DR-TB drugs under the microscope 2020

Tuberculosis (TB) is the world’s deadliest infectious disease, and drug-resistant (DR) TB is a global health emergency. The World Health Organization (WHO) has estimated that only 1 in 3 people with DR-TB is started on treatment, and those treated have faced exceedingly poor cure rates of 56% for multidrug- resistant TB (MDR-TB) and 39% for extensively drug-resistant TB (XDR-TB), as of 2018. Before the innovations in TB over the last few years, the best DR-TB treatment entailed long regimens with painful injections, severe side effects and poor outcomes. Safer and more effective DR-TB drugs are now available for use in all- oral regimens recommended by WHO.

In the face of poor cure rates and clear need to scale up DR-TB treatment in high-burden places, improvements in DR-TB management are finally at hand. But to achieve these improvements, the barriers to treatment scale-up must be addressed with haste, so that people with TB can benefit from these shorter, less toxic, more potent therapies. Access to testing and key DR-TB medicines, especially bedaquiline and delamanid, and potentially pretomanid, must be accelerated, including through more affordable pricing and by overcoming patent and licensing hurdles.

Also, the global COVID-19 pandemic has complicated and diverted resources from TB care, amongst other health areas. As the pandemic continues, disruption of TB services must be monitored and minimised.

This Issue Brief by Médecins Sans Frontières (MSF)’s Access Campaign examines the current landscape of DR-TB and TB- prevention drug pricing and patents, and what needs to be done to accelerate people’s access to these lifesaving medicines.