MULTIDRUG-RESISTANT
TUBERCULOSIS (MDR-TB)
2014 UPDATE
GLOBAL BURDEN IN 2013
Globally, 5% of TB cases were estimated to have had
MDR-TB in 2013 (3.5% of new and 20.5% of previously
treated TB cases).
Drug resistance surveillance data show that an
estimated 480 000 people developed MDR-TB in 2013
and 210 000 people died.
Extensively drug-resistant TB (XDR-TB) has been
reported by 100 countries in 2013. On average, an
estimated 9% of people with MDR-TB have XDR-TB.
DETECTION OF MDR-TB PATIENTS
If all notified TB patients (6.1 million, new and previously
treated) had been tested for drug resistance in 2013, an
estimated 300 000 cases of MDR-TB would have been
detected.
In 2013, 136 000 of the estimated 300 000 MDR-TB
patients who could have been detected were diagnosed
and notified. This represents a tripling in MDR-TB
detection compared with 2009.
TREATMENT ENROLLMENT
TREATMENT OUTCOMES
A total of 97 000 patients were enrolled on MDR-TB
treatment in 2013, a three-fold increase compared with
2009.
The gap between diagnosis and treatment widened in
2013 in several countries. 39 000 patients diagnosed
with MDR-TB (plus an unknown number detected in
previous years) were on waiting lists for treatment.
TRENDS
A new analysis of trends focusing on the years
20082013 shows that, at the global level, the
proportion of new cases with MDR-TB remains
unchanged at around 3.5%. However, serious MDR-TB
epidemics in some countries jeopardise progress.
For more information please access:
http://www.who.int/tb/challenges/mdr/
World Health Organization October 2014
Only 48% of the MDR-TB patients in the 2011 cohort
of detected cases were successfully treated. 16%
died, 24% did not have their treatment outcome
documented or interrupted treatment, and 12% were
not cured despite receiving treatment.
The treatment success rate for XDR-TB patients in the
2011 cohort was only 22%.
Five priority actions to address the global MDR-TB crisis
PREVENT THE DEVELOPMENT OF DRUG RESISTANCE THROUGH
HIGH QUALITY TREATMENT OF DRUG-SUSCEPTIBLE TB
Prevent MDR-TB as a first priority.
EXPAND RAPID TESTING AND DETECTION OF DRUGRESISTANT TB CASES
Scale up rapid testing and detection of all MDR-TB cases.
PROVIDE IMMEDIATE ACCESS TO EFFECTIVE TREATMENT AND
PROPER CARE
Ensure prompt access to appropriate MDR-TB care, including adequate supplies of quality
drugs and scaled-up country capacity to deliver services.
PREVENT TRANSMISSION THROUGH INFECTION CONTROL
Implement appropriate TB infection control measures and quickly enroll diagnosed patients on
effective treatment to minimize the risk of disease transmission.
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INCREASE POLITICAL COMMITMENT WITH FINANCING
Underpin and sustain the MDR-TB response through high-level political commitment, strong
leadership across multiple governmental sectors, ever-broadening partnerships, and adequate
financing for care and research.
FINANCING FOR MDR-TB
It is estimated that about US$ 8 billion per year is
required for a full response to the TB epidemic in lowand middle-income countries, of which about 20% is for
detection and treatment of MDR-TB.
Additionally about US$ 2 billion per year is required for
research and development for new TB diagnostics,
drugs and vaccines.
NEW DRUGS FOR MDR-TB
Bedaquiline and delamanid are two new drugs for use
in the treatment of MDR-TB, and WHO has developed
interim guidance on their use.
Novel drug regimens for shortened treatment of drugresistant TB, including new or re-purposed drugs, are
under investigation.
WHO has produced a generic policy implementation
package for the introduction of new TB drugs or
combination of drugs, and is supporting, with other
partners, uptake in several countries to inform scaledup efforts.
More funding is needed from both domestic and
international donor sources. It is essential that full
coverage of TB and MDR-TB patients is included in
national health financing mechanisms to ensure that
they can access care without incurring catastrophic
costs.
WHAT ARE MDR-TB AND XDR-TB?
Standard anti-TB drugs have been used for decades, and resistance to the medicines is widespread. Disease strains that are
resistant to a single anti-TB drug have been documented in every country surveyed.
Multidrug-resistant tuberculosis ( MDR-TB) is a form of TB caused by bacteria that do not respond to, at least, isoniazid and
rifampicin, the two most powerful, first-line (or standard) anti-TB drugs.
Extensively drug-resistant TB (XDR-TB), is a form of multidrug-resistant tuberculosis that responds to even fewer available
medicines, including the most effective second-line anti-TB drugs.
