With cases on the rise, MSF repeats call for more affordable DR-TB treatment

The price of a full DR-TB treatment course should be no more than $500 per person.

A child sits between two people in surgical masks after completing TB treatment from MSF in Papua New Guinea.

Papua New Guinea 2019 © Sara Bechstein/MSF

NEW YORK/GENEVA, OCTOBER 27, 2022—The World Health Organization’s (WHO) 2022 Global Tuberculosis (TB) Report released today shows an increase in the estimated incidence of TB in 2021 for the first time in two decades, including for the more difficult to treat form of this disease, drug-resistant TB (DR-TB). Only one in three people with DR-TB is currently being treated, partly because of the high price of newer TB medicines. To help save more lives, Doctors Without Borders/Médecins Sans Frontières (MSF) continues to demand that the price of a complete DR-TB treatment course be no more than $500 per person.

MSF’s groundbreaking TB clinical trial that concluded in 2021, TB PRACTECAL, showed that newer and shorter all-oral, six-month DR-TB treatment regimens are safer and more effective at treating DR-TB than the previously accepted standards of care. In response, in May, WHO updated its global guidance on TB treatment and recommended programmatic use of the TB PRACTECAL regimen consisting of bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM).

The new BPaLM regimen could have a huge positive impact on the quality of care for many of the 500,000 people who fall sick each year with DR-TB, but the current lowest global price for a six-month treatment course of BPaLM is still too high at around $700, which could slow uptake in high-TB-burden countries. The two most expensive drugs in the BPaLM regimen, pretomanid and bedaquiline—which were both developed with taxpayer funding—could be produced and sold at a profit for significantly less than their current prices.

Dr. Hannah Spencer, TB/HIV/hepatitis advisor for MSF’s South African Medical Unit, said today:

“DR-TB is curable, but alarmingly cases are on the rise around the world for the first time in years. It’s urgent that shorter, safer, and more effective treatments are scaled up now to save lives.

“MSF teams support the scale-up of shorter DR-TB regimens in collaboration with health ministries in places where we work, but it remains devastating for us to see so many people continue to struggle on the longer, older DR-TB treatments. National TB treatment programs and donors should make it their first order of business to make better treatments available. And prices must come down, so that a complete DR-TB treatment course is priced no higher than $500 per person. Everyone with DR-TB should have access to groundbreaking newer treatments.

“In light of these grim statistics, there is an urgent need for all WHO-recommended tools to be optimally used against TB, and for an increase in investment to develop new medical tools to treat, diagnose, and prevent TB.”

MSF is one of the largest non-governmental providers of TB treatment in the world. In 2021, 17,221 people in MSF’s care were started on TB treatment, including 2,309 people with DR-TB.