Multidrug-resistant tuberculosis: Successes, challenges, and the road ahead

Tuberculosis (TB) is a leading cause of infection-related mortality globally and imposes a significant burden on morbidity among survivors. While progress has been achieved toward the World Health Organizations End TB goal, it has been slower than anticipated and, in part, reversed by the impact of the severe acute respiratory syndrome coronavirus 2 pandemic. Multidrug-resistant TB (MDR-TB) presents a formidable challenge, characterized by catastrophic costs, reduced treatment success rates, and increased loss to follow-up, leading to its perpetuation in local communities and the risk of onward transmission. Given this, the need to reshape services and refine management in a cost-effective manner is of paramount importance, particularly in developing countries where the majority of cases reside. In this short piece, we discuss the economic impact of MDR-TB and how this impact can be mitigated through several methods, including decentralized models of care.