MDR-TB Tag

  • All
  • Advocacy Hub
  • Advocacy Update
  • Blog Posts
  • GHC Announcements
  • News Center
  • Statement
MSF at the 48th Union World Conference On Lung Health

Organized by

 

More MSF Events

EndTB Symposium: Accelerating TB Elimination Through Access to Bedaquiline and Delamanid
October 12
2:00 PM – 3:30 PM
Hall 10, Jalisco Hall
Guadalajara, Mexico

The symposium will provide an update on the UNITAID-funded endTB initiative and findings, including culture conversion and reversion and adverse events for the 600 people who have received bedaquiline or delamanid.

Community space (Encuentro) session: Five urgent improvements to DR-TB treatment
October 13
5:00 PM – 6:00 PM
Foro – Encuentro Expo
Guadalajara, Mexico

Evidence for treatment with newer DR-TB drugs, shorter treatment regimens, ambulatory care instead of hospitisation, and fast-track registration of new drugs.

MSF Symposium: Reducing Catastrophic Costs for People with TB through Patient-Centred care
October 14
10:30 AM – 12:00 PM
Hall 10, Jalisco Hall

Session will analyse the barriers to reducing costs and burden for people with drug-resistant TB including: decentralised and ambulatory treater, shorter treatment and newer drugs to reduce toxicity, and interventions to reduce out-of-pocket costs of treatment.


2
PQM Increases the Supply of, and Affordability of, Life-Saving Anti-TB Medication

This guest post was provided by GHC member United States Pharmacopeial Convention (USP).

The United States Pharmacopeial Convention (USP) promotes and supports end-to-end quality assurance across health systems in partnership with regulatory authorities, policymakers, donors, and other key stakeholders. Through multiple programs, USP provides technical assistance, workforce development, and sets standards to improve access to quality-assured, life-saving medicines that protect patients. USP’s longstanding partnership with United States Agency for International Development (USAID) has led to significant advancements in medicine quality in priority regions, with key activities currently implemented through the Promoting the Quality of Medicines (PQM) program in 34 countries.

Most tuberculosis (TB) cases can be treated with first line, or preferred, medicines. However, bacteria that cause TB can become resistant to first line medicines, which causes a condition known as multi-drug resistant TB (MDR-TB). In 2015, the World Health Organization (WHO) estimated that of the 580,000 people requiring multi-drug resistant tuberculosis (MDR-TB) treatment, only 20% were enrolled in therapy. For individual patients, this form of TB can mean longer, less effective, and more expensive treatment, which is inhibited further if the medicine provided is not quality-assured. Therefore, increasing supply of and access to quality-assured second line MDR-TB medicines is a high priority in treatment efforts.

Kanamycin is one of the key second line medicines used for treatment of MDR-TB. In 2016, to help increase the availability of quality-assured kanamycin, PQM negotiated the purchasing price with manufacturers based on the costs incurred by the producer in exchange for technical assistance. This intervention had two significant results: the price of quality-assured kanamycin fell, becoming available in liquid form for widespread distribution for the first time to the Global Drug Facility, WHO’s procurement mechanism. The price of 1-g kanamycin solution made available through PQM’s intervention is 73% less than the same product from other suppliers; the intervention also set the lowest price benchmark for 0.5-g and 1-g kanamycin injection solutions on the global public health market, which is expected to drive down the price of kanamycin produced by other manufacturers as well. Ultimately this will enable donors and national TB programs to save millions in public health funding, allowing more efficient and widespread service delivery.

 

 

0
Without Community Organizations, MDR-TB Runs Rampant

Angela Orlov has multidrug-resistant TB and HIV but cannot get a space in the local TB hospital in Balti, Moldova.

Angela Orlov has multidrug-resistant TB and HIV and is so weak that she is often unable to get out of bed. She is thin and tired, and her health is rapidly deteriorating. She is trying to get admitted to the local TB hospital, but so far has been unable to do so. Every day Galina Zaporojan, a volunteer health worker with a local NGO, brings Angela her TB medicine to make sure that she is able to adhere to her treatment. Speranta Terrei, the NGO that Galina works with, is the only organization working in Balti, the town with Moldova’s highest TB rate.

