Divisive drug-resistance.

Medicines for tuberculosis. The drugs for the lengthy treatment of MDR-TB can cost more than 100 times that of the drugs to treat common tuberculosis strains. Even in places where tuberculosis control has seen the greatest progress, such as many of the countries in WHO’s Western Pacific Region, the fight against drug-resistant tuberculosis faces huge challenges. “In most of the high-burden countries in the region, MDR-TB is either managed outside the public health sector or in the public sector, but outside the national tuberculosis programme” says Dr Pieter van Maaren, regional adviser for Stop TB in WHO’s Western Pacific Region, adding that treatment outside national programmes tends to be poor. “In many countries public health is under a different department to curative services, and it’s difficult for national tuberculosis programmes to control what is happening in hospitals. As a result all kinds of poor management of MDR-TB are happening.” Multidrug-resistant tuberculosis (MDR-TB) refers to strains of the tuberculosis bacillus that are resistant to at least the two most efficacious drugs (rifampicin and isoniazid), while a sub-set of MDR-TB, extensively drug-resistant tuberculosis (XDR-TB), refers to strains that are resistant to nearly all current tuberculosis drugs,