Experts during a session at the 39th Union World Conference on Lung Health in Paris on Saturday discussed developments in addressing multi-drug resistant tuberculosis. D'Arcy Richardson, director of the TB department at PATH, said health workers have "one more chance" to treat people with MDR-TB to avoid an epidemic of extensively drug-resistant TB. Richardson called on delegates to work together to avoid the emergence of XDR-TB epidemics by addressing MDR-TB and strengthening health systems worldwide.

Giovanni Battista Migliori of the World Health Organization's Collaborating Centre for Tuberculosis and Lung Diseases provided an overview of a country assessment tool that helps countries evaluate the extent of MDR-TB and efficiently address drug-resistant TB with country-specific performance data. According to Migliori, the paper-based tool can help identify weaknesses within TB programs that are related to wider gaps in health systems and assist health officials determine appropriate actions. Salmaan Keshavjee of Harvard Medical School and Partners in Health discussed an online community called Global Health Delivery that aims to connect health workers worldwide by providing information and forums to discuss issues related to TB control and health system strengthening. The tool was launched in June and offers communities on four specific topics: treatment adherence and retention, TB infection control, drug-resistant TB and technology, Keshavjee said.

Rais Mazitov -- PIH program manager in Tomsk, Russia -- discussed the results of PIH's efforts to increase continuity of TB care between prison and community treatment in Tomsk. The program -- which involves administrators from the Ministry of Justice, Ministry of Internal Affairs and the Ministry of Health -- integrates TB services among prisons and civilian settings to ensure a common approach to treatment. Both prison and civilian physicians specializing in TB receive the same training from the Central TB Research Institute in Moscow under the program to ensure all physicians understand the plan and how to implement it, Mazitov said. According to Mazitov, about 80% of all patients from 2000 to 2004 successfully completed TB treatment under the program.

Also at the session, Karen Shean, senior researcher in the lung and infection control unit at the University of Cape Town in South Africa, discussed challenges related to MDR- and XDR-TB facing health workers in South Africa. Brain drain, poor working conditions, and TB and HIV cases among health workers are hindering efforts to address drug-resistant TB, Shean said. In addition, a lack of treatment adherence and information among patients is contributing to the TB situation in the country, according to Shean. She added that interventions to educate patients about TB and provide emotional support should be scaled up to ensure increased treatment adherence. TB education and better working conditions also are needed for health workers, Shean said (Sarah Mann, GlobalHealthReporting.org, 10/18).

Kaisernetwork.org is the official webcaster of the conference. Webcasts of select sessions, interviews and other resources are available online. A webcast of the session is available online.