By Institute of Medicine
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Additional resources for Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary
The incidence of MDR TB, by Friedland’s calculation, is 100 per 100,000 population, much higher even than nonresistant TB in most parts of the world. Among MDR and XDR TB patients, the rate of HIV coinfection is greater than 90 percent. , 2006), many thought it was an outbreak that would dissipate over time. As indicated in Figure 2-6, however, from 2005 to 2007, both MDR and XDR TB cases continued to increase, and the ratio of XDR to MDR remained very high. In 2007, there were 102 MDR and 146 XDR cases.
Without accurate forecasting, manufacturers may have to dispose of unsold drugs; donors face uncertain supplies and prices; and shortages of quality-assured drugs may occur, resulting in incomplete treatments and increased drug resistance. Significant care-delivery problems exist as well, ranging from difficulties with infection control in congregate settings to inadequate capacity to deliver care over the 2-year course of treatment. Workshop Objectives To address the issues outlined above, the Institute of Medicine’s (IOM’s) Forum on Drug Discovery, Development, and Translation held a workshop in Washington, DC, on November 5, 2008.
To provide baseline information on MDR TB and outline the issues for discussion during the workshop, the IOM commissioned a white paper from Partners In Health (see Appendix C). The original intent of the workshop was primarily to release the white paper and to discuss its conclusions and recommendations with an expert audience. As the workshop agenda was being developed, however, the scope expanded significantly. Gail Cassell of Eli Lilly and Company, who served as chair of the workshop, said that the reporting of MDR TB (approximately 500,000 new cases annually) is a gross underestimate of the true burden.
Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary by Institute of Medicine