There is good reason to be sceptical about the link between healthcare policy and implementation in South Africa. Policies such as those on mental health and palliative care, for example, may be good on paper but have generally gone unimplemented. The Competition Commission’s Health Market Inquiry is arguably one of the most impressive and thorough investigations into a set of healthcare issues in recent years but most of the HMI report’s recommendations are gathering dust.

Finding out which medicines work and which ones do not work can be a tricky business – especially if you are under severe time pressure. The ideal is to compare different options in large randomised controlled trials (RCTs), preferably trials where neither the study participants or healthcare workers know who is getting which treatment.

In a move that could help save the hearing of thousands of people with TB, the World Health Organisation (WHO) is advising wider use of newer and repurposed drugs, bedaquiline and linezolid in place of injections that cause deafness. Rather perplexingly, the WHO is however also maintaining its recommendation for a shorter and cheaper, but much less impressive treatment regimen and advised that the new South African regimen should only be used under conditions of operational research.

Marcus Low's reflections on the Global Ministerial Conference on TB held on 16-17 November 2017 in Moscow, Russia.

Médecins Sans Frontières would like to treat 300 drug resistant TB patients in Khayelitsha with linezolid, but can only afford to buy the drug for little more than 20 patients.