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Antimicrobial resistance is a major public health problem globally. Likewise, forms of tuberculosis (TB) resistant to first- and second-line TB medicines present a major challenge for patients, health care workers and health care services. In November 2019, WHO convened an independent international expert panel to review new evidence on the treatment of multi-drug and rifampicin resistant (MDR/RR)-TB, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Updated WHO guidelines emerging from this review, published in June 2020, recommend a shorter treatment regimen for patients with MDR/RR-TB not resistant to fluoroquinolones (of 9–11 months), with the inclusion of bedaquiline instead of an injectable agent, making the regimen all oral. For patients with MDR-TB and additional fluoroquinolone resistance, a regimen composed of bedaquiline, pretomanid, and linezolid may be used under operational research conditions (6–9 months). Depending on the drug-resistance profile, extent of TB disease or disease severity, a longer (18–20 months) all oral, individualised treatment regimen may be used. The review of new data in 2019 also allowed WHO to conclude that there are no major safety concerns on the use of bedaquiline for longer than 6 months duration, the use of delamanid and bedaquiline together and the use of bedaquiline during pregnancy, although formal recommendations were not made on these topics.The 2020 revision has highlighted the ongoing need for high-quality evidence and has reiterated the need for clinical trials and other research studies to contribute to the development of evidence-based policy.

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The definition of extensively drug resistant tuberculosis has been updated by the World Health Organization and pre-extensively drug-resistant tuberculosis has been defined https://bit.ly/30Fdffc

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Objective: Having up-to-date health policy recommendations accessible in one location is in high demand by guideline users. We developed an easy to navigate interactive approach to organize recommendations and applied it to tuberculosis (TB) guidelines of the World Health Organization (WHO).Study Design: We used a mixed-methods study design to develop a framework for recommendation mapping with seven key methodological considerations. We define a recommendation map as an online repository of recommendations from several guidelines on a condition, providing links to the underlying evidence and expert judgments that inform them, allowing users to filter and crosstabulate the search results. We engaged guideline developers, users, and health software engineers in an iterative process to elaborate the WHO eTB recommendation map.

In 2021, WHO revised its tuberculosis treatment outcome definitions, making them uniformly applicable for different lengths of treatment for both drug-susceptible and drug-resistant disease https://bit.ly/3jFFgOu

• The development process for new tuberculosis (TB) regimens remains slow and costly. In this concluding paper of the PLOS Medicine Special Collection, we highlight the key suggestions made at a WHO Technical Consultation on "Advances in Clinical Trial Design for Development of New TB Treatments" held in 2018 to address this challenge.