World Medical Association scales up training for multidrug resistant tuberculosis to fight epidemic

BMJ 2008; 336 doi: (Published 22 May 2008) Cite this as: BMJ 2008;336:1155
  1. John Zarocostas
  1. 1Geneva

    The World Medical Association is scaling up its training courses on multidrug resistant tuberculosis and placing emphasis on reaching health professionals in nations heavily affected by the epidemic, such as South Africa, India, China, and Russia.

    The thrust of the association’s actions is to provide online training to help doctors to use the latest World Health Organization guidelines and treatment protocols for multidrug resistant tuberculosis so that they can diagnose, prevent, and treat the drug resistant strains more effectively.

    “All healthcare is local. The intention of the programme is to get all knowledge and know-how to physicians. This includes revising the multidrug resistant tuberculosis course for online use, plus providing a refresher course in tuberculosis treatment,” said Edward Hill, chairman of the association’s council.

    “We shall now be making the course more interactive, with more case studies and a progressive learning pattern. A tuberculosis refresher course is important to get physicians back on track regarding the basic knowledge of standard tuberculosis,” said Jon Snaedal, the association’s president.

    The association says the course is a free self learning tool that allows doctors to learn and test their knowledge about multidrug resistant tuberculosis through the internet.

    Its easy access, it notes, will allow “more physicians around the globe to acquire the basic knowledge on standard tuberculosis management at a time when there is a resurgence of the epidemic.”

    WHO estimates that 489 139 cases of multidrug resistant tuberculosis emerged in 2006—5% of the nine million new tuberculosis cases worldwide.

    In addition, the global medical grouping plans to develop a toolkit for physicians on how to manage tuberculosis in the workplace.

    South Africa’s Foundation for Professional Development authored the learning programme—based on WHO clinical guidelines—which was reviewed by an international advisory committee and converted to an internet based course by the Norwegian Medical Association. The pilot course was then tested and evaluated by 40 doctors in South Africa.

    The course is available in English and is being translated into Spanish, French, Chinese, and Russian. The association said the course will be available as a handbook and a CD in addition to the online format.

    The association’s objective of increasing education and knowledge about multidrug resistant tuberculosis and tuberculosis has been boosted by a grant of nearly $1m (£510 000, €642 000) from the drug company Eli Lilly.

    “No single organisation can do it alone, more healthcare professionals are essential in fighting tuberculosis,” said Jacques Tapiero, president of Eli Lilly’s intercontinental operations, and added that more public-private sector resources and tools need to be developed.

    The Eli Lilly multidrug resistant tuberculosis partnership is supporting the fight against the epidemic through $135m in donations and the transfer of drugs and technology to increase treatment and focus global resources on prevention, diagnosis, and treatment of patients with multidrug resistant tuberculosis.

    The company has already helped transfer technology for the manufacture of tuberculosis drugs to four companies in South Africa, China, India, and Russia.

    However, medical experts such as Dr Kgosi Letlape, chairman of South Africa’s Medical Association, stressed that research into new drugs is crucial to countering the epidemic.

    “The drugs we have are decades old; it’s important to have modern first line treatment,” he said and noted that in the case of South Africa the HIV epidemic adds to the problem. “Sixty per cent of HIV infected patients have tuberculosis and vice versa,” he said.


    • The multidrug resistant tuberculosis online training course can be found on the association’s web page:

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