National Action Plan for Combating Multidrug-Resistant Tuberculosis

The plan builds on the U.S. Government's domestic and global TB strategies, as well as the World Health Organization's (WHO) END TB Strategy. The goals of the National Action Plan are to strengthen domestic capacity to combat MDR-TB, improve international capacity and collaboration to combat MDR-TB, and accelerate basic and applied research and development to combat MDR-TB. Strengthening domestic capacity to combat MDR-TB is a critical objective of the National Action Plan. The Centers for Disease Control and Prevention (CDC) is upgrading surveillance systems for tracking drug-resistant TB cases in the U.S. to capture molecular test results and more detailed clinical information about each case. This will enable better tracking of disease burden, targeting of resources, and linkages to care and contact investigations. The CDC is also working with state TB programs to standardize reporting for drug-resistant TB cases, improve methods for transitioning to next generation sequencing for molecular detection, and refining methods for culture-based drug susceptibility testing. The CDC is also finalizing metrics for tracking TB transmission using molecular epidemiology. This will enable epidemiologists to identify related cases of drug-resistant and drug-susceptible TB that have been transmitted from one person to another. The CDC is working with state TB programs to strengthen state and local capacity to prevent transmission of drug-resistant TB. This includes providing funding and technical assistance to help TB programs address the burden of MDR-TB in each state. In addition to strengthening domestic capacity, the National Action Plan aims to improve international capacity and collaboration to combat MDR-TB. The plan proposes increasing the number of MDR-TB treatment initiatives in countries with the highest MDR-TB burden. This includes providing funding and technical assistance to help countries strengthen their TB programs and improve their capacity to diagnose and treat MDR-TB. Accelerating basic and applied research and development to combat MDR-TB is also a critical objective of the National Action Plan. The plan proposes increasing investments in research and development to improve treatment outcomes for individuals with MDR-TB. This includes discovering new tools that are easy to implement in existing health systems, better use of existing and newly licensed TB drugs, an enhanced drug-development pipeline, increased availability of rapid assays for TB diagnosis and drug-susceptibility testing, effective vaccines, and other preventative interventions. The National Action Plan is intended to promote greater coordination of U.S. Government resources, including domestic, bilateral, and multilateral funding, to reduce the domestic and global risk of MDR-TB. The plan also aims to increase the American public's awareness of the threats posed by MDR-TB and serve as a call to action to encourage bilateral and multilateral donors, the private sector, and affected countries to increase investments in this critical area of worldwide concern.