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Author Notes:

Corresponding author: Emily A. Kendall. CRB2 Room 106, 1550 Orleans St, Baltimore, Maryland, USA 21287. Telephone: +1-410-502-8234. ekendal2@jhmi.edu


Research Funding:

EAK is supported by a career development award from the National Institute of Allergy and Infectious Disease of the National Institutes of Health, award number K08AI127908.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Infectious Diseases
  • Respiratory System
  • drug resistance
  • elimination
  • incidence reduction
  • prevention
  • cost effectiveness
  • MDR-TB

What will it take to eliminate drug-resistant tuberculosis?


Journal Title:

The International Journal of Tuberculosis and Lung Disease


Volume 23, Number 5


, Pages 535-546

Type of Work:

Article | Post-print: After Peer Review


The Union Drug-resistant tuberculosis (DR-TB) is challenging to diagnose, treat, and prevent, but this situation is slowly changing. If the world is to drastically reduce the incidence of DR-TB, we must stop creating new DR-TB as an essential first step. The DR-TB epidemic that is ongoing should also be directly addressed. First-line drug resistance must be rapidly detected using universal molecular testing for resistance to at least rifampin and, preferably, other key drugs at initial TB diagnosis. DR-TB treatment outcomes must also improve dramatically. Effective use of currently available, new, and repurposed drugs, combined with patient-centered treatment that aids adherence and reduces catastrophic costs, are essential. Innovations within sight, such as short, highly effective, broadly indicated regimens, paired with point-of-care drug susceptibility testing, could accelerate progress in treatment outcomes. Preventing or containing resistance to second-line and novel drugs is also critical and will require high-quality systems for diagnosis, regimen selection, and treatment monitoring. Finally, earlier detection and/or prevention of DR-TB is necessary, with particular attention to airborne infection control, case finding, and preventive therapy for contacts of patients with DR-TB. Implementing these strategies can overcome the barrier that DR-TB represents for global TB elimination efforts, and could ultimately make global elimination of DR-TB (fewer than one annual case per million population worldwide) attainable. There is a strong cost-effectiveness case to support pursuing DR-TB elimination; however, achieving this goal will require substantial global investment plus political and societal commitment at national and local levels.

Copyright information:

© 2021 Ingenta.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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