E-DRUG: MSF Report on Drug-Resistant Tuberculosis
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Dear E-druggers,
At the just concluded 45th Union Conference for Lung Health - the biggest
conference on tuberculosis in Barcelona, Spain, MSF launched its report
'Out of Step' on issues surrounding improper policies and practices
associated with the treatment of drug-resistant-tuberculosis.
I am copying the MSF press release on this new report at the end of this note.
Some e-druggers may remember that this follows the alarming global report from
the WHO this past April on worldwide antimicrobial resistance (AMR) and a
warning from a WHO official that 'Without urgent, coordinated action by
many stakeholders, the world is headed for a post-antibiotic era, in which
common infections and minor injuries which have been treatable for decades
can once again kill'. It is time that all the stakeholders including
governments, academia, industry and the patient groups come together to try
to help stop this worldwide epidemic of antimicrobial resistance.
Thanks,
Rizwan
MSF Report on Drug-Resistant Tuberculosis
30th October 2014, BARCELONA, Spain
'Outmoded policies and practices and critical gaps in care for drug-resistant tuberculosis
(DR-TB) are fuelling a worldwide public health crisis, said Medecins Sans Frontieres (MSF) in a
new report,' 'Out of Step'
http://www.msfaccess.org/content/out-step-deadly-implementation-gaps-tb-response)
released today at the 45th Union World Conference on Lung Health. Based on
a survey of eight high TB burden countries, MSF's research reveals that
efforts to control the epidemic are dangerously out of step with
international recommendations and proven best practices, leaving drug
resistant forms of TB to spread unabated. MSF warns that governments,
donors and industry must act now, using every means available, to step-up
the response to the crisis, or face a further growth in resistance.
'This is no time for complacency: in some former Soviet Union states, MSF
diagnoses multi-drug resistant TB (MDR-TB) in more than one in three people
who have never been treated for TB before, indicating its spread from
person to person. In Mumbai, India, MSF sees that primary transmission of
drug-resistant strains is likely driving the epidemic in hot spots like
slums and within vulnerable groups such as people living with HIV,' said
Dr. Petros Isaakidis, Medical Epidemiologist/Senior Operational Research
Fellow, MSF India. 'DR-TB is a manmade disaster, born out of years of
neglect and driven by a slow and piecemeal response. Countries must
increase their efforts to optimise DR-TB care in-line with international
guidelines and seize the opportunity that new tools offer to strengthen and
accelerate the fight against TB.'
"DR-TB is a manmade disaster, born out of years of neglect"
The latest damning data from the World Health Organization shows that less
than a third of the estimated MDR-TB patients worldwide are diagnosed, and
only one in five receive proper treatment. Gaps in care fuel the spread of
DR-TB from person to person; in some countries, MDR-TB is diagnosed in up
to 35% of new TB patients, a trend reflected in MSF clinics.
The 'Out of Step' report reveals five deadly gaps in the TB response that
are costing lives: poor access to drug resistance testing, a growing
number of people diagnosed with DR-TB left untreated, continued use of
outmoded and costly models of care, limited access to promising new and
repurposed drugs, and dire funding shortfalls.
MSF's research found that testing for drug resistance, crucial for
preventing misdiagnosis and incorrect treatment, is grossly insufficient in
most of the countries surveyed. In half of the countries, fewer than 75% of
MDR-TB patients diagnosed are enrolled in treatment. Further, some form of
routine hospitalisation takes place in half of the countries, despite
community-based care having proven more tolerable for patients and more
cost effective while delivering similar medical outcomes. Five out of eight
National TB Programmes face critical funding gaps, with Kenya, Myanmar and
Zimbabwe having less than 50% of the required funding available.
New and promising DR-TB drugs remain out of reach of most patients, more
than a year after their introduction: with bedaquiline and delamanid
unavailable for routine use in all countries surveyed. In four of the
countries surveyed, the new drugs are available to a limited few via
compassionate use or equivalent programmes. None of the countries have all
of the Group 5 repurposed medicines listed in their national guidelines
drugs that are critically important in salvage therapies.
'Patients are missing out on the potential of new and promising treatments
because companies and countries are dragging their feet with registrations.
Meanwhile, the lack of clinical trials incorporating new TB drugs into
much-needed short, tolerable and effective regimens highlights the failings
in the way medical innovation is conducted and incentivized. It's time for
TB research and development efforts to be prioritized and funded in a way
that ensures lifesaving diagnostics and treatments rapidly reach the people
who so desperately need them,' said Grania Brigden, MSF Access Campaign, TB
Advisor.
Syed Rizwanuddin Ahmad, MD, MPH, FISPE, FCP
Consultant with Special Interest to Strengthen National Medicines
Regulatory Authorities in Resource-limited Countries
Formerly (1998-2013) with the U.S. Food and Drug Administration
Assistant Professor (adjunct), Georgetown University School of Medicine,
Washington, DC, USA
Email: drugsafetyconsultant@gmail.com
www.drugsafetyconsultant.com