Tuberculosis elimination, patients' lives and rational use of new drugs: revisited

The World Health Organization (WHO) has recently published a framework on tuberculosis (TB) elimination opening debates on elimination and multidrug-resistant (MDR)-TB [1, 2]. The document highlights MDR-TB as a core area, emphasising the moral duty of preventing the selection of MDR-TB (by treating susceptible cases correctly with first-line drugs) and the necessary efforts to treat it when diagnosed. Unfortunately, treating MDR- and extensively drug-resistant (XDR)-TB is much more onerous, lengthy and terribly expensive; treatment outcomes remain suboptimal, adverse events being frequent and severe [3–6]. The availability of new drugs has offered new possibilities for saving patients who were not previously treatable and posed new challenges related to their rational use in order to prevent selection of resistant strains of Mycobacterium tuberculosis [7–10]. The importance of not fostering resistance and conserving new TB drugs for subsequent generations