New tests and drugs for world’s deadliest infectious disease, TB, remain out of reach - TB Report
MSF calls on governments and donors to step up and speed up TB testing and treatment
Geneva, 18 th November 2020 — As the COVID-19 pandemic threatens to derail the global response to tuberculosis (TB), Médecins Sans Frontières/Doctors Without Borders (MSF) called on governments to accelerate testing, treatment, and prevention for TB, and called on donors to provide the financial support needed to ensure increased access to new medical tools for diagnosing and treating millions of people with this killer disease.
A report released by MSF and the Stop TB Partnership—Step Up for TB—surveys 37 high TB-burden countries and shows that critical medical innovations are reaching far fewer people who urgently need them, because many countries continue to lag behind in getting their national policies in line with new World Health Organization (WHO) guidelines.
While reporting on the severe impact of the COVID-19 pandemic on TB services, WHO revealed a sharp drop in the number of people diagnosed. Besides needing to catch up to maintain continuity of existing TB services, it advised countries to adopt and roll out better testing policies and practices.
Presently, countries continue to fall short on rolling out up-to-date testing policies that can assist in reaching nearly 3 million people still being missed. As highlighted in the report, a whopping 85% of countries surveyed still do not use the lifesaving point-of-care urinary TB LAM test for routine diagnosis of TB in people living with HIV, as recommended by WHO. TB LAM is in use in Kenya but the Ministry of Health must ensure it is implemented widely, including in outpatient settings.
For many people with drug-resistant TB (DR-TB) the treatment is long and uses older, toxic drugs that have to be injected and cause serious side effects. Newer, safer drugs are available but globally, 39% do not use a modified all-oral shorter treatment regimen and 28% of countries surveyed still are using injectable medicines when treating children with DR-TB.
In June, Kenya committed to injectable free treatment regimens for TB patients, and a longer all-oral regimen for the treatment of adults with DR-TB has been implemented for routine use. However, the use of a modified shorter all- oral regimen is yet to begin.
“I have been through an agonising journey of being treated with medicines with excruciating side effects, and lost one of my lungs," said Meera Yadav, a survivor of extensively drug-resistant TB (XDR-TB) in Mumbai, India. “Finally, in 2016, I was able to access newer TB drugs as part of the regimen that saved my life. I don't want anyone else to have to go through this ordeal. With newer medicines, it is now possible to give people all-oral treatment that works to cure them.
People with TB can’t be excluded from accessing these innovations anymore, especially when they are afraid to visit treatment centers due to COVID-19.”
TB remains the world’s top infectious disease killer, and in Kenya is the fifth leading cause of death. “Instead of stepping up for TB, we are at risk of slipping back due to COVID-19,” said Sharonann Lynch, Senior TB Policy Advisor for MSF’s Access Campaign.
“We cannot stress enough how urgent it is now for governments and donors to intensify their efforts so that critical medical innovations and tools reach people with TB. We finally have better drugs and tests to tackle and prevent this extremely infectious yet curable disease, so it’s both mind-boggling and unacceptable that they’re still not being used to save as many lives as possible.”