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Fast access to useful resources and the narrative report of this mapping site.

Resource Quicklinks

The following resources provide additional insight and information on the global landscape, including current challenges and opportunities, confronting TB care and IQA-SLD supply and access.

Narrative Analysis

Download the narrative analysis of this initiative's findings. This data is current as of September 2017.


Seven broad categories were identified as primary market factors affecting access to IQA-SLD MDR-TB therapy, including: Delivery Challenges, Affordability, Regulatory Complexity, Regimen Complexity, Procurement, Forecasting, and Market Incentives. This categorization serves to outline the main challenges facing TB projects globally, and highlights areas of improvement for market functionality.

Affordability Graphic


Affordability is the relationship between the purchasing organization’s ability or willingness to pay, and the purchase price of an SLD order. Beyond the purchase price, all costs that go into monitoring, storing, and maintaining of SLD stocks are considered part of the overall cost of the order. Purchasing cost is directly affected by the market stability and manufacturing competition.

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Delivery Challenges Graphic

Delivery Challenges

Delivery challenges can refer to the practical linking of drug procurement efforts to functioning treatment projects. Once SLDs arrive at a clinic, organization, or national stockpile, the storage, domestic transfer, and clinically/programmatically appropriate utilization of these drugs for patients is a key consideration that can involve many different institutional, governmental, and private sector players.

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Forecasting Graphic


Forecasting can represent a range of predictive methods that quantify needs within a specified time frame. Strong forecasting is an integral part of the market, according to interviewees, as forecasting inaccuracies negatively affect all other market dynamics.

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Market Incentives Graphic

Market Incentives

Market incentives can apply to patients, institutional customers, or most typically to manufacturing firms as a way to increase their involvement within the IQA drug market. This category of activities can facilitate market entrance, participation, and functionality via financial, institutional, or informational innovations or reforms.

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Procurement Graphic


Procurement can refer to tendering, ordering, transportation, and administrative facilitation of SLDs, on both the national and global levels. Procurement in the SLD market, despite some improvements, is characterized by delays and administrative and customs holdups, according to interviewees.

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Regimen Complexity Graphic

Regimen Complexity

Regimen complexity can refer to activities that simplify or streamline treatment options for patients. MDR-TB treatments currently take up to 24 months from start to finish and can manifest in many different combinations. The length of treatment time, negative reactions to medications, and low cure rates all contribute to the complexity of treating MDR-TB.

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Regulatory Complexity Graphic

Regulatory Complexity

Regulatory complexity can refer either to the evidentiary, financial, and administrative burden to register drugs in different settings, or to a country’s qualification to receive IQA medicines from multilateral procurement agencies. This can be an extremely lengthy series of processes that require licensures, guideline adherence, and funding.

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