National Action Plan for Combating Multidrug-Resistant Tuberculosis. December 2015 (USA)
(2015; 38 pages)


Tuberculosis (TB) kills almost 30,000 people each week. The disease is caused by Mycobacterium tuberculosis (Mtb), which is transmitted through the air from person to person. Currently, more than two billion people, nearly one-third of the world’s population, are estimated to be infected with Mtb (latent TB) and are at risk of developing the disease. TB is curable, but inappropriate treatment can lead to multidrug-resistant TB (MDR-TB), which is resistant to the two most effective anti-TB drugs, and extensively drug-resistant TB (XDR-TB), which is resistant to many anti-TB drugs. This year alone, more than 480,000 people will develop MDR-TB (including XDR-TB). Fewer than 20 percent of individuals with MDR-TB access treatment; of that small fraction, fewer than half are cured, due to health systems that are unable to appropriately diagnose and treat the disease. If left unchecked, MDR-TB could erase decades of progress in global TB control, much of it achieved with U.S. leadership and support. Although the vast majority of individuals with TB and MDR-TB live outside the United States, it is critical that the Nation maintain and expand its global efforts to fight the disease, to save the lives of those afflicted with TB, and to prevent the spread of MDR-TB both in the United States and around the world. An MDR-TB outbreak in the United States could have serious consequences due to the costs associated with treating resistant TB. In the United States, the cost to treat and care for a patient with TB averages $17,000 for drug-susceptible TB, $150,000 for MDR-TB, and $482,000 for XDR-TB. An increase in the number of patients with MDR-TB or XDR-TB could have a dramatic financial impact on State and local health-care systems.

Action taken now, while it is still possible to reverse the development and transmission of MDR-TB, will improve health and prosperity around the world. It will also ensure that the health and security benefits derived from decades of strategic U.S. investments in global health are maintained and continue to grow.

This National Action Plan for Combating Multidrug-Resistant Tuberculosis (hereafter referred to as the National Action Plan) identifies a set of targeted interventions that address the core domestic and global challenges posed by MDR-TB and XDR-TB. The recommended interventions represent the U.S. Government’s contributions to reversing the worldwide spread of MDR-TB and should inform policy-development processes around the world. The National Action Plan is an effort to articulate a comprehensive strategy, mobilize political will, and spur additional financial and in-kind commitments from bilateral and multilateral donor partners, the private sector, and the governments of all affected countries.

The goals of the National Action Plan are to:

  1. Strengthen domestic capacity to combat MDR-TB;
  2. Improve international capacity and collaboration to combat MDR-TB; and
  3. Accelerate basic and applied research and development to combat MDR-TB.
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