Drug-resistance: a rising global concernMDR-TB Out-patient Clinic, Indonesia

It is estimated that over 250,000 people die annually as a result of multidrug-resistant tuberculosis (TB), commonly known as MDR-TB. With this form of TB, the normal drug regime prescribed to fight the TB bacillus becomes ineffective and the patient’s chances of recovery are reduced.

In a further development, improper management of MDR-TB is creating a worldwide rise in extensively drug-resistant TB (XDR-TB).

The rapid spread of these forms of TB is a global concern and remains a serious barrier to TB control. While drug-resistant TB affects all continents, the problem is most acute in Eastern Europe and Central Asia – particularly in countries of the former Soviet Union. Here the upsurge of drug-resistant TB has its roots in deteriorating public health systems.

Furthermore, increased migration across borders and international travel means all countries regardless of their location have a bigger risk of drug-resistant TB outbreaks.


Drug-resistant TB is ”man-made”: caused by poor treatment practices, use of poor quality drugs and the failure to support patients’ adherence to treatment. Treating drug-resistant TB however is costly, toxic and very long (up to 24 months). In addition, treatment success is low and the availability of the complex (second-line) drugs remains limited.

KNCV Tuberculosis Foundation is advocating for:

  • the early diagnosis of drug-resistant TB
  • more and better access to quality drugs
  • shorter treatment regimens and
  • adequate infection control measures, which must reduce the transmission to contacts, particularly of health care workers.

Programmatic Management of Drug-Resistant TB (PMDT)

Over the years, KNCV has amassed considerable experience with the comprehensive management of TB and with the implementation of the Stop TB Strategy, including the PMDT. We have been supporting the scale-up of PMDT in 8 of the 27 countries where the MDR-TB problem is most acute, under the USAID-supported TB CARE I program.

KNCV is working to reduce the transmission of drug-resistant TB by:

  • training local staff on early diagnosis, treatment and infection control measures;
  • supporting National TB Programs (NTPs) to assess the risk of infection and to take proper infection control measures;
  • advocating NTPs to integrate PMDT into existing TB and TB/HIV health services;
  • advising NTPs to take preventive measures in hospitals, high-risk and crowded settings such as prisons and at home during ambulatory treatment;
  • assist countries to collect and analyse data in line with international standards. This data makes it possible to monitor drug-resistant TB burden, trends and to develop a response.

In addition to our direct country-level involvement, KNCV is also active in international policy development through the Stop-TB MDR-TB Working Group, the Global Laboratory Initiative, regional Green Light Committee mechanisms and the Global Drug Facility

Our PMDT experts

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  • Sustainable implementation of new tests and drugs

  • Nigeria’s first pilot for ambulatory PMDT

  • Introducing new drugs and shorter drug regimens

  • Lees meer over Programmatic Management of Drug-Resistant TB

    Sustainable implementation of new tests and drugs

    After the collapse of the Soviet Union in the 1990s, the health systems of the Central Asian Republics were in disarray. Following decades of poorly managed TB treatment and inadequate regulation and supply of TB drugs, many Central Asian countries now struggle with very high rates of drug-resistant TB.

  • Lees meer over Programmatic Management of Drug-Resistant TB

    Nigeria’s first pilot for ambulatory PMDT

    The introduction of the rapid diagnostic test Xpert MTB/RIF in Nigeria has led to a rise in the number of people diagnosed with and requiring treatment for MDR-TB.

  • Lees meer over Programmatic Management of Drug-Resistant TB

    Introducing new drugs and shorter drug regimens

    Current treatment of multidrug-resistant forms of TB (MDR-TB) requires the use of multiple drugs with limited efficacy for a prolonged period of time (18-24 months). The treatment is complicated, costly and difficult for patients.