E-DRUG: MSF: The XDR-TB emergency will require new strategies and new tools
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[Relatively long posting]
The XDR-TB Emergency Will Require New Strategies and New Tools:
Business as Usual Would be Fatal
New MSF analysis shows greater investment required to make TB history
Paris/Geneva, 30 October 2006 Relying on the standard World Health
Organization (WHO) TB strategies in the face of extensively drug resistant
tuberculosis (XDR TB) will be fatal, the international medical humanitarian
organisation MSF warned today. To respond to
the XDR-TB outbreak, WHO will need to get newer drugs to patients as soon
as possible by ensuring accelerated development of new drugs already in
clinical trials. Existing TB drugs and diagnostics are not adequate to
combat the disease, and a new analysis being released by MSF as the 37th
Union World Conference on Lung Health begins this week in Paris shows that
none of the TB drugs currently in development, however promising, will be
able to drastically improve TB treatment in the near future. WHO must take
the lead in ensuring there is major reprioritisation and increased funding
of TB research.
With 450,000 new cases of drug resistant TB globally each year, resistance
to drugs is a problem that is growing at a rapid pace. People with XDR-TB
are resistant to both of the first-line antibiotics used to treat TB as
well as to two classes of second-line drugs, making treatment with existing
drugs virtually impossible. XDR-TB is particularly alarming in the context
of HIV, as people who are co-infected with HIV/AIDS could die before test
results can confirm their drug resistance. Using standard drugs to treat
XDR-TB without knowing whether there is drug resistance could effectively
condemn a patient to death. MSF doctors have been struggling to treat TB
with the tools available today, a matter which is exacerbated by the HIV
pandemic.
'Business as usual would be a disaster when it comes to treating XDR-TB,'
said Dr. Francoise Louis, MSF TB and HIV/AIDS advisor. 'XDR-TB has the
potential to be devastating in places where HIV/AIDS is widespread. But
trying to treat XDR-TB with the tools we have today would be like trying to
put out a forest fire with a garden hose.'
To respond to the XDR-TB outbreak, WHO will need to get newer drugs to
patients as soon as possible by working with regulatory agencies and
pharmaceutical companies to ensure fast-track clinical development and
availability of new drugs for 'compassionate use.' The organization will
also need to push to accelerate the development of more easy-to-use tests.
This will require WHO to take a lead and not simply delegate responsibility
to product development partnerships.
The emergence of XDR-TB is a reflection of how the WHO approach to TB has
failed, particularly by neglecting research and development into urgently
needed new drugs and diagnostics that could help reduce the nearly two
million TB deaths each year. The drugs in today's standard TB treatment
were developed in the 1950s and 1960s and the most commonly used TB test
was developed over a century ago and manages to detect TB in only about
half of the cases. In addition, existing TB drugs and tests are even less
adapted for use in people who also have HIV/AIDS.
'The XDR-TB outbreaks in southern Africa should sound the alarm for what's
going on with TB on a larger scale,' said Dr. Tido von Schoen-Angerer,
director of MSF's Campaign for Access to Essential Medicines. 'We're still
simply not seeing the necessary urgency and major investment into research
and development that is needed to make sure the basic science of TB gets
translated into newer drugs that can shorten and improve treatment, and
diagnostic tests that can be used in resource-poor settings.'