and health care workers, health systems, political commitments, and social mobilization. Ultimately, as has been the case in developed nations, addressing issues of health disparities and social inequities that lie at the root of TB, drug-resistant TB, and HIV will be necessary to combat these convergent epidemics successfully. Actions taken today can help prevent the crisis from worsening. A sense of urgency needs to be communicated to the public and policy makers to mobilize efforts against MDR and XDR TB, said Bond. Central to fostering this agenda is the creation of a strong patient advocacy culture to champion the need for increased resources, help educate the public and policy makers, and raise awareness of human rights issues.

Abdool Karim remarked that the patient, the community, and the family must be regarded as partners if information about TB is to be communicated successfully. This information often needs to be provided proactively, with the proper balance of fear and awareness. Different advocacy partners are needed at different levels. Members of the scientific and medical communities must communicate the realities of drug-resistant TB to the public and to policy makers, and they must translate data into policies commensurate with the magnitude of the problem, said Abdool Karim.

Bond concluded that the collaboration of the IOM and ASSAf at this workshop demonstrates the need for as well as the potential benefit of engaging neutral bodies to assess the evidence; build and share expertise; and prepare medical and educational institutions to play roles in prevention, diagnosis, treatment, training, and research. Bond noted that ASSAf is in an excellent position to continue to convene groups to address the issues surrounding MDR and XDR TB and to solicit the input of a broad array of groups that include patients; health care workers; public health officials; policy makers; the academic community; and groups from the sectors of industry, government, academia, and advocacy.



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