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Summary Background Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are emerging worldwide. The Green Light Committee initiative supported programmatic management of drug-resistant tuberculosis in 90 countries. We used estimates from the Preserving Effective TB Treatment Study to predict MDR and XDR tuberculosis trends in four countries with a high burden of MDR tuberculosis: India, the Philippines, Russia, and South Africa. Methods We calibrated a compartmental model to data from drug resistance surveys and WHO tuberculosis reports to forecast estimates of incident MDR and XDR tuberculosis and the percentage of incident MDR and XDR tuberculosis caused by acquired drug resistance, assuming no fitness cost of resistance from 2000 to 2040 in India, the Philippines, Russia, and South Africa. Findings The model forecasted the percentage of MDR tuberculosis among incident cases of tuberculosis to increase, reaching 12·4% (95% prediction interval 9·4–16·2) in India, 8·9% (4·5–11·7) in the Philippines, 32·5% (27·0–35·8) in Russia, and 5·7% (3·0–7·6) in South Africa in 2040. It also predicted the percentage of XDR tuberculosis among incident MDR tuberculosis to increase, reaching 8·9% (95% prediction interval 5·1–12·9) in India, 9·0% (4·0–14·7) in the Philippines, 9·0% (4·8–14·2) in Russia, and 8·5% (2·5–14·7) in South Africa in 2040. Acquired drug resistance would cause less than 30% of incident MDR tuberculosis during 2000–40. Acquired drug resistance caused 80% of incident XDR tuberculosis in 2000, but this estimate would decrease to less than 50% by 2040. Interpretation MDR and XDR tuberculosis were forecast to increase in all four countries despite improvements in acquired drug resistance shown by the Green Light Committee-supported programmatic management of drug resistant tuberculosis. Additional control efforts beyond improving acquired drug-resistance rates are needed to stop the spread of MDR and XDR tuberculosis in countries with a high burden of MDR tuberculosis. Funding US Agency for International Development and US Centers for Disease Control and Prevention, Division of Tuberculosis Elimination.

Using multiple lenses of strategic choice theories (diffusion of innovation, organizational innovativeness) and institutional theory as the basis and reflecting data from semi-structured interviews and news reports, the study develops an integrative conceptual RFID adoption model and presents testable hypotheses at the construct and rationale levels. The model incorporates different rationales for adoption and integration of interorganizational systems (IOS) namely the strategic choice perspective where adoption is voluntary with a view to improve organizational efficiency and performance and the institutional perspective where adoption is more a result of conforming to pressures from organizations within an organization's field of operation. Two technological factors (perceived benefit and perceived costs), three organizational readiness factors (top management support, financial readiness, IS infrastructure and capabilities) and three external environmental factors (perceived standards convergence, perceived consumer privacy and perceived stakeholder privacy) have been suggested as adoption and integration drivers from a strategic choice perspective while the three Interorganizational pressure factors (coercive, mimetic and normative pressures) have been proposed as predictors of adoption intent and expected integration from the institutional perspective . The study allows for a comparison of the relative influence of each rationale on the adoption and post adoption integration decisions by a firm.

Establishing and expanding government led networks to strengthen infection prevention and control and healthcare associated infection surveillance are essential to effectively tackle antimicrobial resistance. Soumya Swaminathan and colleagues discuss the progress in India