Stop TB Working Group on MDR-TB - History

In 1994, the WHO/The Union global project on anti-TB drug resistance surveillance began with the objective of developing a standard methodology for surveillance to allow comparability of data between and within countries. The project promotes the implementation of nationwide surveys to estimate the magnitude of drug resistance, particularly MDR-TB, assist in programme planning and policy development and increases the capacity of the laboratory to conduct culture and drug susceptibility testing.

In 1998, WHO and partners launched "DOTS-Plus for MDR-TB" to manage MDR-TB with second-line drugs in resource-limited settings. In 1999, WHO established the Working Group on DOTS-Plus for MDR-TB. The Working Group was renamed in May 2006 to The Stop TB Working Group on MDR-TB.

The Green Light Committee (GLC) was formed in 2000 as a sub-group of the Working Group. It was established as a multi-institutional partnership to promote access to life-saving high-quality second-line drugs at reduced prices for the treatment of MDR-TB and under rigorous monitoring to prevent the creation of resistance to second-line drugs, the last line of defence against TB.

The first five years of the GLC were crucial for developing a replicable model for feasible and cost-effective MDR-TB control in resource-limited countries. Major reductions in the prices of second-line drugs were achieved through negotiations with pharmaceutical companies, concessional prices provide by Eli Lilly, and pooled procurement of drugs. The initial phase ended in 2005, when compelling evidence on feasibility, effectiveness and cost-effectiveness of MDR-TB management under programmatic conditions was obtained from the projects approved and monitored by the GLC. By May 2006, 41 projects in 37 countries had been granted access to quality-assured second-line drugs at reduced cost to 21,196 MDR-TB patients. Drawing upon the experiences in these projects, WHO and partners have developed guidelines for the programmatic management of drug resistant tuberculosis

Currently less than 2% of the 424,000 incident MDR-TB cases estimated in 2004 get appropriate treatment through the GLC mechanism. The Stop TB Partnership's Global Plan to Stop TB, 2006-2015, plans that almost 800,000 MDR-TB cases will be adequately treated from 2006 to 2015. While the last five years have been crucial for developing the foundation for practical approaches to manage MDR-TB in resource-limited countries the next few years will be crucial for the scale-up of MDR-TB management at country level in line with the new Stop TB Strategy.

While the last five years have been crucial for developing the foundation for practical approaches to manage MDR-TB in resource-limited countries the next few years will be crucial for the scale-up of MDR-TB management at country level in line with the new Stop TB Strategy.