Leaders must make bold commitments at first-ever UN summit on tuberculosis

MSF doctor Joan providing a consultation to Nischaya, a TB patient in the MSF clinic in Mumbai.
INDIA 2016 © Atul Loke/Panos Pictures
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NEW YORK, SEPTEMBER 24, 2018—As global leaders gather for the first-ever United Nations High-Level Meeting on Tuberculosis (TB) in New York on Wednesday, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is calling on governments to scale up TB testing and treatment to save more lives today, and make real commitments to develop more effective and easier-to-use tools to defeat TB tomorrow.

Update: Read MSF's response to the summit

New global TB figures released last week by the World Health Organization (WHO) show that the response to the world’s deadliest infectious disease remains grossly inadequate, resulting in the deaths of 1.6 million people in 2017, with 10 million people developing TB in 2017. Under-diagnosis and under-reporting of TB remain major challenges as more than a third of people with TB have remained undiagnosed year after year for the past seven years.

“We have seen too many senseless and painful deaths in countries where we work because people are still not getting access to today’s best-available TB tests and treatments that are more effective and cause fewer severe side effects,” said Dr. Gabriella Ferlazzo, TB/HIV advisor with MSF’s Southern Africa Medical Unit. “World leaders have a historic opportunity to turn the tide on the global TB epidemic by making firm commitments for rapid scale-up of new tools for effective diagnosis and treatment of the disease.”

One of the key reasons for this abysmal TB report card is that governments have been slow to make new TB diagnostics and medicines widely available. For example, WHO first recommended use of a newer oral drug bedaquiline for treatment of multidrug-resistant TB (MDR-TB) in 2013. However, bedaquiline and other newer drugs were inaccessible to almost 90 percent of people who could have benefitted from them in 2017. WHO’s recent recommendations for treatment of MDR-TB prioritize newer, better oral drugs, such as bedaquiline, over medicines that need to be injected, meaning governments must act rapidly to expand access to safer, more effective, injection-free treatment regimens.

For decades, there has been chronic under-funding of research and development (R&D) for TB tests and drugs. Most products available to treat TB have not changed much since the 1940s, and only two new TB drugs have been developed in the last fifty years. Today, only 25 percent of people with MDR-TB are properly diagnosed and treated. People “lucky” enough to start the treatment have to go through a painful two-year process, involving nearly 170 injections and more than 12,000 pills, which can cause harsh side effects including deafness, psychosis, and even suicide. Cure rates for MDR-TB are abysmal as only about 55 percent of people who receive treatment are cured.

While there are several new products available today that governments need to immediately scale up, such as bedaquiline, a manageable and fast cure for TB still does not exist. To significantly turn the epidemic around, improved treatments, fast and simple diagnostic tests and effective vaccines for both adults and children need to be urgently developed.

“How is it possible that more than sixty years ago, we managed to send people to the moon and to the deepest point in the ocean, yet people affected with one of the most ancient diseases in human history continue to suffer and die because we’ve failed to find a fast, safe and simple cure for TB?” said Sharonann Lynch, HIV & TB Advisor for MSF’s Access Campaign. “All it would take to have a faster, safer, simpler cure for TB is for governments to care enough to make it a political priority. World leaders this week must show some spine and take collective responsibility to fight this global health emergency, so we don’t keep losing one fellow human to TB every 18 seconds.”

Despite the overwhelming challenges that TB poses, commitments from governments to support and intensify research and development for TB have been extremely insufficient, with an estimated $1.3 billion funding gap per year. Governments need to step up and significantly increase funding for research while also mobilizing the research community and supporting new collaborative research models.

“Governments need to stop starving TB R&D and start supporting smart collaborative R&D with a promise that the resulting tools will be available and affordable.” Lynch said.

MSF is the largest non-government provider of TB treatment worldwide and has been involved in TB care for 30 years, often working alongside national health authorities to treat people in a wide variety of settings, including chronic conflict zones, urban slums, prisons, refugee camps, and rural areas. In 2017, MSF supported more than 22,000 people with TB on treatment, including 3,600 people with drug-resistant forms of TB.