ObjectivesMultidrug-resistant/rifampicin-resistant tuberculosis is a major obstacle to successful tuberculosis control. The recommendation by the WHO to use bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaL(M)) for 6 months, based on results of three trials with high efficacy and low toxicity, has revolutionized treatment options. MethodsIn this study, representatives of the Tuberculosis Network European Trials group in 44 of 54 countries of the WHO Europe region document the availability of the medicines and drug susceptibility testing (DST) of the BPaL(M) regimen through a structured questionnaire between September and November 2023. ResultsIn total, 24 of 44 (54.5%), 42 of 44 (95.5%), 43 of 44 (97.7%), and 43 of 44 (97.7%) countries had access to pretomanid, bedaquiline, linezolid, and moxifloxacin, respectively. Overall, 23 of 44 (52.3%) countries had access to all the drugs composing the BPaL(M) regimen. In total, 7 of 44 (15.9%), 28 of 44 (63.6%), 34 of 44 (77.3%), and 36 of 44 (81.8%) countries had access to DST for pretomanid, bedaquiline, linezolid, and moxifloxacin, respectively. DST was available for all medicines composing the BPaL(M) regimen in 6 of 44 (13.6%) countries. DiscussionOnly in about half of the countries participating in the survey clinicians have access to all the BPaL(M) regimen drugs. In less than a fifth of countries, a complete DST is possible. Rapid scale up of DST capacity to prevent unnoticed spread of drug resistance and equal access to new regimens are urgently needed in Europe.