[...]... 2008a; the number of MDR TB cases is from WHO, 2008b; the deaths from MDR and XDR TB were estimated by Nunn’s team from published literature using the case numbers listed in the table; and the number of XDR TB cases [according to the revised October 2006 definition of XDR TB] was estimated from the MDR TB number listed in the table using the percentages from CDC, 2006.)  THREAT OF DRUG-RESISTANT TUBERCULOSIS. .. Objectives, 17 Organization of This Report, 18 2 THE GLOBAL SPREAD OF MULTIDRUG-RESISTANT AND EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS Scope of the Problem, 19 Underreporting of MDR TB in Africa, 25 The Threat of Totally Drug-Resistant TB, 33 Importance of Better Data, 33 3 MDR TB TRANSMISSION, HIV COINFECTION, AND TRANSMISSION CONTROL Coinfection with HIV, 35 Treatment, 36 Transmission of XDR TB, 37 Perspective... Development of rapid and reliable diagnostic methods that can be used at the point of care; 2 Investment in the pipeline of new drugs, as well as proper use of existing first- and second-line therapies; 3 Investment in research to understand the epidemiology that contributes to the spread of drug-resistant and drug-sensitive strains of TB; 4 Understanding of the relationship between and comorbidities of HIV/AIDS... 2003 The growing burden of tuberculosis: Global trends and interactions with the HIV epidemic Archives of Internal Medicine 163:1009–1021 IOM (Institute of Medicine) 2000 Ending neglect: The elimination of tuberculosis in the United States Washington, DC: National Academy Press summary 13 Keshavjee, S., and K Seung 2008 Stemming the tide of multidrug-resistant tuberculosis: Major barriers to addressing. .. broad range of stakeholders The goals of the workshop summarized in this report were to understand the magnitude and nature of the drug resistance problem; to assess the adequacy of the current global response; and to examine in depth three primary areas of concern—diagnosis, drug supply, and treatment delivery The workshop brought together a wide range of experts and organizations engaged in the global... systems for the purchase and delivery of TB drugs (Chapter 6); and research on the global control of TB and the role of drugs, vaccines, and funding (Chapter 7) The final chapter summarizes strategies put forth by workshop participants for confronting the global crisis of drug-resistant TB    t should be noted that this paper represents the views of its authors and not those of the I IOM 2 The Global... disrupts the flow of drug supplies Ruth Levine of the Center for Global Development discussed the critical role of accurate demand forecasting, drawing on lessons learned from  THREAT OF DRUG-RESISTANT TUBERCULOSIS dealing with malaria WHO’s malaria drug demand forecasts have been off by orders of magnitude For example, the original demand for Coartem was estimated to be 55 million doses; the actual... at all These drugs are consequently unlikely to shorten therapy, an objective requiring drugs that act against other kinds of targets A number of new discovery projects are focused on energy 10 THREAT OF DRUG-RESISTANT TUBERCULOSIS metabolism, and if these candidates are successfully developed, they will likely contribute to shortening therapy Research Priorities at the National Institutes of Health... MDR TB and outline the issues for discussion during the workshop, the IOM commissioned a white paper from Partners In Health (see Appendix C) This paper provides updated information on the epidemiology and treatment of MDR TB and describes the barriers to effective 18 THREAT OF DRUG-RESISTANT TUBERCULOSIS global response. The original intent of the workshop was primarily to release the white paper and... coinfected with TB (WHO, 2008c) As a result of their weakened immune system, HIV-positive patients often develop active TB In 2000, TB was identified as the cause of 11 percent of all AIDS-related deaths (Corbett et al., 2003)   THREAT OF DRUG-RESISTANT TUBERCULOSIS The global health apparatus has been slow to respond to the transformation of TB into highly drug-resistant forms Outmoded techniques for . Rapporteur s Addressing the Threat of Drug-Resistant Tuberculosis W O R K S H O P S U M M A R Y A Realistic Assessment of the Challenge THE NATIONAL. dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress