This is clearly of great importance to Southeast Asia, where incidence and prevalence rates are high and HIV is increasing dramatically. WHO is coincidentally seeking to establish a network for the surveillance of the emergence of resistance in TB worldwide, and our activity is being coordinated with their efforts. WHO has established a list of collaborative laboratory centers, and some areas of further research are under consideration. In our participating countries, surveillance for Tuberculosis resistance is variable. The United States has only restarted federal support for state level monitoring in the last three years, so there was not countrywide coverage prior to that time.
Canadian surveillance is nationwide.
In Indonesia, limitations of sampling and budget have severely restricted such testing, a situation which also holds true for the Philippines. In Thailand surveillance and access to treatment are both extensive. It is postulated that the widespread use of BCG in the region has enhanced the selection of this family in China, Thailand and South Korea. Beyond such speculation in the literature there has been little detailed study of the acquisition of resistance in the region. This kind of project activity will foster further studies into this important phenomenon.