Implementation of fixed-dose combinations in tuberculosis control: outline of responsibilities

Fixed-dose combinations (FDCs) of antituberculosis drugs have been available on the world market for more than forty years. For more than twenty years rifampicin-containing FDCs have become increasingly visible on the market in combinations of two, three and even four fixed-dose combinations, but in different dosages depending on the country and the region. As a result, instead of simplifying tuberculosis treatment and the application of standardised chemotherapy regimens, the situation has become progressively more complicated, and at the same time neither bioavailability nor patients' safety is guaranteed. It is time to rationalise and extend the use of FDCs in national tuberculosis programmes. International, supranational and national responsibilities must be clearly defined in this process.