We need people – people like those in TB Alert, who are focused and ambitious and care for people at grass roots in the UK, India and Africa. Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership
Drug resistant forms of TB can develop if treatment is incorrect or incomplete – known as acquired drug resistance. People with infectious TB that is drug resistant can also pass drug-resistant TB on to others – known as primary drug resistance.
The standard six-month treatment for TB is not effective for people with MDR-TB and XDR-TB. Instead, they must be treated with drugs that are less effective, more toxic and much more costly – typically US$2,000–5,000 per patient. Treatment takes longer – up to two years – cure rates are lower and fatalities are higher.
A person may not complete their treatment for a number of reasons. They may:
- Experience unpleasant side effects
- Fear stigma, and not want to be seen taking their medication
- Have difficulty maintaining the long treatment regimen
- Feel better and not know the risks of not completing treatment
- Be unable to afford their medication, or the associated costs of treatment
- Be unable to get hold of their medication – a regular supply of medication can be difficult to obtain in many developing countries
- Specific tests are required to identify drug resistant strains of TB: many developing countries lack the laboratory facilities to carry out this testing and patients may be unable to return to a clinic for test results
- People may not visit a healthcare practitioner who is suitably qualified to identify TB or prescribe the correct medication. Unqualified private practitioners and traditional healers are often the first point of call for people experiencing TB symptoms in the developing world
- Developing countries may lack supplies of good quality drugs
What is being done to tackle drug resistance?
The Global Plan to Stop TB 2011-15, sets out the following measures to halt the spread of drug-resistant forms of TB:
- Standardised drug regimen for drug-sensitive TB
- Directly Observed Treatment (DOT)
- Reliable supplies of high quality drugs, through the Global Drug Facility
- Infection control measures: including monitoring and isolation of infectious patients with drug resistant TB
- Upscaling of laboratory facilities to detect MDR and XDR TB
» Side effects