Overview of MDR-TB Action Plan

In September 2011, WHO Europe launched an Action Plan called ‘Roadmap to prevent and combat drug-resistant tuberculosis’ in the European Region.  The Plan was fully endorsed by all 53 member states at the WHO Europe Regional Committee meeting held in Baku, Azerbaijan in September 2011 and calls for the resources and political commitment to make inroads against a disease that has devastated the lives of thousands of people. The Plan is intended to serve as a guide for Member States to develop and integrate drug-resistant TB responses into their national TB programmes.

Why does drug-resistant TB need to urgently be addressed?

The European Region has the highest rate of MDR-TB in the world. An estimated 76,000 MDR-TB cases occurred in the WHO European Region in 2011, accounting for nearly 25 percent of cases worldwide.

Due to limited access to diagnostics, only one third of all MDR-TB cases are currently being diagnosed. Both MDR-TB and XDR-TB are contagious and can spread from person to person, and although TB strains are changing and becoming more and more lethal, almost no new drugs or effective vaccines have been developed over the past few decades. Many countries have developed plans to address drug-resistant TB, but the global response is still insufficient.

What will the WHO Action Plan do?

The Action Plan is meant to serve as a roadmap to consolidate efforts in addressing the alarming rate of drug-resistant TB in the WHO European Region. The Plan aims to contain the spread of drug-resistant TB by achieving universal access to prevention, diagnosis and treatment in all Member States in the Region by 2015.

The Plan includes budgets, targets, timelines, six strategic directions, such as collaboration on more effective drugs, vaccines and diagnosis, and seven areas of intervention, including advocacy, partnership and policy guidance. Major targets to reach by 2015 include:

  • To decrease the proportion of MDR-TB cases among previously treated patients by 20 percentage points.
  • To diagnose at least 85 percent of all estimated MDR-TB patients.
  • To successfully treat at least 75 percent of all MDR-TB patients identified.

The Plan includes a monitoring and evaluation framework where Members states will have to report on implementation progress every two years.

Who is the Action Plan aimed at and can it help civil society organisations (CSOs)?

The primary audience of the Action Plan are national authorities within health ministries in the WHO European Region responsible for TB control, as well as other government bodies responsible for health in penitentiary services, health financing, health education and social services.

The Plan urges intensified involvement of civil society, communities affected by the disease, professional societies and national and international technical agencies and donors. It calls for consolidated and coordinated action between all stakeholders engaged in TB control and urges all Member States to strengthen partnerships.

As the Plan has been officially endorsed by all WHO European Region Ministers of Health, CSOs can use the Plan as an advocacy tool to call for transparent and objective assessment of programmatic gaps and to hold their governments accountable. The Plan explicitly calls for mechanisms to be set up by mid-2012 that ensure collaboration and coordination with CSOs.

The Plan includes two chapters describing activities and milestones that should be of particular interest for CSOs: Chapter six lays out activities to “Expand country capacity to scale up the management of drug-resistant TB, including advocacy, partnership and policy guidance”. Chapter seven describes activities to “Address the needs of special populations”, including people with HIV, children and pregnant women, homeless, injecting drug users and alcoholics.

How will the Action Plan be financed?

Implementation of the plan will cost an estimated US$ 5.2 billion. Most of the resources needed are expected to be provided by Member States, but a funding gap will remain. The Global Fund to Fight AIDS, Tuberculosis and Malaria, the European Commission and other international agencies will have an essential role to play in filling this gap.

Based on an economic analysis of lives saved and disability-adjusted life years, WHO Europe states that the Plan should prove to be highly cost-effective. WHO Europe warns that if the Plan is not implemented, the economic loss to the Region would be US$ 12 billion within five years.

What are the expected outcomes?

Modelling developed by WHO Europe estimated that the Plan, if fully implemented, will achieve:

  • Prevent 250,000 MDR-TB and 13,000 XDR-TB cases
  • Diagnose 225,000 MDR-TB patients
  • Successfully treat 127,000 drug-resistant cases
  • Save 120,000 lives, US$ 5 billion in the short term and US$ 48 billion in the long term

We are calling for WHO European Region Member States and the European Commission to urgently take action and to endorse and back, with clear political, financial and policy commitments, the WHO’s Action Plan to fight drug-resistant TB in the Region. It is essential that political and financial commitments do not waver. The consequences of doing so in the long term would be far more costly than sustained and increased investment now.

Advocacy Tools: 

Sample Press Release

Sample Letter to your Health Minister



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