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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 (2011) / Chapter Skim
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10 Convergence of Science and Policy to Create a Call for Action
Pages 101-108

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
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From page 101...
... Coetzee observed that South Africa has been hit by multiple "avalanches," including the HIV epidemic, drug-resistant TB, and a rapidly migrating population. In response, the country has been deploying line probes to identify MDR TB patients early, but this effort has caused the 101
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From page 102...
... Patients are being diagnosed earlier and are being given effective treatment, but for that reason they also are present in the health care system longer. And because MDR TB is much more expensive to treat than drug-susceptible TB, budget pressures are severe.
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From page 103...
... For example, a molecular diagnostic for rifampin resistance would be invaluable, since one mutation describes about 80 percent of rifampin resistance, and rifampin resistance stands as a marker for MDR TB. Yet such a diagnostic is not yet widely available, although Farmer commended the Russian TB community for working hard to improve the quality of diagnostics (see Chapter 3)
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From page 104...
... Tobias emphasized that strengthening the regulatory authorities in countries with a high burden of MDR TB and in countries that export drugs is important as well. Coetzee noted that in South Africa, the biggest policy debate currently involves treatment of MDR TB in the community.
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From page 105...
... In the early 1990s, a major epidemic of pediatric HIV in the United States was feared because there had been a substantial epidemic of HIV infection among women living in poverty. Yet in 2007, said Farmer, fewer than five American children died of AIDS.
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From page 106...
... "There is no profit to be made in tuberculosis, as we all know too well," he said. In the United States, the CDC and the states maintain good TB control programs, but the public−private mix has not thrived in many developing countries.
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From page 107...
... "I hope this will be regarded by others as one in a series of potentially historic meetings that push forward the envelope as we contemplate improving our responses to drug-resistant tuberculosis," said Farmer.
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Key Terms

  • infection control
  • affluent countries
  • clinical care
  • rifampin resistance
  • control programs

  • farmer noted
  • diagnostic methods
  • rapid diagnostic
  • drug facility
  • global drug

  • hiv epidemic
  • involves treatment
  • socially vulnerable
  • laboratory initiative
  • moving forward

  • abuse alcohol
  • migrating population
  • facility mechanism
  • five american
  • accept policy

  • sent home
  • experienced changes
  • diagnostic capacity
  • individual countries
  • health infrastructure

  • require partnerships
  • contemplate improving
  • development pipeline
  • domestic manufacturers
  • promote lesser


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