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Arms sales, health, and security : A call for US leadership

BMJ Publishing Group Ltd
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  • Editorials
  • Medicine


MULTIDRUG-RESISTANT TB Globally in 2012, an estimated 450 000 people developed multidrug-resistant TB (MDR-TB) and there were an estimated 170 000 deaths from MDR-TB. The number of people diagnosed with MDR-TB nearly doubled between 2011 and 2012, and reached 94 000 worldwide This includes 84 000 with confirmed MDR-TB and 10 000 with rifampicin resistance detected by Xpert MTB/RIF. However, worldwide and in most countries with a high burden of MDR-TB, less than one in four of the people estimated to have MDR-TB in 2012 were detected. Just over 77 000 people with MDR-TB were started on second-line treatment in 2012, leaving at least 16 000 detected patients without treatment. Treatment coverage gaps for detected cases were much larger in some countries, especially in the African Region (51% enrolled in treatment), and widened in China, Pakistan and South Africa. At least one case of extensively drug-resistant TB (XDR-TB) has been reported by 92 countries by the end of 2012. On average, an estimated 9.6% of MDR-TB cases have XDR-TB. NEW DIAGNOSTICS Xpert® MTB/RIF, a rapid molecular diagnostic test, is being rapidly adopted by countries to detect TB and rifampicin- resistant TB. By end June 2013, 1 402 testing machines and 3.2 million test cartridges had been procured by 88 of the 145 countries eligible for concessional prices. FINANCING FOR TB CARE AND CONTROL Between 2013 and 2015 up to US$ 8 billion per year is needed in low- and middle-income countries, with a funding gap of up to US$ 3 billion per year. International donor funding is especially critical to sustain recent gains and make further progress in 35 low-income countries (25 in Africa), where donors provide more than 60% of current funding. National contributions provide the bulk of financing for TB care and control in Brazil, the Russian Federation, India, China and South Africa (BRI

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