Although management of drug resistance in tuberculosis (TB) and HIV in poor settings is in its infancy, lessons learned from TB may be relevant to HIV and vice versa. The experience with HIV has shown that rapid scale-up and lower drug pricing are achievable goals. The current prerequisites for obtaining drugs to treat multidrug-resistant TB (MDR-TB) may be too stringent given the immediacy of the MDR-TB problem. We call for a more rapid roll-out of treatment for MDR-TB with fewer administrative encumbrances and a greater sense of urgency in national TB control programmes. On the other hand, antiretroviral roll-out programmes should learn from the genesis of the MDR-TB problem; laboratory monitoring should be enhanced and compliance optimized to avoid the acquisition of additional drug resistance in HIV.