What should we do when faced with MDRTB

* The cause of the problem is usually a poorly performing NTP. The answer is to spend time, effort and resources to improve the NTP. In some countries, one or two specialist centres may have the expertise and second-line drugs available to treat patients with MDR-TB.

* NTPs are establishing "DOTS-Plus" pilot projects in areas where MDR-TB is common.A global DOTS-Plus Working Group coordinates these pilot projects. DOTS-Plus aims to assess the feasibility and cost-effectiveness of the use of second-line drugs within the DOTS strategy. In negotiation with the Working Group, the pharmaceutical industry has agreed to provide second-line drugs at preferential prices to DOTS-Plus pilot projects. Part of the Working Group is the Green Light Committee.This assesses applications from TB programmes for inclusion among the projects supported by the Working Group. You should refer to the guidelines for establishing DOTS-Plus pilot projects (see "Suggestions for further reading").

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