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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

The New Profile of
Drug-Resistant Tuberculosis
in Russia

A Global and Local Perspective

SUMMARY OF A JOINT WORKSHOP
by the Institute of Medicine and
the Russian Academy of Medical Science

Steve Olson, Rebecca English, and Anne Claiborne, Rapporteurs

Forum on Drug Discovery, Development, and Translation

Board on Health Sciences Policy

INSTITUTE OF MEDICINE
               OF THE NATIONAL ACADEMIES

and

RUSSIAN ACADEMY OF MEDICAL SCIENCES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This study was supported by Department of Health and Human Services (Contract Nos. N01-OD-4-2139 and 223001003T), the U.S. State Department (S-LMAQM08-GR-071), the American Diabetes Association, the American Society for Microbiology, Amgen Inc., the Association of American Medical Colleges, Bristol-Myers Squibb, the Burroughs Wellcome Fund, Celtic Therapeutics, LLLP, the Critical Path Institute, the Doris Duke Charitable Foundation, Eli Lilly & Co., GlaxoSmithKline, Johnson & Johnson, Novartis Pharmaceuticals Corporation, and Pfizer, Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-16297-5
International Standard Book Number-10: 0-309-16297-1

Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2011 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.

                                                                     —Goethe

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INSTITUTE OF MEDICINE
                 OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

PLANNING COMMITTEE FOR THE WORKSHOP ON THE
NEW PROFILE OF DRUG-RESISTANT TUBERCULOSIS
IN RUSSIA: A GLOBAL AND LOCAL PERSPECTIVE1

GAIL H. CASSELL (Chair), Eli Lilly and Company (retired)

DONALD M. BERWICK,2 Centers for Medicare and Medicaid Services

BARRY R. BLOOM, Harvard School of Public Health

ENRIQUETA C. BOND, QE Philanthropic Advisors

RICHARD E. CHAISSON, Johns Hopkins University

PAUL FARMER, Partners In Health, Harvard Medical School

ANTHONY FAUCI, National Institute of Allergy and Infectious Diseases

GARY FILERMAN, Atlas Research

GERALD H. FRIEDLAND, Yale University School of Medicine

ELAINE K. GALLIN,3 QE Philanthropic Advisors

STEPHEN C. GROFT, Office of Rare Disease Research, National Institutes of Health

VICTORIA McGOVERN, Burroughs Wellcome Fund

NANCY SUNG, Burroughs Wellcome Fund

ROY WIDDUS, Global Forum for Health Research

 

 

images

1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

2 Donald Berwick was with the Institute for Healthcare Improvement during planning for the workshop.

3 Elaine Gallin was with the Doris Duke Charitable Foundation until December 2010.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

FORUM ON DRUG DISCOVERY,
DEVELOPMENT, AND TRANSLATION1

Gail H. Cassell (Co-Chair), Eli Lilly and Company (retired), Indiana

Jeffrey M. Drazen (Co-Chair), New England Journal of Medicine, Massachusetts

Barbara Alving, National Center for Research Resources, Maryland

Leslie Z. Benet, University of California-San Francisco

Ann Bonham, Association of American Medical Colleges, Washington, DC

Linda Brady, National Institute of Mental Health, Maryland

Robert M. Califf, Duke University Medical Center, North Carolina

Scott Campbell, Foundation for the National Institutes of Health, Maryland

C. Thomas Caskey, University of Texas-Houston Health Science Center

Peter B. Corr, Celtic Therapeutics, LLLP, New York

James H. Doroshow, National Cancer Institute, Maryland

Gary L. Filerman, Atlas Research, Washington, DC

Garret A. FitzGerald, University of Pennsylvania School of Medicine

Elaine K. Gallin,2 QE Philanthropic Advisors, Maryland

Steven K. Galson, Amgen Inc., California

Harry B. Greenberg, Stanford University School of Medicine, California

Stephen Groft, Office of Rare Disease Research, Maryland

Annalisa Jenkins, Bristol-Myers Squibb, New Jersey

Michael Katz, March of Dimes Foundation, New York

Jack D. Keene, Duke University Medical Center, North Carolina

Ronald L. Krall, University of Pennsylvania Center for Bioethics

Freda Lewis-Hall, Pfizer, Inc., New York

William D. Matthew, National Institute of Neurological Disorders and Stroke, Maryland

