TB is treated with a number of drugs taken over a six to nine month period. It is essential that patients take their medication exactly as prescribed and complete the full course of treatment. If medication is taken incorrectly or stopped prematurely, the TB bacteria can re-emerge and become resistant to the drugs used to treat TB. This can be due to a variety of reasons, including because of drug stock-outs, patients interrupting treatment due to their strong side effects or cases being inappropriately managed by health professionals.

Multidrug-resistant TB (MDR-TB) is a form of TB that does not respond to the standard treatment using first-line drugs and is extremely difficult and expensive to treat.

Extensively drug-resistant TB (XDR-TB) occurs when resistance to second-line drugs develops on top of MDR-TB.

MDR-TB and XDR-TB can take two years or more to treat with drugs that are less potent, more toxic and much more expensive than drugs used to treat a standard case of TB. It is estimated that MDR-TB costs 5-8 times more than standard treatment in the EU.

In 2013, an estimated 480,000 people developed MDR-TB and there were an estimated 210,000 deaths from MDR-TB.  The WHO estimates that about 3.5% of new TB patients worldwide have MDR-TB. In addition to MDR-TB, by the end of 2013 100 countries had reported at least one extensively drug-resistant TB (XDR-TB) case.



The collapse of the Soviet Union left the population in the newly independent states in Eastern Europe and the Russian Federation with uneven access to health care. The European Region has one of the highest burdens of MDR-TB in the world. An estimated 74,000 of MDR-TB cases occurred in the WHO European Region in 2013.  Eastern European and especially Central Asian countries continue to have the highest levels of MDR-TB.

The highest rates of MDR-TB ever documented have been reported in Belarus, which found that 45 percent of TB patients had MDR-TB. XDR-TB cases have been confirmed in many countries around the world, including all G8 nations.