"XDR-TB sounds a clamorous warning: without the political will to control TB, we will not only fail to defeat HIV but may enable the rise of an incurable, airborne disease." – Desmond Tutu
Multidrug-resistant TB (MDR-TB) is a dangerous form of TB that is resistant to the two most powerful anti-TB drugs. Ineffective treatment of MDR-TB gives rise to extensively drug-resistant TB (XDR-TB). Resistant to a number of critical first and second-line anti-TB drugs, XDR-TB is extremely difficult and costly to treat and is highly fatal.
New Data Warns MDR-TB and XDR-TB Are Increasing at an Alarming Rate
- There was an estimated 650,000 MDR-TB cases in 2010.
- China and India together hold 50% of the world’s TB burden, and have the highest absolute numbers of MDR-TB cases.
- 5.4% of MDR-TB cases are XDR-TB.
- Drug resistance is entirely man-made and caused by inconsistent or incorrect treatment.
- XDR-TB has now been reported in 69 countries, including all G8 countries. XDR-TB is likely under-reported, since many endemic countries do not have the laboratory capacity to detect drug resistance.
Drug-Resistant TB Threatens Progress in the Fight against HIV/AIDS
- TB is the number one infectious killer among people with HIV/AIDS. People with HIV are more susceptible to contracting MDR-TB and XDR-TB.
- By 2015, all treatment coverage and screening of HIV positive TB patients should be at 100%. However in 2010, 77% were being treated with cotrimoxazole treatment, 46% were treated with anti-retroviral treatment, 58% of people living with HIV receiving care were screened for TB during their visit to health clinic, and 12% were enrolled on IPT.
- There were 350,000 deaths from HIV associated TB in 2010.
New Resources and Political Commitment are Desperately Needed
- To prevent the spread of drug resistant strains, especially where HIV is common, more resources are needed to support TB control programs.
- TB programs must be strengthened and expanded to prevent drug resistance. Increased resources are needed to support better diagnostics, lab strengthening, treatment and patient follow-up.
- Drug-resistant TB demonstrates the desperate need for new drugs and diagnostics. No new TB drugs have emerged in 40 years, no effective TB vaccine exists, and the diagnostic test used in most poor countries has changed little in a century.
- Current methods of testing for drug resistance can take between 6 to 16 weeks; many patients die before the disease can be accurately diagnosed. However, a new diagnostic test - Xpert MTB/RIF - is able to quickly and accurately detect common forms of drug resistance. Resources are urgently needed to make Xpert MTB/RIF available worldwide.
- We must stop the spread of TB in public settings, including hospitals and clinics. Cost-effective infection control measures could reduce the spread of XDR-TB by 50%, even before new tools are developed.
- XDR-TB does not have to be a death sentence. With early and accurate diagnosis and access to all second-line drugs, countries with good TB control programs have been able to achieve a cure rate of 50–60%.
 World Health Organization. (2011). TB/HIV Facts 2011 [fact sheet]. Geneva: World Health Organization.
 World Health Organization. (2010). Multidrug and extensively drug-resistant TB (M/XDR-TB): Global Report on Surveillance and Response. Geneva: World Health Organization.
 World Health Organization. (2011). Tuberculosis MDR-TB & XDR-TB 2011 Progress Report [fact sheet]. Geneva: World Health Organization.
 TB/HIV Facts, 2011.
 World Health Organization. (2011). 2011/2012 Tuberculosis Global Facts [fact sheet]. Geneva: World Health Organization.