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Resistance to tuberculosis (TB) drugs is a formidable obstacle to effective TB care and prevention globally. Multidrug-resistant TB (MDR-TB) is multifactorial and fuelled by improper treatment of patients, poor management of supply and quality of drugs, and airborne transmission of bacteria in public places. Case management becomes difficult and the challenge is compounded by catastrophic economic and social costs that patients incur while seeking help and on treatment. In 2006, MDR-TB strains with additional resistance to second-line drugs were described as extensively drug-resistant TB (XDR-TB) strains, further compromising treatment options available to patients infected with these strains. Since then, clinicians in some settings have reported patients infected with strains in which virtually all treatment options have been exhausted. This rapidly evolving landscape is a clarion call to policy-makers and practitioners to respond with improvements in care delivery and introduction of innovative tools and approaches. In 2009, the 62nd World Health Assembly urged WHO Member States to provide universal access to care for drug-resistant TB patients. In that resolution, it was acknowledged that national TB programme managers, clinicians, nurses, all care providers and affected people themselves need guidance on how best to bring together different elements of health systems and services needed to effectively address the MDR-TB challenge. Therefore, this Handbook has been developed for the purpose of describing ways to implement established WHO policies relevant for the management of MDR-TB. These WHO policy recommendations have been produced using the GRADE methodology for evidence assessment, as adopted by WHO in 2008.

Drug resistance. --- Tuberculosis --- Treatment.

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Drug Resistance, Neoplasm

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Drug resistance in microorganisms.

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The WHO Malaria Policy Advisory Group (MPAG) convened in March 2022 to review and provide strategic guidance on malaria control and elimination efforts globally. Key topics included updates on the RTS,S malaria vaccine, the operational manual for subnational malaria tailoring, and strategies to address antimalarial drug resistance, particularly in Africa. The meeting highlighted progress and challenges in malaria control, emphasizing the need for immediate action to meet the 2030 targets of reducing global malaria incidence and mortality by 90%. The report underscores the uneven progress across countries, with significant setbacks in high-burden regions exacerbated by COVID-19 disruptions.

Malaria. --- Drug resistance.

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This publication by the World Health Organization provides comprehensive guidance on the surveillance of drug resistance in tuberculosis. The sixth edition offers updated methodologies and strategies for accurate diagnosis and treatment, emphasizing universal drug testing to combat TB effectively. It aims to support global efforts in line with the End TB Strategy and the Sustainable Development Goals to eradicate the TB epidemic by 2030. The document is intended for health professionals, policymakers, and researchers involved in TB control and prevention, offering insights into surveillance techniques, laboratory methods, and data management practices.

Tuberculosis. --- Drug resistance.