Tuberculosis (TB)

Surveillance of drug resistance in tuberculosis

In 1994, due to lack of standardized data on anti-tuberculosis drug resistance and in an effort to estimate the global prevalence of resistance, WHO, International Union Against Tuberculosis and Lung Disease (The Union) and other partners developed the Global Project on Anti-tuberculosis Drug Resistance Surveillance (the Global Project). Since that time, the Global Project has collected and analysed data on drug resistance from surveys of sampled patients and from national surveillance systems from an ever-increasing number of settings around the world.

The Global Project has served as a common platform for country, regional and global level evaluation of the magnitude and trends in anti-tuberculosis drug resistance. It has also quantified the growing global burden of multidrug-resistant tuberculosis (MDR-TB) and, in recent years has started to document the spread of extensively drug-resistant tuberculosis (XDR-TB). Since the inclusion of MDR-TB management in the new and comprehensive Stop TB Strategy, a new and fundamental role of the Global Project has been to assist countries in planning the scale-up of MDR-TB management with essential data on national burden and patterns of drug resistance.

Basic principles of the Global Project

  • Accurate representation of the population studied and, when sampling is used, careful survey design and sampling methods
  • Data collection and analysis that differentiates between new and previously-treated cases
  • Use of quality-assured drug-susceptibility testing and other laboratory processes, in cooperation with the Supranational Reference Laboratory Network

Objectives of the Global Project

  • Strengthen national surveillance systems for drug-resistant tuberculosis (DR-TB) to estimate the magnitude and monitor trends of drug resistance at the national, regional, and global levels
  • Assist countries in planning and monitoring the scale-up of DR-TB management programmes via the provision of essential data
  • Strengthen laboratory capacity at country level through the establishment of linkages with partner Supranational Reference Laboratories


  • Technical assistance to countries in design and implementation of anti-tuberculosis drug resistance surveys or strengthening of existing DR-TB surveillance systems
  • Training of specialists at country and regional level to ensure running of high quality surveys/surveillance and proper analysis and interpretation of the results
  • Periodic collection and analysis of global DR-TB data and publication of results
  • Provision of regular updates on anti-TB drug resistance surveillance methods

For more information on the project or technical assistance in developing a protocol contact the Global Project secretariat at


Supranational Reference Laboratory Network (SRLN)