In November 2015, the World Health Organization (WHO) convened a meeting of a Guideline Development Group (GDG) for the update of policy recommendations on the treatment of drug-resistant TB. The GDG was composed of a multidisciplinary group of tuberculosis (TB) and drug-resistant TB experts external to WHO. Before the meeting, the members of the GDG and the WHO Guideline Steering Committee had decided upon the priority questions in the treatment and care of patients with drug-resistant TB to be considered for the update of the guidelines.

The scope of the 2016 update comprised the following:

The optimal combination of medicines and approach towards regimen design for TB patients (both adults and children) with isoniazid-resistant, rifampicin-resistant (RR-TB), multidrug-resistant (MDR-TB), and extensively drug-resistant (XDR-TB) forms of TB, as well as for patients with M. bovis disease. The effectiveness and safety of standardized regimens lasting up to 12 months for the treatment of patients with MDR-TB (“shorter regimens”) when compared with longer treatment. The effect of delay in starting treatment on treatment outcomes for patients with drugresistant TB. The effect of surgical interventions on treatment outcomes for patients with drug-resistant TB. The scope of the WHO treatment guidelines for drug-resistant tuberculosis, 2016 update thus differed from the one that guided the previous update of the WHO policy recommendations on the programmatic management of drug-resistant TB in 2011. It did not cover aspects of policy guidance on the programmatic management of drug-resistant TB that were of lesser priority or for which no new evidence has emerged since the 2011 revision. These included questions relating to the use of rapid diagnostics for RR-TB, the monitoring of response to treatment, the duration of longer (“conventional”) MDR-TB regimens, the delay in starting antiretroviral therapy in MDR-TB patients with human immunodeficiency virus (HIV) and models of care. The GDG considered that the 2011 recommendations relating to these areas would continue to apply until future evidence reviews show a need for revision of current WHO policy.