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Drug-resistant tuberculosis: collaborative regional leadership required

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The drug-resistant tuberculosis crisis provides urgency and focus for coordinated action to improve regional health and development

Success in stabilising the global tuberculosis (TB) epidemic is threatened by the emergence and spread of drug-resistant (DR) strains. The DR-TB challenge is similar in scale and impact to HIV infection in the 1980s; however, the international response has been slow and insufficient. Those worst affected by TB or DR-TB are from disadvantaged communities in low-income countries with little visibility or political influence. The Asia−Pacific region carries the bulk of the global TB burden (58%), including the majority of all estimated multidrug-resistant (MDR) cases (54%) (resistance to isoniazid and rifampicin).1,2 The regional DR-TB challenge is daunting and needs to be tackled before it overwhelms health systems, as happened in some former Soviet Union countries. Visionary political leadership is urgently needed to champion a comprehensive regional strategy that draws on novel and creative solutions,1 similar to the Asia Pacific Leaders Malaria Alliance created to contain the emergence of drug-resistant malaria.3

Four years ago, the World Health Assembly declared DR-TB a “global public health threat” and ministers from 22 high…