Nurses prepare patients’ ‘directly observed treatment’ (DOT) in the pharmacy of the ambulatory ward at the National Centre for Tuberculosis and Lung Disease in Georgia’s capital, Tbilisi. Because drug-resistant tuberculosis treatments can be toxic and cause many side effects, patients must take their pills in front of a medical professional (usually a nurse) to ensure that they take all drugs, hence the treatment is ‘directly observed’. Photograph by Daro Sulakauri
Issue brief |

Out of time - Access to treatment for DR-TB

TUBERCULOSIS
TB_Out_of_Time_DRTB_Drug_Briefer-ENG_Dec-2015.pdf
Photograph by Daro Sulakauri

An update on the latest developments in DR-TB medicines.

In 2014, 1.5 million people died from tuberculosis (TB), displacing HIV as the top infectious disease killer, according to the World Health Organization’s (WHO) 2015 Global Tuberculosis Report. The latest figures for multidrug-resistant TB (MDR-TB) were no less disturbing: only 26% of people estimated to have acquired MDR-TB in 2014 were diagnosed, and only 23% were put on treatment.1 Only about 50% of people who start the gruelling two-year treatment for MDR-TB are successfully treated, while for people with extensively drug resistant TB (XDR–TB), the treatment success rate drops to 26%.2

A significant obstacle to radically improving outcomes for drug-resistant TB (DR-TB) patients in the short term is the inadequacy of current treatment regimens: patients must endure two years of treatment with severe side effects and unacceptably low cure rates. With two new TB drugs now available and increasing evidence of the potential value of some “group 5” drugs (existing drugs that are not approved to treat MDR-TB) in treating MDR-TB emerging, clinicians must have access to the full toolbox of potentially effective drugs, so they can create individualized regimens that offer each DR-TB patient the best possible cure available today. This fact sheet provides an overview of price and availability of the key medicines being used to treat DR-TB today.

To fundamentally improve DR-TB treatment outcomes, however, robust new regimens containing multiple novel and better tolerated drugs are desperately needed to completely replace the old, toxic drugs that remain a part of the current recommended DR-TB regimens.