Conclusion
Achieving the three goals of access, affordability, and sustainability in the MDR-TB context is a public health imperative. Novel financing mechanisms, such as advance purchase agreements and a global strategic stockpile, are necessary to improve the affordability of and access to MDR-TB treatment—in turn, improving the efficiency of use of country and donor resources. In parallel, any novel financing mechanism must also address the implementation gap affecting MDR-TB scale-up, such as through targeted investments in health systems strengthening and innovative care delivery models.