MIN/Sp/AU/CAMH3/6 TB Page 12 3.2.7 Transfer out: A patient who has been transferred to another recording and reporting unit and for whom the treatment outcome is not known. 3.3 Drug resistant TB 3.3.1 Multidrug resistant TB (MDR-TB): TB caused by a strain resistant to, at least, Isoniazid (H) and Rifampicin ® at the same time. 3.3.2 Extensively drug resistant TB (XDR-TB) : TB caused by a strain that is resistant to at least Rifampicin and Isoniazid (i.e. MDR-TB), plus resistance to any medicine in the fluoroquinolone family such as Ciprofloxacin and Ofloxacin; and also resistance to at least one of the three second line injectable anti-TB drugs such as Capreomycin, Kanamycin and Amikacin. 4: Situation Analysis. Report on TB situation in the WHO African Region 4.1: Leadership at National, Regional and Continental Levels Since TB was declared an emergency in the African Region, 18 countries 24 declared TB a national emergency /crisis and implemented special action plans to accelerate control. In August 2007, the 57th session of the Ministers of Health of the African Region adopted a Strategy for control of the TB/HIV dual epidemic that highlights strengthening of mechanisms for collaboration between TB and HIV/AIDS control programmes, improving prevention, case finding and treatment of TB among people living with HIV and AIDS, improving access to HIV testing and counselling among TB patients, infection control to reduce transmission, advocacy, communication and social mobilisation, partnerships and resource mobilisation , and research. During its 46th Conference, Health Ministers of the East, Central and Southern African (ECSA) health community in March 2008, adopted among others, a resolution on increasing access to medicines and medical supplies that urges all member states to develop and implement national medicines policies by 2009 and review essential drug lists and treatment guidelines at least every two years. 4.2 Prevention, Treatment, Care and Support 4.2.1 Trend of TB Notifications Absolute TB cases notified in the Region have continued to increase every year. With approximately only 11% of the world population, the Region contributes at over 20% of the global TB burden (Figure 4.21). Figure 4.2.1: Proportion of notified TB cases by WHO Region. 2006 24 Botswana, Burkina Faso, Cote d’ Ivoire, DRC, Guinea Conakry, Kenya, Lesotho, Malawi, Mali, Mozambique, Namibia, Nigeria, Senegal, Sierra Leone, South Africa , Tanzania, Togo and Zambia