Yes, the whole question of resistance is a very important one. In your question you mentioned several challenges. One is that there is real criminal activity in some places where they produce fake drugs that are then brought onto the market. This is clearly criminal. This is, by the way, one reason we have this emerging resistance against malaria in Southeast Asia. The background is often that you have fake drugs brought onto the market there that lead to incomplete treatment and the development of resistance.
We actually have—that is, Global Fund together with the WHO and many other agencies, and also agencies such as Interpol—a global steering committee on exactly this issue of fake drugs and the criminal activities around them. This is beyond what we, the Global Fund, can do ourselves. Here you need law enforcement agencies, at the country level and the international level, to address the situation. But this global steering committee does exist, and it is currently chaired by a representative of the Global Fund.
That is particularly, I would say, relevant for malaria, because there is a big black market for malaria drugs. For tuberculosis the situation is a little bit different, because as I said before, the standard tuberculosis drugs are all drugs that were discovered 40 years ago. They are off patent. There's not much gain, if you like, in the black market for these. The reason for drug resistance there is more that people in institutions are incompletely treated.
Eastern Europe and central Asia constitute a big area in which you have emerging TB resistance—even more, I would say, than in Africa, for example, where the experience with our TB programs is relatively good. We call it a good outcome if 75% to 80% of the people who are started on TB treatment finalize it. This means that they are really cured after six months.
That's the best way to prevent TB drug resistance: complete and effective treatment. The issue is often more social, if you like, and that's why you have it particularly in eastern Europe. Prisons, for example, are a big breeding ground for TB resistance.
Yes, we do need more research. TB has been completely neglected, I would say, in terms of the development of new drugs. Recently this situation has changed a bit. There are now two drugs that have come to the market. This is the first time in more than 30 years that we have had new drugs that we can now use for the most dangerous drug-resistant forms. We would never use them for standard treatment. You have to be very careful with new drugs that you use them only where appropriate, so that you don't get resistance to these new drugs. But they are now available; you're absolutely right.
Research into TB and other neglected diseases is very necessary. The Global Fund itself does not invest in research, we have to say. That's much more a role for the Gates Foundation and government entities. But we have, of course, what we would call a pull factor. I mean that we incentivize research, because the companies know that if they develop these new drugs, there is an organization that can then pay for them. So that has an effect.
I think there is a pretty good collaboration between the Gates Foundation, the Global Fund, and others. Now we see more research into this and also into the more resistant forms, for all three diseases. It is a very important aspect, and particularly, as you mentioned, in the case of the malaria drugs, and how we can address that issue, together with governmental and law enforcement institutions in those countries.