A new World Health Organisation (WHO) report paints a worrying picture about the drug-resistant strands of tuberculosis (TB).
In a survey of more than 90,000 patients in 81 countries, the WHO found that levels of TB resistant to a range of drugs were far higher than expected.
"What we found in this new report is that we have levels that are unprecedented, which no one would have [expected]," said Dr Mario Raviglione, director of tuberculosis research at the WHO.
"We suspected that this would be possible in some parts of the world, especially the former Soviet Union and some parts of China. [But] we also found that there is MDR-TB -- which is multi-drug resistant forms of tuberculosis."
The WHO says nearly half a million people around the world will become infected with a drug resistant form of TB every year.
Dr Raviglione says drug-resistant TB has been found in 45 countries, but may also be present in other countries as limited data was available from Africa.
"When there is multi-drug resistant TB, it is then an issue of managing the cases that exist in a proper way, which requires a major investment ... because these cases have to be treated with expensive drugs for up to two years," Dr Raviglione said.
"All of this requires essentially two things. That countries that are affected deal with the issue properly. [And] that their governments really put together a TB control program that works, which is not the case in some parts of the world."
Twenty-two cases of multi-drug resistant TB were diagnosed in Australia in one year -- the highest number ever recorded here.
"The problem with multi-drug resistant TB is that it does take much longer to cure. It is much more expensive. People usually have to stay in hospital a long time and there are more side-effects often from the drugs," said the Northern Territory Health Department's Dr Vicki Krause, who is also chair of the National Tuberculosis Advisory Committee.
"It [is] certainly a situation aspect of the disease that we want to keep at a very low rate."
Dr Krause says the WHO report is concerning.
But she says, compared with other countries, Australia is on top of the problem
"We are a wealthy country. We have excellent laboratory facilities, and this is the one area that is very important in this situation of multi-drug resistance. That you need to know what you are dealing with, and that means that you need to have good laboratory facilities," Dr Krause said."But in our very near neighbours, the ability even to show that someone has something in their sputum -- which is what they cough up -- is a very difficult situation."