title: New drugs for the treatment of tuberculosis: needs, challenges, promise, and prospects for the future.
abstract: For the first time in 40 years, a portfolio of promising new compounds for the treatment of tuberculosis is on the horizon. The introduction of new drugs in combination treatment for all forms of tuberculosis raises several issues related to patients' access to novel treatments, programmatic feasibility, cost effectiveness, and implications for monitoring and surveillance, particularly with regard to the development of drug resistance. Particular attention should be given to the identification of optimal drug combination(s) for the treatment of all forms of tuberculosis, particularly in high-risk and vulnerable groups, such as human immunodeficiency virus-coinfected persons and children, and to the rational use of new drugs. Addressing these issues adequately requires the establishment of clear guidelines to assist countries in the development of policies for the proper use of tuberculosis drugs in a way that guarantees access to best treatments for all those in need and avoids inappropriate use of new drugs. After a description of these various challenges, we present activities that will be carried out by the World Health Organization in collaboration with key stakeholders for the development of policy guidelines for optimal treatment of tuberculosis.
authors.affiliation: Stop TB Partnership and Stop TB Department, World Health Organisation, 20 Ave Appia, CH-1211, Geneva 27, Switzerland. lienhardtc@who.int
authors.forename: Christian
authors.initials: C
authors.lastname: Lienhardt
authors.forename: Mario
authors.initials: M
authors.lastname: Raviglione
authors.forename: Mel
authors.initials: M
authors.lastname: Spigelman
authors.forename: Richard
authors.initials: R
authors.lastname: Hafner
authors.forename: Ernesto
authors.initials: E
authors.lastname: Jaramillo
authors.forename: Michael
authors.initials: M
authors.lastname: Hoelscher
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.forename: Jan
authors.initials: J
authors.lastname: Gheuens
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use*; D002648:Child; D002986:Clinical Trials as Topic; D055808:Drug Discovery; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D004335:Drug and Narcotic Control; D015658:HIV Infections / Q000150:complications; D006801:Humans; D011358:Product Surveillance, Postmarketing; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents