Funding vital to boost global TB cure rates

Saturday April 6 2013


Patients, doctors and international aid groups are calling on donors and governments to support measures that would make the treatment of drug-resistant tuberculosis more effective and accessible.

The demands are being made amidst the recent or imminent approval of two new drugs, bedaquiline and delamanid. Advocates say the drugs present a historic opportunity to tackle the notoriously difficult-to-treat disease.

“As we know with all infectious diseases, we need to seize this opportunity before an airborne infectious disease gets too out of control,” said Jennifer Cohn, a policy advisor with Medecins Sans Frontieres (MSF), an aid group.

MSF recently released a manifesto, signed by TB patients and their doctors in 23 countries around the world, noting that “after close to five decades of insufficient research and development into TB… Research is urgently required to determine the best way to use these new drugs so that treatment can be made shorter and more effective.”

It also warns that: “If measures to tackle multi-drug-resistant tuberculosis (MDR-TB) are not immediately expanded, rates of the disease will continue to increase worldwide, and a historic opportunity to improve abysmal cure rates will have been squandered.”

The call to action comes on the heels of a World Health Organisation (WHO) statement on the wide spread of drug-resistant tuberculosis — and warnings over an anticipated funding gap of $1.6 billion needed to both identify new cases and combat existing strains.

An additional $3.2 billion, according to WHO estimates, could be provided by governments. If the combined $4.8 billion is funded, treatment could be provided for 17 million TB and drug-resistant TB patients.

“We have gained a lot of ground in TB control through international collaboration, but it can easily be lost if we do not act now,” said Margaret Chan, the WHO director-general, in a statement.

While the overall incidence of tuberculosis has fallen in recent years, drug-resistant strains have increased. In a 2009 resolution to the World Health Assembly, the WHO noted that the highest levels of multidrug resistance reported in the agency’s global report “pose a threat to global public health security”.

Resistant TB strains

The spread of resistant strains is particularly alarming because their long and difficult treatment process makes them significantly more difficult to cure than traditional strains.

The MSF manifesto makes reference to regimens that require up to 20 pills a day along with daily injections that make it painful to sit or lie down. The treatment is also known for strong side effects, including severe nausea and even deafness.

MSF is calling for universal access to diagnosis and treatment for patients suffering from drug-resistant tuberculosis, as well as the development of “more tolerable” drug regimens, and additional financial support from international donors and governments for research.

Perhaps the most serious obstacle to filling the $1.6 billion funding gap is the massive federal budget cuts that went into effect in Washington, United States, in early March. These are slated to cut deeply into development assistance, including international health.

For instance, the United States will reduce its contribution to the Global Fund to Fight Aids, Tuberculosis and Malaria alone by $300 million, according to figures revealed by Secretary of State John Kerry.