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TB Union Conference 2022 | Collections | MSF Science Portal
TB Union Conference 2022

TB Union Conference 2022

Innovation in preventing, diagnosing and treating drug-resistant tuberculosis (DR-TB) cannot come fast enough—especially given the ground lost due to the Covid-19 pandemic, and with only 1 in 3 people who have DR-TB now receiving care. The content collection linked below offers a snapshot of recent TB work by MSF and collaborators to help change this picture. The TB-PRACTECAL and endTB studies have delivered clear evidence for shorter, safer, more effective treatments against drug-resistant (DR)-TB. Faced with the many hurdles that lie ahead before these and other critical interventions can be widely accessible, other studies investigate patient/family-based models of care adapted to complex settings and neglected groups, including children. Last, several authors explore limited but potentially important options for expanding diagnosis and preventive treatment.

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International Safe Abortion Day 2022

International Safe Abortion Day 2022
Unsafe abortion is a leading cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 28,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion. So in 2016 we launched a program to systematically implement safe abortion care (SAC), starting with ten pilot sites and then applying the lessons learned to scale up at projects across the globe. This Collection presents highlights of these efforts. Since our first publication on the need to provide SAC as a way of reducing maternal death and injury, several studies assessed the role of unsafe abortion in driving this suffering in specific contexts. Others described internal obstacles to providing SAC, operational solutions developed, and outcomes achieved. And we advocated for shifting towards community-led and self-managed SAC, particularly given new obstacles that emerged during the Covid-19 pandemic.
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Combatting antimicrobial resistance

Combatting antimicrobial resistance
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Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.

Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.


MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.

If you're interested in learning more about MSF's work in antimicrobial resistance, view the full list of MSF's publications on the topic.

Journal Article
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Pre-Print

Cost-effectiveness of short, oral treatment regimens for rifampicin resistant tuberculosis

Sweeney S, Berry C, Kazounis E, Motta I, Vassall A,  et al.
2022-11-10 • medRxiv
2022-11-10 • medRxiv
INTRODUCTION
Current options for treating tuberculosis (TB) that is resistant to rifampicin (RR-TB) are few, and regimens are often long and poorly tolerated. Following recent eviden...
Technical Report
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Policy Brief

DR-TB drugs under the microscope 2022

MSF Access Campaign
2022-11-08
2022-11-08
TB was the leading cause of death from a single infectious agent until the COVID pandemic. The number of people newly diagnosed with TB in 2020 fell by 18% from the previous year due to ...
Journal Article
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Research

Safety and effectiveness outcomes from a 14-country cohort of patients with multi-drug resistant tuberculosis treated concomitantly with bedaquiline, delamanid and other second-line drugs

Huerga H, Khan UT, Bastard M, Mitnick CD, Lachenal N,  et al.
2022-10-15 • Clinical Infectious Diseases
2022-10-15 • Clinical Infectious Diseases
BACKGROUND
Concomitant use of bedaquiline (Bdq) and delamanid (Dlm) for multi-drug/rifampicin resistant tuberculosis (MDR/RR-TB) has raised concerns about a potentially poor risk-ben...
Journal Article
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Letter

Family directly observed therapy for children with drug-resistant TB

Rekart ML, Morshed T, Mulanda WK, Klieascikova J, Sitali N,  et al.
2022-08-01 • International Journal of Tuberculosis and Lung Disease
2022-08-01 • International Journal of Tuberculosis and Lung Disease
Conference Material
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Abstract

24-week regimens for treatment of rifampicin-resistant tuberculosis: four-arm randomised trial

Berry C, Motta I, Kazounis E, Fielding K, Dodd M,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
INTRODUCTION
Rifamipcin-resistant tuberculosis (RR-TB) affects around 465,000 people each year globally. Current treatment is of 9-20 months’ duration; is toxic and poorly efficaciou...
Conference Material
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Slide Presentation

Pregnancy outcomes in patients undergoing drug-resistant tuberculosis treatment in two closely monitored cohorts

Lachenal N, Hewison CCH, Berry C, Mitnick CD, Ahmed SM,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
Journal Blog
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Perspective

6 months TB treatment for (almost) all

Berry C
2022-05-10 • PLoS Blogs
2022-05-10 • PLoS Blogs
Journal Article
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Commentary

Recently developed drugs for the treatment of drug-resistant tuberculosis: a research and development case study

Perrin C, Athersuch K, Elder G, Martin M, Alsalhani A
2022-04-19 • BMJ Global Health
2022-04-19 • BMJ Global Health
Two drugs with novel mechanisms of action, the diarylquinoline bedaquiline and the nitroimidazole delamanid—as well as pretomanid from the same class of drugs as delamanid—have recently ...
Journal Article
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Research

Person-centred care and short oral treatment for rifampicin-resistant tuberculosis improve retention in care in Kandahar, Afghanistan

Mesic A, Ishaq S, Khan WH, Mureed A, Mar HT,  et al.
2022-01-03 • Tropical Medicine and International Health
2022-01-03 • Tropical Medicine and International Health
OBJECTIVES
To describe the effect of adaptations to a person-centred care with short oral regimens on retention in care for rifampicin-resistant TB (RR-TB) in Kandahar province, Afgh...
Journal Article
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Commentary

Introducing new and repurposed TB drugs: the endTB experience

Seung KJ, Khan UT, Varaine FFV, Ahmed SM, Bastard M,  et al.
2020-10-01 • International Journal of Tuberculosis and Lung Disease
2020-10-01 • International Journal of Tuberculosis and Lung Disease
In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with the objective of reducing barriers to access to the new and repurposed TB drugs. Here we describe the major imp...