Table 2. Key milestones in the successful introduction of new medicines for MDR-TB patients, Belarus.

Actions to strengthen MDR-TB treatment

Actions to strengthen patient safety

• Aligning national TB guidelines to WHO recommendations • Training of clinical staff in the new policies and in case management • Piloting and subsequent scale-up of video-supported therapy as an adjunct to patient-centred care • Strengthening of laboratory capacity to detect drug resistance using newer techniques and to perform increasing volumes of culture • Changes in the drug procurement system, including ministerial waiver for the importation of new medicines • Updated national electronic TB register to include information on adverse events and details on regimen • Funding proposal to the Global Fund to provide financial resources • Technical support provided by WHO and by Médecins sans Frontières

• 2012: Links cultivated between national TB programme and the NPV • 2012: NPV strengthens its methods for both spontaneous reporting and for active surveillance (using CEM) • 2012: CEM for antiretroviral treatment starts • 2013: CEM for antiretroviral treatment extended to patients with HIV who had MDR-TB • 2014: CEM for linezolid-containing regimens started in MDR-TB • 2016: aDSM introduced for all MDR-TB patients on treatment • 2017: aDSM data reported to global database

Abbreviations: aDSM, active TB drug safety monitoring and management; CEM, cohort event monitoring; MDR-TB, multidrug-resistant TB; NPV, national pharmacovigilance centre; TB, tuberculosis; WHO, World Health Organization