"If you diagnose MDR tuberculosis, up front you need to do a check on resistance and should tailor treatment to the individual patient,” van Helden says. However, in the vast majority of countries with a high tuberculosis burden, this is too expensive and logisitically tricky. Last year, a report4 by the World Health Organization suggested that in 2010, only 16% of people with MDR tuberculosis received appropriate diagnosis and treatment.
There are reasons for hope, however. Some countries, such as Latvia and Estonia, have managed to stabilize or even reduce their levels of MDR tuberculosis by putting in place control measures. Cegielski says that faster diagnostic tools are being developed and implemented, although there is some way to go before they can be used to identify all drug-resistant strains. Two new tuberculosis drugs are in the final stages of development, and could also help to replace those being rendered less useful through resistance, he adds.