Drug resistant tuberculosis in Italy through a global health lens

Drug-resistant tuberculosis (DR-TB) is a major global health challenge. In 2021, about one third of DR-TB patients worldwide were enrolled in treatment. In order to reach the targets set during by the 2018 UN General Assembly (UNGA) Political Declaration on Tuberculosis, a global effort must be made by both high- and low-incidence countries. Data concerning high-incidence countries are vast in the literature, but insufficient political attention has been paid in low-incidence countries to face this infectious threat. This review aims at providing an overview of DR-TB focused on different facets of DR-TB management. First, global and Italian data on the main at-risk populations for TB and DR-TB were gathered, together with the latest studies on the correlation between TB risk factors and the onset of drug resistance. Second, this review provides an analysis of obsolete Italian guidelines on the diagnosis and management of TB and DR-TB, highlighting the challenges that our country is currently facing to properly implement the latest international recommendations. Finally, some key suggestions are provided to design public health (PH) policies that can effectively tackle the DR-TB issue from a "global health" perspective.