MSF responds to groundbreaking new WHO guidelines recommending shorter, safer and better treatment for drug-resistant tuberculosis
Dr. Ilaria Motta, TB Medical Advisor, MSF Access Campaign:
“This is a momentous day for people with drug-resistant tuberculosis, because we can finally replace many of the longer, arduous and less-effective treatments by welcoming better, safer and shorter treatment that is much more likely to cure this deadly disease.
“Governments and donors now need to act swiftly to make sure people with drug-resistant forms of TB are able to access better and safer treatments.
“For governments to be able to provide improved treatment for all people with drug-resistant TB, the price of a full treatment course cannot exceed $500 in total, but as today’s price is still well above that, at $700, we need to see prices come down.
“Making sure more people can access better and shorter treatment will require that more people with DR-TB can be tested. MSF has been calling on TB test maker Cepheid to drop the price of the critical GeneXpert TB tests to below $5 per test, from between $10 and $20 today, so that more people can be tested for TB and its drug-resistant forms and start the lifesaving treatment.”
The World Health Organization’s (WHO) 2022 Global tuberculosis (TB) report highlighted that still only one in three people with drug-resistant tuberculosis (DR-TB) is getting treatment for the disease, and the treatment success rate for those that do receive treatment remains low, at 60% globally.
Following the groundbreaking results of MSF’s TB-PRACTECAL clinical trial—that demonstrated much higher treatment success combining newer TB treatment (BPaLM) for just 6 months, instead of using older treatments for up to 24 months — WHO today has recommended use of the 6-month BPaLM regimen, comprising the drugs bedaquiline, pretomanid, linezolid and moxifloxacin in people with multi-drug/rifampicin resistant TB (MDR/RR-TB), instead of longer, existing regimens. WHO is also recommending a second shorter treatment, BPaL, for people with documented resistance to fluroquinolones.
This is transformative development for TB treatment globally, and all governments should urgently move to implement these critical changes into their treatment guidelines.
However, access to these safer and better treatments will remain a challenge unless price and regulatory barriers are overcome so more manufacturers can enter the market and bring prices down. The newer regimens continue to be priced at almost US$700, well above the $500 ceiling price called for by MSF. The price of the critical GeneXpert TB diagnostic test must also come down by half, to $5 per test, so that more people with DR-TB can be diagnosed and then offered treatment.
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