“TB drug resistance is an urgent public health issue for countries from the former Soviet Union,” the Director of the Geneva-based World Health Organization (WHO) Stop TB Department, Mario Raviglione, said. “It is in the interest of every country to support rapid scale-up of TB control if we are to overcome MDR-TB.” A new report released today confirms geographical concentrations of TB drug resistance across the Commonwealth of Independent States. Six out of the top 10 global hotspots are Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan, with drug resistance in new patients as high as 14 per cent. China, Ecuador, Israel and South Africa are also identified as key areas. WHO’s leading infectious disease experts estimate there are 300,000 new cases per year of MDR-TB worldwide. New evidence proves that drug resistant strains are becoming more intractable, and unresponsive to current treatments, with 79 per cent of MDR-TB cases classified as “super strains” resistant to at least three of the four main drugs used to cure TB.Resistant to the two most commonly used medicines, Isoniazid and Rifampicin, MDR-TB – without costly interventions – is untreatable and in most cases fatal. Though curing normal TB is cheap and effective – a six-month course of medicines costs $10 – treating MDR-TB is 100 times more expensive, according to WHO. Even then a cure is not guaranteed. With no effective vaccine, everyone is vulnerable to infection simply by breathing in a droplet carrying a virulent drug resistant strain. The report “the most effective strategy to prevent the emergence of drug resistance is through implementation of the DOTS” – the internationally agreed treatment strategy designed to ensure patients take their medicines properly. It has proven effective in preventing drug resistance. Highest prevalence of MDR-TB coincides with one of the world’s fastest growing HIV infection rates in Eastern Europe and Central Asia. Recently the UN Development Programme (UNDP) reported there are more than 1.5 million people with the virus in the region, compared to just 30 000 in 1995. People whose immune systems are compromised with HIV are highly susceptible to contracting all forms of TB.