Current challenges with control of multi-drug resistant TB in Peru: Lessons from the past and goals for the future

Abstract

Abstract: This commentary analyzes the historical and current challenges in controlling multi-drug resistant tuberculosis (MDR-TB) in Peru, emphasizing how delays in diagnosis, retreatment approval, and access to medications contributed to the persistence and growth of the epidemic. The authors review the evolution of Peru’s National Tuberculosis Program from the 1970s onward, highlighting both major achievements—such as free nationwide treatment and high cure rates—and critical policy limitations, including inadequate retreatment strategies, restricted chemoprophylaxis, and centralized drug sensitivity testing. The article argues that prolonged waiting times for resistance profiles and tailored treatment increased MDR-TB transmission and treatment failure rates. Drawing lessons from past policies, the authors advocate for earlier initiation of treatment and decentralized decision-making supported by regional and national committees. They conclude that rapid intervention, broader preventive strategies, and timely retreatment could significantly improve control of the Peruvian MDR-TB epidemic in the coming years.