More coordinated measures are needed to improve the prevention and control of multidrug-resistant tuberculosis (MDR-TB) and meet targets to effectively control the spread of TB in China by 2030, said Mao Zongfu, a deputy to the 13th National People's Congress (NPC).

Mao said China attaches great importance to TB control and has so far achieved remarkable progress. "However, as one of the high-TB-burden countries, China still has a long way to go in this regard," he noted.

In 2010, China met its Millennium Development Goal (MDG) for TB control five years ahead of schedule. Committed to ending the TB epidemic by 2030, as outlined by the U.N. Sustainable Development Goals, China set targets to "reduce the incidence of TB to under 55 per 100,000 people by 2022" and "effectively control the spread of the disease by 2030."

From 2015 to 2019, China witnessed a 3.4% annual reduction in its TB incidence rate, marking a faster drop than the world average of around 2%. "But estimates show that the figure needs to remain above 10% until 2030 to reach our target," said Mao.

Mao, director of the Global Health Institute at Wuhan University, said MDR-TB, which features a low discovery rate, low treatment rate, and high drug resistance, poses a major challenge to the overall prevention and control of TB in China.

According to the Global Tuberculosis Report 2020 released by the World Health Organization (WHO), China had the second-largest proportion (14%) of global drug-resistant TB in 2019.

"Drug-resistant TB continues to be a public health threat. Worldwide in 2019, close to half a million people developed rifampicin-resistant TB (RR-TB), of which 78% had MDR-TB," the report states.

Mao said that since MDR-TB treatment is time and cost-intensive, some patients are reluctant to receive standard treatment, leading to low cure rates and in turn reducing other patients' confidence in the treatment.

"Low admission rate may also cause the emergence of extensively drug-resistant TB, making the overall TB prevention and control a more daunting task," Mao added. "Therefore, it is imperative that relevant authorities take coordinated measures to cut patients' expenses for MDR-TB treatment."

Mao suggested adopting a flexible volume-based procurement approach in negotiations with pharmaceutical companies on the prices of MDR-TB drugs and for them to be incorporated into medical insurance catalogs.

"In such negotiations, companies will be informed about the rough quantity of the drugs needed nationwide, and a reasonable price range will be decided based on the volume. This will help lower prices of the drugs," he explained.

Mao said more of the funds for basic public health service programs need to be allocated to community-level medical institutions for screening suspected MDR-TB cases and offering rehabilitation services.

He also advised more sound utilization of medical insurance funds, government-managed specialized funds for TB control, and corresponding local funds, to ensure that those in need can be either tested, hospitalized, or treated.

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