Multidrug-resistant TB (MDR-TB) is defined by resistance to the two most commonly used drugs in the current four-drug (or first-line) regimen, isoniazid and rifampin. WHO treatment standards require that at least four drugs be used to treat TB in order to avoid the development of further resistance. The stories of those living with drug-resistant TB are harrowing.
According to the WHO, Eastern Europe’s rates of MDR-TB are the highest, where MDR-TB makes up 20 percent of all new TB cases. In some parts of the former Soviet Union, up to 28 percent of new TB cases are multidrug-resistant. Among previously treated cases in the same region, reported rates of drug resistance are commonly above 50% and as high as 61%. During the late 1980s and early 1990s, outbreaks of MDR-TB in North America and Europe killed more than 80% of those who contracted the disease. During a major TB outbreak in New York City in the early 1990s, one in 10 cases proved to be drug-resistant. Today, drug-resistant TB is also quite common in India and China — the two countries with the highest MDR-TB burdens.
Treatment for MDR-TB consists of what are called second-line drugs. These drugs are administered when first-line drugs fail. Treatment for MDR-TB is commonly administered for 2 years or longer and involves daily injections for six months. Many second-line drugs are toxic and have severe side effects. Further, the cost of curing MDR-TB can be staggering — literally thousands of times as expensive as that of regular treatment in some regions — posing a significant challenge to governments, health systems, and other payers.
The complexity and prohibitive cost of MDR-TB treatment means that fewer than 20 percent of the world’s MDR-TB patients receive proper treatment. Without a significantly simpler, faster cheaper, oral treatment for MDR-TB, countries cannot scale up treatment to serve their populations. The World Health Organization has issued a target of treating 80% of MDR-TB cases by 2015. Without new, simple, and affordable treatments for MDR-TB, this is not realistically possible. – See more at: http://www.tballiance.org/why/mdr-xdr.php#sthash.BXxGxfnZ.dpuf