Tuberculosis programmes face tremendous challenges in reducing MDR-TB rates. But there are encouraging signs that even in the presence of severe epidemics, governments and partners can turn around MDR-TB by strengthening efforts to control the disease and implementing WHO recommendations.

Two regions in the Russian Federation, Orel and Tomsk, have achieved a remarkable decline in MDR-TB in about five years. These regions join two countries, Estonia and Latvia, which have reversed rising high rates of MDR-TB, ultimately achieving a decline. The United States of America and China, Hong Kong Special Administrative Region (SAR), have achieved sustained successes in controlling
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