Progress Report - Global strategy and targets for tuberculosis prevention, care and control after 2015
Médecins Sans Frontières recommends Member States take the following actions to improve treatment outcomes for people with drug-resistant tuberculosis.
Secure full rollout of TB diagnostic tools,including rapid TB molecular testing capacity at every secondary-level district hospital and beyond in high-burden countries, to help close the deadly diagnosis gap, and better ensure people receive timely, appropriate treatment.
Scale up access to optimised treatment regimens with new TB drugs. Treatment with newer drugs, like bedaquiline and delamanid, can help improve cure rates from the abysmal 50% for MDR-TB and 26% for XDR-TB. However, in 2016, only 5% of those in need received the drugs. We call on Janssen and Otsuka to lower the price of these drugs and allow generic competition. There are promising drugs in the pipeline for improved outcomes, shorter regimens and fewer side effects, including pretomanid and sutezolid. We call on Pfizer and Sequella to release the clinical trial data for sutezolid so other drug developers don’t have to repeat trials unnecessarily.
Enable mechanisms for early access. Lack of registration in most high-burden countries remains a barrier to access for new and repurposed treatments. We call on Member States to implement efficient regulatory procedures to ensure timely access to new medicines including the WHO PQP Collaborative Registration Procedure, and early access mechanisms such as import waivers and compassionate use.
Finally, we ask WHO and member states to lend political, scientific and financial support to the 3P Project to develop a short-course pan-TB regimen. Through a combination of innovative funding incentives, the creation of an open collaborative framework and the pooling of data and intellectual property on drug candidates, combination treatments can be developed whilst ensuring affordable access.
Without such interventions and investments, DR-TB could cause one quarter of the potential 10 million annual antimicrobial resistance-related deaths by 2050.