A new report released by Partners In Health (PIH), Médecins Sans Frontières (MSF), and Treatment Action Group (TAG) finds that a lack of international commitment, funding and effective reform has allowed multidrug-resistant tuberculosis (MDR-TB) to continue to spread and cost lives. Each year 150,000 people die from MDR-TB and a total of 440,000 people develop or become infected with the disease.

According to the report, “An evaluation of drug-resistant TB treatment scale-up,” a lack of urgency and commitment from governments is severely limiting efforts to identify new MDR-TB cases. The report also states that donors are failing to make TB a priority. “Almost all of the major donors we contacted were unable to tell us how much of their funding was directed at MDR-TB diagnosis and treatment,” said Javid Syed, TB/HIV Project Director at TAG.

In India, patients are concerned about poor hygiene and lack of infection control at health centers, states the report. 

Unpredictable and expensive drug supplies contributed to the poor scale-up of treatment, as well. The report, which looked at the MDR-TB treatment programs of India, Russia and South Africa, found that countries were prone to drug shortages at both a national and international level. “If MDR-TB patients can’t take their medications regularly because their local clinic has run out of supplies, then they’re at increased risk of developing resistance to second-line TB drugs,” said Donna Barry, Advocacy and Policy Director for PIH.

Download the report.

Major shortfalls are cited among initiatives administered by the World Health Organization (WHO). The report finds, for instance, that the outcome of a 20-month effort to reform the Green Light Committee — designed to help countries gain technical support for scale up of MDR-TB and access to quality MDR-TB drugs — is insufficient to address many key bottlenecks.

"Discrimination was also a repeated concern, at the workplace, in the community, and even in the health centers," states the report.

As part of its conclusion, the report offers a comprehensive list of recommendations, including the need for improved information about the quality of MDR-TB drugs and treatment outcomes, not just the numbers of patients treated. Civil society groups are also encouraged to play an important role in the monitoring of global efforts to scale up MDR-TB.