"[T]he highest levels ever of drug-resistant tuberculosis (TB) have been found in Russia and Moldova," the WHO reports in research published in the February edition of the WHO Bulletin, but "the agency didn't have data from most of Africa and India, where tuberculosis rates are much higher," the Associated Press/USA Today's "Your Life" reports. According to the AP, the "experts reported that about 29 percent of new TB patients in parts of Russia were drug-resistant" and that "65 percent of previously treated patients in Moldova had resistance problems." The news service notes, "Normally, less than five percent of TB cases are drug-resistant" (2/2).

In this New York Times opinion piece, Paul Farmer, chair of the department of global health and social medicine at Harvard Medical School and a co-founder of Partners in Health, examines the importance of the Global Fund to Fight AIDS, Tuberculosis and Malaria as it faces a "serious financial shortfall," writing, "Beyond AIDS, the Global Fund is currently the largest donor in the world for tuberculosis and malaria programs. ... The question is not whether the Global Fund works, but how to ensure it keeps working for years to come."

The Guardian examines the future of the Global Fund to Fight AIDS, Tuberculosis and Malaria as it enters its second decade, writing, "Despite its staggering successes -- including helping put 3.3 million people on AIDS treatment, 8.6 million on anti-tuberculosis treatment and providing 230 million insecticide-treated nets for the prevention of malaria -- the fund's recent troubles had threatened to overshadow its accomplishments as it prepared to mark a decade as the world's main financier of programs to fight these three global epidemics." The news service highlights a $750 million pledge to the Fund by Bill Gates, co-chair of the Bill & Melinda Gates Foundation, discusses recent managerial changes within the Fund, and quotes a number of experts about future challenges (Kelly, 2/2).

In this post in the Center for Global Development's (CGD) "Rethinking U.S. Foreign Assistance" blog, Connie Veillette, director of CGD's rethinking U.S. foreign assistance initiative, highlights two recent posts by CGD's Amanda Glassman and Nandini Oomman on the future of the Global Health Initiative (GHI). She writes, "With the Appropriations Committee weighing in by requiring a status report by mid-February on transitioning GHI to USAID, it is no understatement that the GHI is at an important juncture. Declining budgets for foreign assistance will also require new thinking on where the U.S. provides assistance and for what purpose" (1/31).

"A pilot community program to improve [tuberculosis (TB)] detection in northern Tanzania has shown good results and could be replicated nationwide as the country seeks to improve its TB treatment and prevention systems," IRIN reports. The program, run by Management Sciences for Health with help from PATH and Tanzania's National Tuberculosis and Leprosy Programme and financial support from USAID, "emphasized that TB and HIV treatment must be done 'hand in hand,'" according to IRIN.

"The Global Fund's drive to ensure sustainability and efficiency means that it may not be able to meet its commitments to combat disease, says Laurie Garrett," a senior fellow for global health at the Council on Foreign Relations, in Nature's "World View" column. Citing his resignation letter, Garrett discusses the "the political struggle" that led Michel Kazatchkine to step down as executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria last week and writes, "It is a classic battle of titans, pitting urgency against long-term sustainability. ... Kazatchkine essentially conceded victory to the forces for sustainability."

In this post in the PLoS "Speaking of Medicine" blog, guest blogger Christian Lienhardt, senior scientific adviser at the Stop TB Partnership and WHO, "discusses the International Roadmap for Tuberculosis (TB) Research, a framework outlining priority areas for investment in TB research." He writes, "The tools available for TB control are old, lack effectiveness, and are not readily accessible in many settings," adding, "Fortunately there is hope, thanks to notable progress in the development of new tools for TB control over the last decade," such as "the recent introduction of Xpert MTB/RIF -- a DNA-based molecular assay that can diagnose TB and the presence of rifampicin-resistance in 100 minutes" (1/26).

In this post on USAID's "IMPACTblog," Christina Lau, USAID health officer for Central Asia, discusses tackling tuberculosis (TB) in migrant populations, writing, "Most migrants are unable to access the health care system because they are undocumented laborers, who lack proper identification documents required for health care treatment, and who fear deportation if their documentation status becomes known." She notes, "USAID is working in coalition with government and international partners in order to improve access to TB services and treatment for this crucial population" (1/26).

This post in the Center for Strategic and International Studies' "Smart Global Health" blog examines drug-resistant tuberculosis (TB), stating, "[S]ince the recent outbreak of the so-called totally drug-resistant tuberculosis (TDR-TB) in India, TB has a new face." The blog details what TDR-TB is, recaps how resistant strains of TB develop and suggests several ways in which the global health community should respond (Kramer, 1/25).

"As the Global Fund [to Fight AIDS, Tuberculosis and Malaria] turns 10 on January 26, 2012, Nigerian families should join in the celebration of this innovative initiative that has saved the lives of millions here in Nigeria and across the globe," Bello Bissalla, project manager for private sector and government partnerships at Friends of the Global Fund Africa, writes in Nigeria's BusinessDay. "Much of the Global Fund's success could be attributed to its performance-based financing mechanism, which creates room for transparency in the purchase, distribution and administration of drugs for these three diseases," Bissalla continues, noting the grant review process "ensures that grant recipients show verified evidence of performance before receiving the next tranche of funding, thus ensuring transparency and implementation of the grant according to the plan."

