The World Health Organization, in response to the emergence of "hot spots" of disease in the Russian Federation, the Baltic States and other areas, has called for an immediate, well-coordinated response to the problem of multidrug resistant tuberculosis (MDR-TB) in resource-poor settings. The term "DOTS-Plus" has been adopted to describe an approach that incorporates pilot projects for treatment of MDR-TB into existing DOTS programs. WHO's endorsement of DOTS-Plus is a departure from earlier cost-effectiveness arguments that concluded that MDR-TB treatment, due to its reliance upon costly second-line drugs, was not feasible in resource-poor settings. At a January 1999 meeting of tuberculosis experts, non-governmental organizations, and national health administrators, increasing both access and control of second-line anti-tuberculosis medications was identified as a critical factor in a global response to MDR-TB. The WHO Working Group on DOTS-Plus for MDR-TB initiated direct negotiations with both the research-based and generic pharmaceutical industry and established a "Green Light Committee" to control the distribution of second-line anti-tuberculous medications. This paper will describe these efforts to facilitate the implementation of MDR-TB treatment programs throughout the world through rational procurement of second-line anti-tuberculous medications.
Learning Objectives: 1. Identify critical issues in the supply of drugs for the control of MDR-TB. 2. Describe a rational approach to both lowering the price and increasing control of drugs. 3. Articulate a model of public-private collaboration in response to an international public health emergency
Keywords: TB, Drugs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.