АSSESSMENT OF THE PRODUCTIVE AND RESOURCE CAPABILITIES OF COUNTRIES FOR MULTIDRUG-RESISTANT TUBERCULOSIS CONTROL

Abstract

The spread of multidrug-resistant and extensively drug-resistant tuberculosis (MDR and XDR) requires the search and implementation of not only new diagnostic methods, but also innovations in the treatment of the disease. Aim. The assessment of current treatment options for multidrug-resistant tuberculosis in different countries. Materials and Methods. There was carried out the content analysis of the official sources of 24 countries concerning the drugs that had been registered at these countries and recommended by the World Health Organization for the treatment of multidrug-resistant tuberculosis and put into circulation from 2000 to 2020: linezolid, bedaquiline, delamanid, clofazimine (as of 07.2020). The data were compared with the characteristics of the epidemiological situation in the country. Results. There was developed a six-digit classification by the following criteria: the presence of international nonproprietary names for drugs; the availability and range of dosage forms; the number of drugs subject to all dosage forms, dosages, pharmaceutical forms and units of packaging; the presence in the domestic market of the original product; the time of registration of drugs in the specified territory; the level of multi-drug resistance of the pathogen in the country per 100,000 population. Among the countries with the highest market coverage with a low (up to 0.5 per 100 thousand) level of multidrug resistance, a large share falls on European countries. As for a number of African States, there may be a threat of spreading the disease taking into account the epidemiological situation for multidrug-resistant tuberculosis and with only linezolid registered. The list of countries with a level of the same indicator above 15 per 100,000 population includes Russia and Namibia with radically different market characteristics. If Russia possesses the entire available range of medicines with the number of nomenclature items above 200, then Namibia has no more than 10 linezolid preparations registered only in tablet form. The main supplier of innovative products in the field of tuberculosis control is the Asia-Pacific region. Сonclusion. It is defined that the characteristics of the drug market differ significantly depending on the economic development of states and are determined by the indicator of the disease burden. Success in the tuberculosis control is impossible without the active development of the pharmaceutical industry and the replenishment of the market with innovative products.