12 May 2016
GENEVA - The Global Fund to Fight AIDS, Tuberculosis and Malaria welcomes the new recommendations issued by WHO to encourage the use of a shorter treatment regimen for multidrug-resistant tuberculosis (MDR-TB) and a rapid diagnostic test, which could save lives by speeding detection and improving outcomes.
WHO is recommending a standardized shorter MDR-TB regimen of 9-12 months that can reduce the length of treatment by one half for many adults and children. The conventional treatment regimens, which take 18-24 months to complete, have low cure rates at just 50 percent on average globally.
The shorter treatment regimen, which costs less than US$1,000 per patient or at least half the cost of the current conventional treatment, is expected to benefit the majority of MDR-TB patients in many countries, enabling improved outcomes and potentially lower deaths due to better adherence to treatment and reduced loss to follow-up, according to WHO.
The conventional treatment regimens yield low cure rates largely because patients find it very hard to keep taking second-line drugs, which can be quite toxic, for prolonged periods of time, so they are often interrupted.
The shorter regimen is recommended for patients diagnosed with uncomplicated MDR-TB, or patients whose MDR-TB is not resistant to the most important drugs used to treat MDR-TB (fluoroquinolones and injectables), known as second-line drugs. It is also recommended for individuals who have not yet been treated with second line drugs. People living with HIV and children are encouraged to use the new regime.
The novel diagnostic test, called MTBDRsl, is a molecular test that produces results in just 24-48 hours – a vast improvement over the 3 months or longer, currently required. The much faster turnaround time means that MDR-TB patients with additional resistance can quickly be placed on the right second-line treatment regimens, which enable better outcomes.
“More effective diagnoses and treatment are an essential tool to end TB as epidemic,” said Mark Dybul, Executive Director of the Global Fund. “We need to put human beings at the centre of our response and focus our efforts on the most vulnerable.”
Multidrug-resistant tuberculosis is a serious public health crisis and a global health security risk. An estimated 480,000 people developed MDR-TB in 2014 and 190,000 people died as a result of it.
The Global Fund provides more than three-quarters of all international financing for TB, focusing on countries with the highest disease burden and with the highest proportion of affected populations.