Tackling TB – the burden remains significant

Last week I was lucky enough to attend a roundtable event titled ‘Tackling the Global Tuberculosis (TB) Threat: Can we learn from the HIV response?’ It was hosted by the Centre for Global Health Policy, University of Sussex. With World TB Day being marked on the 24 March, the event offered a timely reminder that the burden of TB is still significant. The World Health Organization states that TB is the second greatest killer worldwide due to a single infectious agent, being responsible for 1.3 million deaths in 2012. The roundtable addressed various dimensions of TB, including the global disease burden, access to treatment, drug resistance, and recent efforts by pharmaceutical companies and global health initiatives to develop new therapies.

While all of the speakers delivered informative presentations on TB both in the UK and overseas, the presentation of Dr Grania Brigden from Médecins Sans Frontières (MSF) stood out for me. Grania is the TB adviser for MSF’s Access campaign, which was launched in 1999 after MSF were awarded the Nobel Peace Prize. The purpose of the campaign has been to push for access to, and the development of life-saving and life prolonging medicines, diagnostic tests and vaccines for patients in MSF programmes and beyond. To address TB, MSF has been calling for the development of a point-of-care testing and aims to increase access to treatment for drug resistant (DR) TB by supporting the introduction of promising new medicines and tackling supply problems of older drugs. In 2011, MSF supported projects benefited 26,600 TB patients in 39 countries. Half of these projects involved treating multidrug-resistant TB (MDR TB) – a total of 1,300 patients in 21 countries.

Grania emphasised that the funding gap for TB in high burden countries remains significant. Although TB exists in western countries, over 95% of TB deaths occur in low- and middle-income countries. As such, the market for TB drugs in western countries is limited, which has stifled research and development. TB does not exist in a vacuum. The burden of TB is intertwined with the burden of many other diseases and conditions. For example TB is responsible for the deaths of one in five people who are living with HIV. Grania stated that for progress to be made and for lives to be saved, there should be crossover in the research and development to address both problems. Research and development should complement, and contribute to, progress towards addressing both.

As part of the Access campaign, a petition has been developed to support DR-TB patients and medical care providers. Full details on this are available through MSF’s DR TB Manifesto. The manifesto is centred on three key points:

1)     Access to DR TB diagnosis and treatment should be universal and immediately available.

2)     Better treatment regimens are needed – the TB research community, including research institutes and drug companies, are called upon to urgently deliver effective, more tolerable, shorter and affordable DR TB drug regimens.

3)     Financial support must increase support for DR TB treatment and research into developing better treatment.

The roundtable event served as a reminder that although TB is curable, current efforts to address it are not sufficient. Grania’s presentation was a call to arms to mobilise political and social commitment to address TB. It was perfectly timed as we mark World TB Day.

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Blog by Stephen Thompson, Research Officer with the Health & Education Advice & Resources Team (HEART)

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