"TB kills two million people every year, but where is the sense of urgency that will secure resources and accelerate the process of developing new tools to fight it?"
- Dr Rowan Gillies, International President of MSF
Médecins Sans Frontières (MSF) launched its new TB report, "Running out of breath? TB care in the 21st century," which looks at some of the shortcomings of the global TB strategy, TB diagnostic tests and drugs.
MSF is calling for an urgent increase in worldwide investment in TB research and development. "We can't be satisfied with the TB treatment we and our colleagues in national TB programmes have at our disposal today," said Olivier Brouant, head of mission for MSF's TB project in Mumbai. "A patient must take TB treatment daily during six to eight months - surely we can do better than this." The report also highlights the Global Alliance for TB Drug Development (TB Alliance) as being "the only significant public-private partnership for TB."
MSF's report concludes:
- Expanding the current WHO-recommended global TB strategy, DOTS, is not the only answer to TB. Improving DOTS is key too, if we are going to try to effectively treat the growing number of TB patients.
- Vigorous action for improved, more inclusive DOTS and for resources to develop new tools to fight TB is needed.
FULL REPORT CONCLUSIONS AND RECOMMENDATIONS
1. Revision of the global TB strategy
WHO should lead the process of revising a global TB strategy that adequately addresses the HIV/AIDS pandemic and its consequences for TB care.
- Access to treatment for smear-negative patients must be ensured: programme objectives need to be revised to eliminate perverse incentives to focus on subsets of patients.
- Innovative means of improving treatment adherence must be found, including reduced need for direct observation.
- More resources to develop new tools to fight TB adapted for resource-poor settings are urgently needed.
2. Boost development and validation of new diagnostic tools
- An emergency plan is needed to speed up validation of promising diagnostics.
- Ensure affordability of existing diagnostic and DST (e.g. MGIT).
- More R&D into entirely new TB diagnostic tools (e.g. antigen detection).
3. Quicken the pace of developing new, easier-to-use drugs and make them available at affordable prices
- WHO and governments must work together to develop and fund an essential TB clinical research agenda, ensuring that needed clinical trials take place. The agenda should consist of developing new TB treatments among: TB indications of existing drugs and new compounds.
- Governments should insist that companies make compounds with potential activity against TB available to those that are willing to develop them into drugs. When commercial interests hamper the development of a potential TB treatment, governments need to intervene.
- New TB drugs must be affordable to the people who need them.
MSF presently treats approximately 20,000 patients for TB in 32 MSF projects in 17 countries, namely: Afghanistan, Angola, Burma, DRC, Ethiopia, Georgia, Guinea, India, Ivory Coast, Azerbaijan, Kenya, Malawi, Sudan, Somalia, Turkmenistan, Thailand and Uzbekistan.