Tuberculosis (TB) is one of the world's deadliest communicable diseases. Drug resistant - TB (DR-TB) occur when resistance develop to one or more anti-TB drugs. The emergence of, and increasing cases of DR-TB are purely human factor and this poses a great danger to the global TB care and control. Current treatment regimens and modalities for treatment are quite far from satisfactory with problems arising from long duration of treatment and complications from drugs used in the treatment. These two factors make the control of MDR- TB difficult with a risk of increasing numbers of extended drug resistant TB (XDR-TB). The cost implication is also enormous, both human and material resources. MDR-TB cure and control is demanding, requiring quality treatment of drug susceptible TB, expansion of rapid testing to diagnose MDR-TB, access to quality care, nfection control and political commitment. Therefore all stakeholders are encouraged to intensify effort in the prevention and management of drug susceptible TB to avoid a global time bomb of increasing drug resistant TB which is much more difficult to manage.