MSF doctor Christoph Höhn performs an eye test on 16-year-old patient Shahnoza in her family home. Shahnoza started MDR-TB treatment in October 2012 but was later diagnosed with XDR-TB. Since January 2013, she is on the right drug regimen, but she will ne Photograph by Wendy Marijnissen
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Out of Step: Deadly implementation gaps in the TB response, 1st Ed., 2014

Report cover: Out of step
Photograph by Wendy Marijnissen

A survey of TB diagnostic and treatment practices in eight countries

This is a pivotal time in the fight against tuberculosis (TB), a curable disease that continues to kill more than a million people a year. Amid an emerging drug-resistant TB (DR-TB) crisis, new tools are emerging that offer the potential to strengthen and accelerate the global TB response. How quickly and effectively these will be leveraged to impact the overall TB response is largely dependent upon three factors: effective policies at the national level; full implementation of current WHO guidelines; and access to new drugs and diagnostics.

Based on a survey of eight high TB burden countries, MSF’s research reveals that efforts to control the epidemic are dangerously out of step with international recommendations and proven best practices, leaving drug resistant forms of TB to spread unabated. MSF warns that governments, donors and industry must act now, using every means available, to step-up the response to the crisis, or face a further growth in resistance.

Note: The full survey results are available upon request via email to access(at)

Additional publications in the Out of Step report series are available here.

Learn more about MSF’s work to improve access to lifesaving TB treatment.

Out of Step: Deadly implementation gaps in the TB response, 1st Ed., 2014