One of the biggest obstacles in the struggle to contain tuberculosis is finding ways that make it easy for patients to adhere to the often long and arduous treatment process. Even the mildest cases of TB require months of daily medication that can have uncomfortable side effects, and it is common for patients to skip days or stop the treatment altogether if they begin to feel better. This is a result of little awareness or education about the disease and its treatment, sub-par health care systems, and the fact that many of the patients live in difficult economic situations and sometimes must decide between getting to the hospital to take their medicine or getting to work to feed their family. Multidrug-resistant TB (MDR-TB) can arise when patients incorrectly take their treatment, or default altogether. These strains of the disease are deadlier than traditional TB and require longer and more difficult treatment regiments, making it even harder to ensure that patients adhere to the treatment for MDR-TB.

Read the full blog on the Pulitzer Center’s website.

See David Rochkind’s article and multi-media piece Moldova: What Happens to MDR-TB Patients.

 

0
As the Health System Declined, TB Increased

The third in a series of blogs on MDR-TB in Moldova by photojournalist David Rochkind

The former TB hospital in Balti sits on the outskirts of town, unused and surrounded by overgrown foliage, far from the city’s everyday activities. Local health specialists say that it used to be a very good hospital with a large garden on the grounds where patients and their families could walk and different wings to house patients depending on the severity of their symptoms. The day I visited, there were two drunk locals passed out in the trees in front of the wing that once held the sickest patients.

The hospital has been closed since 1999 when authorities, low on cash after the breakup of the Soviet Union, decided that they could no longer afford such a large hospital and, moreoever, that a city the size of Balti didn’t require one. The hospital is now empty with crumbling and decaying walls. The rooms are vacant, and only cobwebs, broken windows and dangling electrical wires remain; there are old, glass bottles clustered on the floor of a few rooms. It is an eerie experience to walk the halls of the defunct hospital, seeing total decay alongside remnants of a past productive life: beautiful, decorative tiling in the nurses’ offices and large dining halls on every floor with natural light, views of the city and colorful, educational paintings about Tuberculosis on the glass doors. The view becomes even sadder when you consider that this huge, four-story building lies in ruins while the new, smaller TB hospital struggles to keep up with the demand of the region’s current TB patients.

Read the full blog on the Pulitzer Center’s website

LEARN MORE
See David Rochkind’s article and multi-media piece Moldova: What Happens to MDR-TB Patients.

0
Arrival to Moldova

The second in a series of blogs on MDR-TB in Moldova by photojournalist David Rochkind

I am in Moldova to learn more about multidrug-resistant TB (MDR-TB), a new strain of the disease that is very serious and very deadly. There are a variety of reasons that MDR-TB arises. It is easiest, though perhaps a bit simplistic, to think of it as follows: A patient must take medicine to treat “normal” TB daily, usually for a period of 6-12 months. It is imperative that the patient follow the treatment exactly; if not, the disease can begin to grow resistant to the drugs, requiring a second line of much more expensive and uncomfortable drugs to kill it. There are now strains that are resistant even to the second line of drugs. In some cases, patients must resort to chemotherapy.

Moldova has one of the highest rates of MDR-TB in the world. That is to say that of the total number of TB cases in the country, an exceedingly high percentage are multidrug-resistant. Some put that figure as high as 30% in Moldova. The total raw numbers may be small at the moment, but it is important to consider the percentages as well as the circumstances that allow MDR-TB to arise. In Moldova, there are several factors, ranging from a large migrant population to generally poor health services (more on the specifics of these in future posts), that have created a fertile environment for MDR-TB. At first glance, it does not seem that these factors are being adequately addressed, indicating that MDR-TB will continue to spread. According to the director of an NGO that works on TB in Moldova, many patients are unresponsive to any currently available treatment. This means that dozens of people are sick, have no options for treatment, and are essentially waiting to die. At this point, there is literally nothing they can do. Remember, TB is a totally treatable disease.

Read the full blog on the Pulitzer Center’s website

LEARN MORE

See David Rochkind’s article and multi-media piece Moldova: What Happens to MDR-TB Patients.

 

0