Mark B. McClellan, Brookings Institution, Washington, DC

Carol Mimura, University of California-Berkeley

John Orloff, Novartis Pharmaceuticals Corporation, New Jersey

Amy P. Patterson, National Institutes of Health, Maryland

Janet Shoemaker, American Society for Microbiology, Washington, DC

Ellen V. Sigal, Friends of Cancer Research, Virginia

Nancy S. Sung, Burroughs Wellcome Fund, North Carolina

Jorge A. Tavel, National Institute of Allergy and Infectious Diseases, Maryland

 

images

1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

2 Elaine Gallin was with the Doris Duke Charitable Foundation until December 2010.

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

Janet Tobias, Ikana Media, New York

Joanne Waldstreicher, Johnson & Johnson, New Jersey

Janet Woodcock, U.S. Food and Drug Administration, Maryland

Raymond L. Woosley, The Critical Path Institute, Arizona

 

IOM Staff

 

Anne B. Claiborne, Director

Andrew Pope, Director, Board on Health Sciences Policy

Rebecca A. English, Associate Program Officer

Yeonwoo Lebovitz, Program Associate (until November 2010)

Genea S. Vincent, Senior Program Assistant (until November 2010)

Elizabeth F. C. Tyson, Research Associate (as of January 2011)

Robin A. Guyse, Senior Program Assistant (as of January 2011)

Rona Briere, Consulting Editor

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

 

Elaine K. Gallin, QE Philanthropic Advisors

Ann Ginsberg, TB Alliance

Maria Giovanni, National Institute of Allergy and Infectious Diseases, National Institutes of Health

Alexander Golubkov, Partners In Health

Sergey Popov, I.M. Sechenov Moscow Medical Academy

Irina Vasilyeva, Central Tuberculosis Research Institute, Russian Academy of Medical Sciences

 

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

Dr. Melvin Worth. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×
Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

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Page xvii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×

Acronyms

AIDS acquired immune deficiency syndrome
ART antiretroviral therapy
   
BCG Bacillus Calmette-Guérin vaccine
   
CD4 Cluster of Differentiation 4
CDC Centers for Disease Control and Prevention
CTRI Central Tuberculosis Research Institute
   
DNA deoxyribonucleic acid
DOTS Directly Observed Treatment Short course
   
FDA Food and Drug Administration
FIND Foundation for Innovative New Diagnostics
   
GDF Global Drug Facility
GLC Green Light Committee
GLI Global Laboratory Initiative
GMP Good Manufacturing Practices
   
HIV human immunodeficiency virus
   
IL-7 interleukin-7
IOM Institute of Medicine
ISTC International Science and Technology Center
Page xviii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
×
ISTC International Standards for Tuberculosis Care
   
LPA line probe assay
   
M.tb. Mycobacterium tuberculosis
MDR TB multidrug-resistant tuberculosis
MRSA methicillin-resistant Staphylococcus aureus
   
NIAID National Institute of Allergy and Infectious Diseases
NIH National Institutes of Health
NTM nontuberculosis mycobacteria
   
PCR polymerase chain reaction
PETTS Preserving Effective Tuberculosis Treatment Study
PEPFAR U.S. President’s Emergency Plan for AIDS Relief
PPD purified protein derivative
   
RAMS Russian Academy of Medical Sciences
   
TB tuberculosis
TDR TB totally drug-resistant tuberculosis
   
USAID U.S. Agency for International Development
UV ultraviolet
   
WHO World Health Organization
   
XDR TB extensively drug-resistant tuberculosis
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Page xvii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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Suggested Citation:"Front Matter." Institute of Medicine. 2011. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science. Washington, DC: The National Academies Press. doi: 10.17226/13033.
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An estimated 2 billion people, one third of the global population, are infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis. Spread through the air, this infectious disease killed 1.7 million in 2009, and is the leading killer of people with HIV. Tuberculosis (TB) is also a disease of poverty--the vast majority of tuberculosis deaths occur in the developing world. Exacerbating the devastation caused by TB is the growing threat of drug-resistant forms of the disease in many parts of the world.

Drug-resistant tuberculosis presents a number of significant challenges in terms of controlling its spread, diagnosing patients quickly and accurately, and using drugs to treat patients effectively. In Russia in recent decades, the rise of these strains of TB, resistant to standard antibiotic treatment, has been exacerbated by the occurrence of social, political, and economic upheavals. The Institute of Medicine (IOM) Forum on Drug Discovery, Development, and Translation, in conjunction with the Russian Academy of Medical Sciences held a workshop to discuss ways to fight the growing threat of drug-resistant TB. The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective: Summary of a Joint Workshop presents information from experts on the nature of this threat and how it can be addressed by exploring various treatment and diagnostic options.

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