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Despite recent advances and well-known treatment options, cure rates for resistant tuberculosis (TB) cases remain extraordinarily low. We present in first person the case of a patient who suffered from TB for over 7 years, and travelled to four countries in search of a cure. This experience shows how resistance patterns worsen under poor programme conditions and illustrates many of the obstacles faced by patients to obtain appropriate care: late diagnosis, lack of experienced care capacity and drug availability, and absence of psychosocial support during toxic and lengthy regimens. In addition to new tools, patient-centred systems are needed to tackle the drug-resistant TB epidemic.

Uptake of fixed-dosed combinations (FDCs) of anti-tuberculosis drugs remains low worldwide, despite decades of recommendations. FDCs are thought to be important tools for tuberculosis (TB) control and drug resistance (DR) prevention. However, evidence relating to this is limited. This article provides a critical review of the most relevant studies on anti-tuberculosis FDCs. The majority of published studies have sought to demonstrate that FDCs and single drugs have similar efficacy. This hypothesis has been proved with relation to similar sputum conversion, cure and relapse rates in a range of studies over the last 20 years using FDCs of two, three and four anti-tuberculosis drugs. However, one of the most relevant features of FDCs, the prevention of DR, has been addressed in only one study. Nevertheless, based on their similar efficacy, user-friendliness, lower costs, and operational and logistical advantages, generalised use of FDCs should continue to be recommended.