to the main first-line drugs, isoniazid and
rifampicin. There are an estimated 424 000 new cases of MDR-TB every year.
Multidrug resistance emerges when there is mismanagement of drugs and
under-investment in quality TB control. It can also be spread from one
person to another. The cost of treating MDR-TB can be 1000 times more than
treating standard TB.
XDR-TB occurs when there is resistance to all of the
most effective anti-TB drugs, and is defined as TB with MDR-TB resistance as
well as resistance to any one of the fluoroquinolone drugs and to at least
one of the three injectable second-line drugs, amikacin, capromycin and
kanamycin.Extensive drug resistance emerges through mismanagement of MDR-TB
and can also spread from one person to another. There are an estimated 25
000 to 30 000 new cases of XDR-TB every year. So far, 37 countries have
confirmed cases of XDR-TB.
(back to reference above)
The Global MDR-TB and XDR-TB Response Plan 2007-2008 [pdf 554kb] (go
back reference in text)
MDR/XDR-TB factsheet (English) [pdf 272kb]
MDR/XDR-TB factsheet (Francais) [pdf 305kb]
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