This post in the Foreign Policy Association blog discusses reports from earlier this month of "an emerging strain of 'totally drug-resistant' tuberculosis (TDR-TB)" in India, which the Indian government last week denied, "arguing that the 12 cases were in fact extensively drug resistant (XDR)." The blog states, "Whether or not it's fair to use the TDR moniker, drug resistance is a serious, emerging issue that may very well define the next stage of global health," concluding, "We are reaching a turning point, one at which some drug resistant pathogens are on the cusp of shifting from a handful of cases, an endemic, to a bigger, epidemic or even pandemic problem. Now is the time to initiate discussions on what the global community will do to stem drug resistance" (Robinson, 1/21).

In this post in Global Health Frontline News' "Notes From the Field" blog, Kevin Cain, chief of the tuberculosis (TB) branch for a research and public health collaboration between the Kenya Medical Research Institute (KEMRI) and the CDC in Kisumu, Kenya, reports on TB research underway as part of the collaboration. Cain highlights several current research initiatives in Kisumu and concludes, "The world cannot afford another phase of neglect. We know by partnering with governments as well as affected communities in innovative ways more progress can be made improving programs and the tools available for diagnosing, treating, and preventing TB, and lives will be saved" (1/20).

A funding shortfall led the Global Fund to Fight AIDS, Tuberculosis and Malaria to announce in November that "it won't make any grants to fund programs for at least two years," a Deseret News editorial notes and calls on the U.S. to take a leadership position in saving the fund. The editorial states, "Few worldwide initiatives have the success record of the Global Fund ..., but those breakthroughs may not have much chance to save many lives," and notes that the non-profit lobbying group "Results is calling for the Obama administration to assemble an emergency meeting of donor nations this spring to find ways to ensure that the fund and its programs are able to continue and to provide new medicines where they are needed most."

Discussing the recent reports of so-called "totally drug-resistant" tuberculosis (TDR-TB) in India, journalist John Donnelly in this GlobalPost "Global Voices" blog entry writes, "Overall, the world is treating drug-resistant TB extraordinarily poorly, and that creates more and more cases of resistant TB that aren't being cured." Donnelly describes his experience in Peru, where he and photographer Riccardo Venturi recently traveled at the invitation of the Japanese company Otsuka Pharmaceutical and "met with local scientists, doctors and patients to explore the scope of the struggle to fight drug-resistant TB" (1/19).

In a January 17 statement, India's Ministry of Health and Family Welfare "dismissed reports that a form of incurable tuberculosis [TB] has arrived in the country," saying "that a team of doctors sent by the ministry found that seven of the patients are responding to treatment" and the cases would be classified and managed as extremely drug-resistant TB (XDR-TB), Nature News Blog reports (Jayaraman, 1/19). "Earlier, doctors in Mumbai said 12 patients had a 'totally drug resistant' form of TB, and three had died," according to BBC News. "A WHO official in India told the BBC that there is no recognized case of totally drug resistant TB anywhere in the world," the news service writes (1/20).

The Los Angeles Times' "Booster Shots" blog features an interview with Otto Yang, a professor at the Geffen School of Medicine at UCLA, who speaks about drug-resistant tuberculosis (TB) and the implications of a highly drug-resistant strain found in India. Yang said, "Obviously [the drug-resistant TB] could be devastating if it spreads, because treatment options are so limited. So far it seems not to have been as contagious as other strains, possibly because the mutations required to make it drug-resistant also make it a little less virulent" (Brown, 1/18).

Health officials from India and the WHO are scheduled to meet in Mumbai on Tuesday to discuss how to manage the cases of at least 12 patients infected with a highly drug-resistant tuberculosis (TB) strain, Bloomberg reports (Narayan, 1/17). "The 'totally drug-resistant' tuberculosis (TDR-TB) reportedly emerging in India is actually an advanced stage of drug-resistant TB, which researchers called totally drug-resistant for lack of a better term," IRIN notes (1/17).

Al Jazeera examines how "[a] series of public-health campaigns, including more aggressive screening, have been credited with a drop in tuberculosis [TB] cases in Kenya" in this video report. "The screening and treatment program, regarded as one of the best in the developing world, is credited with taking the rate of TB infections in the East African country from a high of 116,000 in 2006 to 106,000 last year," but not without "an economic and political price," the news service reports. "For TB screening and treatment programs to be effective, supply chains for drugs and equipment and proper training for staff and administrative back-up must be in place," Al Jazeera reports (Greste, 1/9).

"For the first time in India, 12 people have been detected with totally drug-resistant lung tuberculosis (TDR-TB), a condition in which patients do not respond to any TB medication" and for which the mortality rate is 100 percent, the Hindustan Times reports. "Doctors treating these patients say the absolute resistance is a result of the patients being prescribed wrong antibiotics," the newspaper reports (1/7). "While Iran first reported TDR-TB cases three years ago, India seems to be only the second country to report this deadly form of the disease," the Times of India notes (Iyer, 1/7).