Tuberculosis (TB) and multidrug-resistant TB (MDRTB) are a major global health problem, and the Western Province of Papua New Guinea (PNG) has some of the highest rates of TB and MDRTB in the world. Due to its geographical location at the intersection of PNG, Australia and Indonesia, MDRTB in Western Province has significant health security implications. This article explores TB and MDRTB from a global health perspective with reference to the United Nations Millennium Development Goals and Sustainable Development Goals, followed by analysis of the unprecedented outbreak of MDRTB in Western Province PNG. This is followed by a focused history of the regulatory instrument, Public Health Emergency of International Concern (PHEIC), the advantages and disadvantages of declaring a PHEIC for MDRTB, and whether a PHEIC declaration is the right instrument to assist in combating MDRTB in Western Province, and MDRTB globally.