In response to the increasing spread of multidrug-resistant tuberculosis (MDR-TB), the World Health Organization (WHO) has issued new guidelines for the control of these virulent strains of the disease. The new guidelines were released today in London at a meeting of the world’s top MDR-TB specialists.

As the global TB pandemic continues to be a major public health burden to the world, a new problem is threatening TB control efforts. The epidemic of MDR-TB, defined as TB resistant to at least isoniazid and rifampicin (the two most powerful anti-TB drugs), has reached extraordinarily high levels in some areas and standard drug regimens may be insufficient to contain it. To prevent the emergence of MDR-TB, the DOTS strategy has to be followed closely. To prevent its spread, patients with MDR-TB have to be treated aggressively with second-line drugs.

In an attempt to address the problem of MDR-TB, WHO and its international partners are piloting a new initiative known as "DOTS-Plus". This initiative builds upon the foundation of the DOTS strategy for TB control, but includes additional components, such as the use of second-line anti-TB drugs to directly manage MDR-TB cases. Pilot projects have been established at six sites in South America, eastern Europe, the Russian Federation, and south-east Asia, with plans to expand to more sites (including Africa). To assist these projects, WHO today issued Guidelines for Establishing DOTS-Plus Pilot Projects for the Management of MDR-TB.