Drug-resistant tuberculosis: time for visionary political leadership

Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug re...

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Veröffentlicht in:The Lancet infectious diseases Jg. 13; H. 6; S. 529 - 539
Hauptverfasser: Abubakar, Ibrahim, Zignol, Matteo, Falzon, Dennis, Raviglione, Mario, Ditiu, Lucica, Masham, Susan, Adetifa, Ifedayo, Ford, Nathan, Cox, Helen, Lawn, Stephen D, Marais, Ben J, McHugh, Timothy D, Mwaba, Peter, Bates, Matthew, Lipman, Marc, Zijenah, Lynn, Logan, Simon, McNerney, Ruth, Zumla, Adam, Sarda, Krishna, Nahid, Payam, Hoelscher, Michael, Pletschette, Michel, Memish, Ziad A, Kim, Peter, Hafner, Richard, Cole, Stewart, Migliori, Giovanni Battista, Maeurer, Markus, Schito, Marco, Zumla, Alimuddin
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London Elsevier Ltd 01.06.2013
Lancet Publishing Group
Elsevier Limited
Schlagworte:
Antitubercular Agents - therapeutic use
Bacterial diseases
Biological and medical sciences
Drug resistance
Epidemics
Global Health
Human bacterial diseases
Human immunodeficiency virus
Humans
Infectious Disease
Infectious diseases
Medical sciences
Mycobacterium tuberculosis
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - isolation & purification
Pandemics
Prevalence
Public health
Tuberculosis
Tuberculosis and atypical mycobacterial infections
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - epidemiology
World Health Organization
Infection
Resistance
Bacteriosis
Tuberculosis
Mycobacterial infection
ISSN:1473-3099, 1474-4457, 1474-4457
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Zusammenfassung:Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630 000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans.
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ISSN:1473-3099
1474-4457
1474-4457
DOI:10.1016/S1473-3099(13)70030-6