The Union is the leading scientific organisation in tuberculosis (TB) and lung health, with expertise across all forms of TB, including drug-resistant TB (DR-TB).
With the World Health Organization (WHO) recently updating its consolidated guidelines on TB, we explore what this means for TB treatment, care and diagnosis, and how The Union can support national TB programmes and healthcare professionals to understand and apply these changes on the ground.
One of the key updates to the “WHO Consolidated Guidelines on Tuberculosis” is the new recommendation for a novel, all-oral, 6-month regimen (BDLLfxC) for the treatment of multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones. Modified 9-month regimens have also been recommended for the treatment of MDR/RR-TB, where fluoroquinolones resistance is excluded.
In recent years, The Union has joined the WHO's call to action for shorter and more effective treatment for all people suffering from drug-resistant TB. Our Director of TB, Dr Kobto Ghislain Koura, is a member of the WHO Guideline Development Group on DR-TB treatment that has developed these recommendations. Dr Koura explains the importance of these changes: “For the first time, countries have several evidence-based treatment options for people with DR-TB that are shorter, safer and more effective. The Union has actively contributed to the development of these recommendations and are committed to supporting countries to translate these advances into real impact on the ground.”
Dr Robert Horsburgh, Co-Chair of The Union’s DR-TB Working Group, said: “While it is promising to see the inclusion of these new drug regimens within the WHO guidelines, there is no mention of how they will be implemented where they are most needed. We must go beyond what is addressed in these guidelines and prioritise prompt implementation. Only by improving access to better diagnosis, susceptibility testing and the drugs in the newly recommended regimens, can we make any real difference to the lives of those suffering from DR-TB.”
The recent funding cuts made by the US Government will severely hamper countries’ ability to implement the new regimens. According to a rapid survey conducted by The Union, 65% of National TB Programmes in Africa (11 out of 17 respondents) declared that the US Government funding stoppage has already negatively affected TB care and prevention.
How The Union can help navigate the changes
Providing educational support to develop clinical expertise
This year, The Union will offer three courses focused on the clinical and programmatic management of DR-TB, all of them will include the latest WHO updates:
-
Online Course on Drug-Resistant Tuberculosis: From Clinical to Programmatic – available in November 2025 on The Union Courses Online platform. Asynchronous course (self-study).
-
International Course on the Clinical and Programmatic Management of Drug-Resistant Tuberculosis – in-person from the 13-17 October 2025 in Taipei (Taiwan) in English. Led by Prof Chen-Yuan Chiang with guest speakers from the World Health Organisation.
-
Cours International sur la Tuberculose Multirésistante – in-person from 6-10 October 2025, Lomé (Togo), in French. Led by Prof Gisele Badoum, with guest speakers from the World Health Organisation.
Working hand-in-hand with countries to develop and implement protocols
The Union is committed to providing technical assistance to turn policy into practice. By working directly with national TB programmes, The Union helps countries build the capacity needed to introduce and sustain effective DR-TB care. This includes on-the-ground mentoring and training to support with operational research and adapting global guidelines to fit local realities.
A 2024 study by The Union highlights how challenging it can be to turn new DR-TB treatment recommendations into real-world impact in several African Countries. The study makes it clear that a one-size-fits-all approach will not work. Each country requires tailored support and local research to ensure these regimens are rolled out safely and effectively. This reinforces The Union’s call for global guidance and practical, context-sensitive support to ensure these life-saving innovations reach those in need.
With proven approaches and a deep understanding of country-specific challenges, The Union is well-positioned to help ensure that the latest scientific advances translate into meaningful improvements in treatment for people living with DR-TB.
Disseminating the latest knowledge and research
The Union’s International Journal of Tuberculosis and Lung Disease (IJTLD) and IJTLD Open play a vital role in advancing knowledge of DR-TB by sharing high-quality, peer-reviewed research. Recent publications, including studies on core drug regimens, treatment success rates, long-term outcome trends, and care attrition in vulnerable populations, contribute to a growing evidence base that informs clinical practice, policy-making, and future research directions in DR-TB management.
Connecting the lung health community with scientific breakthroughs in DR-TB
The world's largest lung health conference, the Union World Conference on Lung Health, taking place in Copenhagen, Denmark from 18-22 November 2025, will undoubtably showcase the latest findings and breakthroughs in DR-TB treatment, care and diagnosis.
Prof Katharina Kranzer, Chair of the Conference Scientific Committee, explains: "Drug-resistant TB continues to be a major challenge for diagnosis and treatment. Thus, it is not surprising that we received many very high-quality submissions (symposia and abstracts) on the topic. One of the plenaries will be dedicated to diagnostic and antibiotic stewardship with a special focus on antimicrobial resistance testing. Also, it is very exciting that we had a large number of submissions in the clinical trial category."