Current therapy for MDR TB requires the use of multiple, toxic, and expensive drugs for 18–24 months. Even worse, it results in success in only about half of treated patients, with the rest dying of the disease. Patients urgently need better options in terms of treatment.
The introduction of two new medications to treat MDR TB—bedaquiline (BDQ) and delamanid (DLM)—has renewed hope for the nearly half million people with MDR-TB.
These drugs can greatly increase a patient’s chance of a cure and survival. In a recent review by WHO, bedaquiline was found to be effective in the treatment of MDR-TB with 79.7% of patients experiencing sputum culture conversion (no evidence of TB disease) at 6 months.
Other studies have shown even better results with bedaquiline, and, in terms of safety, the Treatment Action Group has noted, “the accumulating evidence…suggests that the drug is in fact quite safe.”
A study of the use of delamanid found that 67.6 of patients experiencing sputum culture conversion at 6 months. In addition, delamanid can be used a wider age group, including children aged six and over.
These new drugs also offer new hope for stopping the ongoing transmission of MDR TB, since once on effective treatment a patient quite rapidly becomes uninfectious.
The rate of introduction, however, has not kept pace with patient needs. Most high-burden countries are eligible for donated bedaquiline, yet, as of September, 2017 only about 10,000 patients are receiving it, out of 190,000 eligible patients. That is only about 5 percent.
Global Fund resources can be used to purchase delamanid, yet the level of access to delamanid is less than one percent of those in need (688 on the medication, out of 260,000 eligible).
As stated by noted TB experts, Dr Madhukar Pai and Dr Jennifer Furin:
“The clock is ticking and urgent action is needed if we are committed to ending TB in a mere 13 years. This means embracing innovation, increasing financial investments in TB, addressing implementation gaps, and making sure that new technologies are available in the service of those who are trying to survive. More importantly, the global TB community needs to learn from the HIV/AIDS experience, and not settle for less.
Contact ministries of health to urge faster progress in increasing access to these medications, and inform parliamentarians and other officials.
National TB Programs must 1) update treatment guidelines; 2) get drugs registered by regulatory authorities, if necessary, and/or secure import waiver; 3) procure the medications (and companion drugs); and 4) identify the patients in need and initiate treatment.
Countries must scale up their infrastructure, human resources, and information systems to diagnose and treat MDR-TB patients appropriately and comprehensively, as well as to carefully monitor and follow up with patients on these new drugs.
We all must also support efforts to develop entirely new, much shorter and simplified regimens, not only including these new drugs in the existing, difficult regimen of medications for MDR and XDR-TB. Yet, meanwhile the world has these new medications and patients deserve the best science has to offer!
Hashtags to use
#BDQaccess & #DLMaccess
#StopSuperbugs & #AntimicrobialResistance
Sample Twitter and Facebook posts
New drugs much better chance survival MDR-TB - but little access! #BDQaccess #AMR
Why so few patients on new MDR-TB drugs? Must speed up #BDQaccess
Save more lives with new #tuberculosis drugs. We must speed up access #DLMaccess
It’s time to end tuberculosis
TB is among the leading antimicrobial-resistant diseases
Drug-resistant TB is a serious threat to global public health
Let’s reverse the chronic underfunding of tuberculosis R&D
TB continues to mutate into one of the world’s greatest superbugs
TB is the drug-resistant infection spread through the air
We all live with the costs of DR-TB in economic, human, public health terms
Drug-resistant tuberculosis (DR-TB) has taken us back 100 years to days before antibiotics
Encuentro booth at the Union Conference
On Thursday and Friday, ACTION will be running a fun booth to test your knowledge about TB and the world's plans to address the growing threat of drug resistance. Also, come talk to us about simultaneous transition. What's that, you ask?! Find out here. Join us!