The Virtual Medical Consilium (VMC) is an initiative of the WHO Regional Office for Europe. The VMC consists of a coordinator and 9 to 11 members (experts) selected on the basis of significant experience in the clinical and program management of patients with DR-TB, experience in conducting operational research, observational studies or clinical trials in the relevant field. If necessary, invited experts can be called for specific cases. Each request for consultation is distributed among experts who are on duty on a rotational basis. The final response on behalf of the VMC summarizes the recommendations based on the quorum and consensus of the three experts.