Today’s TB medicines are inadequate to tackle the TB pandemic. New treatments that are faster, simpler, and affordable are urgently needed.
Today’s Drugs
Traditionally, TB treatments have taken too long to cure, and have been too complicated to administer, and toxic. Negative interactions between commonly used antiretrovirals and TB treatment are common. Today, people with active TB take drugs for 6 months or longer —or risk developing more difficult to treat drug-resistant TB. Prior to TB Alliance’s most recent innovations, treatment for drug-resistant TB took two years, and was so complex, expensive, and toxic that many people were unable to access treatment. Even treatment for latent TB takes 3-4 months. These factors pose enormous strains on people and communities affected by TB and health systems. New, faster, simpler and more effective treatments for all forms of TB are needed to overcome the TB pandemic.
The Grim Facts of Today’s TB Therapy
Today’s TB therapies place undue burden on patients and health care systems. The pandemic can’t be overcome without improved cures.
Only about half the people with MDR-TB around the world are successfully cured.
TB treatment is lengthy and burdensome to patients and treatment providers alike.
MDR-TB treatment can consist of more than 14,000 pills, plus daily injections for six months.
TB Treatment: From Bad to Worse
TB must be treated with a combination of drugs to prevent the development of resistance. But when treatment is erratic or incomplete, the disease quickly becomes more difficult to treat. Here’s what it looks like:
TB
Current treatment for drug-sensitive TB consists of 4 medicines (known as first-line drugs which consist of HRZE) and is administered for a period of 4 to 9 months. While the regimen is effective when taken as prescribed, many people with TB struggle to take their medication daily over the long treatment period.
Drug-Resistant TB (DR-TB)
If patients are not cured, and their disease becomes resistant, they must be treated with different medications. Traditionally, treatment for MDR-TB took 18 months or longer, included daily injections for six months, and was highly toxic. It’s cost and complexity meant that many people were not able to access proper treatment. TB Alliance recently developed a new three-drug combination treatment that can treat most forms of DR-TB in six months with success rates similar to treatment for drug-sensitive TB. TB Alliance is working diligently to ensure these new therapies reach all who need them, but many people around the world are also still treated with older, longer, toxic therapies.
Side effects
There can be side effects to any medication, and TB treatment is no exception. Generally, side effects are more serious in second-line treatment compared to first-line treatment. Some of the most common side effects of older treatments for drug-resistant TB include hearing loss, depression or psychosis, and kidney impairment. However, even first-line drugs cause side effects including gastrointestinal issues, rash, and drug-induced hepatitis. Simpler and safer TB treatments with fewer side effects are urgently needed.
Test and Treat: The Challenges of Diagnosis
Drug-susceptibility testing (DST) should be a mainstay of TB care and treatment. People with TB should understand their disease, and what treatment to take to ensure a cure. DST plays a crucial role in improving the management of people with TB, facilitating drug development and rational use of new TB drug regimens, and better understanding the epidemiology of the epidemic. TB Alliance is working with partners to ensure companion diagnostics and DST is developed alongside tomorrow’s regimens.
PHOTO: A mobile diagnostics lab helps doctors in Mbeya, Tanzania reach patients who might otherwise not make it to a regular clinic for help.
Our Pipeline
To overcome treatment challenges, TB Alliance is developing the largest pipeline of new TB drugs in history.