Other parts of the world, mainly China and parts of Africa are also becoming the breeding grounds for the spread of multi-drug resistant tuberculosis and extensively drug resistant TB, said the report. WHO experts are worried that if multi-drug resistant TB penetrates Africa and coincides with AIDS, it will be a "disaster situation."
The Geneva-based agency said that the highest rate was in Baku, the capital of Azerbaijan, where 22.3 percent of new tuberculosis cases from 2002 to 2006 were mainly drug resistant. That exceeded the previous high of 14.2 percent, in Kazakhstan.
The WHO has urged that the nations to take aggressive action to control the disease else the drug resistant strains could become the dominant making it extremely difficult to treat a bug.
It estimates nearly half a million new cases of multi-drug resistant tuberculosis are arising each year, and 110,000 people a year are dying from this form of TB.
Dr. Mario Raviglione, director of the WHO's Stop TB program, said from Washington, "We are seeing levels of multiple-drug-resistant TB that we never expected - 20 percent is a very high level." The Global Plan to Stop TB is a road map for reducing by half TB prevalence and deaths by 2015 compared with 1990 levels.
There has been a sudden rise in the new multi-drug resistant cases occurring in people who have never before taken TB drugs, making it clear that drug resistant strains are able to compete with non-resistant bacteria in nature.
Based on the mathematical modeling done by the WHO, Raviglione said the concern is real and these difficult-to-treat strains could in theory take over. "When you have levels of around nine, 10 per cent I think things are addressable and we can actually get it down. And the Baltics show that this is possible," he added.
Estonia and Latvia - hotspots of drug resistant TB a decade ago - have succeeded in driving down rates through aggressive action. But those countries had MDR TB rates in the range of about 10 per cent.
The WHO estimates US$4.8 billion is needed to fight TB in low and middle income countries this year but the agency has raised only about half of what is needed. The report, the fourth from the WHO on this issue, is based on data from 81 countries covering the years 2002 to 2006.
