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Costs, cost-effectiveness, and financing of tuberculosis treatment | Collections | MSF Science Portal
Costs, cost-effectiveness, and financing of tuberculosis treatment

Costs, cost-effectiveness, and financing of tuberculosis treatment

Tuberculosis (TB) is the world's deadliest infectious disease, and the leading killer of people with HIV. TB is curable, but it can be difficult to diagnose and tough to treat, especially for increasingly prevalent drug-resistant TB. In 2023, 22,700 people started TB treatment in MSF programs. Understanding the costs and cost-effectiveness associated with TB treatment and innovations, ranging from TB diagnostics and medications to TB care models, can help to plan resource needs and allocate resources effectively. Analyzing financing mechanisms can support developing sustainable funding models for TB control.

This collection spotlights articles by MSF and collaborators to analyze and document the costs of care, particularly diagnostics and medications.

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Snake envenoming: a neglected crisis

Snake envenoming: a neglected crisis

Every year 2 million or more people fall victim to snakebite envenoming, mostly in poor, rural communities of Africa, Asia and Latin America. Between 83,000—138,000 of them die, while hundreds of thousands more suffer debilitating long-term complications or disabilities.


Although some antivenom medicines are highly effective when used promptly and appropriately, many snakebite victims get no treatment at all. Those who do may receive antivenoms which don’t work against the type of snake that bit them, or were not rigorously tested for safety and effectiveness.


To mark World Snakebite Awareness Day on September 19th, the Collection linked below brings together recent MSF work on this highly neglected disease. Several articles and conference presentations help fill evidence gaps on the burden of disease and its impacts or on treatment outcomes with specific antivenoms in specific regions. Others examine how to tackle the formidable challenges of availability and affordability, the absence of regulatory oversight for making, testing and registering antivenoms, and the anemic R&D pipeline for new products—all of which impede access for patients to safe, effective treatment tailored to local snake species.

Mental health in humanitarian settings

Mental health in humanitarian settings
Medical and humanitarian harms of restrictive European migration policies

Medical and humanitarian harms of restrictive European migrat...
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Complex humanitarian emergencies and other low-resource settings can be exceedingly difficult places to provide quality mental health (MH) care. Yet these environments also often have a high burden of mental health care needs. This collection presents a set of articles describing how MSF teams have adapted and evaluated ways of bringing clinically impactful MH care to neglected communities and patients—from forcibly displaced populations in northern Nigeria to Syrian refugees in Lebanon and typhoon survivors in the Philippines. It also highlights work on developing new tools for providing clinical supervision and for identifying those patients most in need of care in fragile settings, and on new approaches to delivering MH services during the Covid-19 pandemic.
Conflict, persecution, poverty, food insecurity and natural disasters—increasingly fueled by climate change—continue to drive migration globally. Yet many wealthy countries are doubling down on hostile policies to prevent people from seeking safety within their borders, thereby subjecting them to a wide range of harms. In a newly-published report MSF focuses on European Union and member state policies that intensify exposure to violence, exploitation, risk of drowning at sea, disease, and lack of access to basic health care and shelter, both within European Union borders and beyond. The Collection linked below presents this report alongside selected publications illustrating the broader context, based on quantitative studies and accounts from MSF patients and medical teams over nearly a decade of operational experience along the European migration route. From violent, squalid detention centers in Libya— where people intercepted by the EU-supported Libyan coast guard are forcibly returned —to perilous Mediterranean crossings in flimsy rubber boats and often abysmal reception centers and camps within the EU, it documents how these policies and practices further harm highly vulnerable people seeking safety and protection.
Journal Article
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Research

Trends in the availability and prices of quality-assured tuberculosis drugs: a systematic analysis of Global Drug Facility Product Catalogs from 2001 to 2024

Kohler S, Achar J, Mulder C, Sitali N, Paul N
2024-06-25 • Globalization and Health
2024-06-25 • Globalization and Health
BACKGROUND
The Global Drug Facility (GDF) of the Stop TB Partnership was launched in 2001 with the goal of increasing access to quality-assured tuberculosis (TB) drugs and products. ...
Journal Article
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Research

Costs and import costs of past, present, and future TB drug regimens: a case study for Karakalpakstan, Uzbekistan

Kohler S, Sitali N, Achar J, Paul N
2022-11-23 • Journal of Public Health
2022-11-23 • Journal of Public Health
BACKGROUND
Tuberculosis (TB) drugs and their import are costly. We assessed how shorter TB drug regimens, which were non-inferior or superior in recent TB trials, can affect the cost...
Journal Article
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Research

The contribution of drug import to the cost of tuberculosis treatment: A cost analysis of longer, shorter, and short drug regimens for Karakalpakstan, Uzbekistan

Kohler S, Sitali N, Achar J, Paul N
2022-08-03 • PLOS Global Public Health
2022-08-03 • PLOS Global Public Health

Tuberculosis (TB) programs depend on a continuous supply of large amounts of high-quality TB drugs. When TB programs procure TB drugs from international suppliers, such as the Global ...

Journal Article
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Research

Programme costs of longer and shorter tuberculosis drug regimens and drug import: a modelling study for Karakalpakstan, Uzbekistan

Kohler S, Sitali N, Achar J, Paul N
2022-03-21 • ERJ open research
2022-03-21 • ERJ open research
BACKGROUND
The introduction of new and often shorter tuberculosis (TB) drug regimens affects the cost of TB programmes.

METHODS
We modelled drug purchase and import cost...
Journal Article
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Research

A framework for assessing import costs of medical supplies and results for a tuberculosis program in Karakalpakstan, Uzbekistan

Kohler S, Sitali N, Paul N
2021-08-25 • Health Data Science
2021-08-25 • Health Data Science

BACKGROUND

Import of medical supplies is common, but limited knowledge about import costs and their structure introduces uncertainty to budget planning, cost ma...

Journal Article
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Research

Health system support and health system strengthening: two key facilitators to the implementation of ambulatory tuberculosis treatment in Uzbekistan

Kohler S, Asadov DA, Bründer A, Healy S, Khamraev AK,  et al.
2016-07-12 • Health Economics Review
2016-07-12 • Health Economics Review

Uzbekistan inherited a hospital-based health system from the Soviet Union. We explore the health system-related challenges faced during the scale-up of ambulatory (outpatient) treatme...

Journal Article
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Research

Ambulatory tuberculosis treatment in post-Semashko health care systems needs supportive financing mechanisms

Kohler S, Asadov D, Brunder A, Healy S, Khamraev AK,  et al.
2014-12-01 • International Journal of Tuberculosis and Lung Disease
2014-12-01 • International Journal of Tuberculosis and Lung Disease
The tuberculosis (TB) control strategy in the Republic of Karakalpakstan, Uzbekistan, is being changed to decentralised out-patient care for most TB patients by the Government of Uzbekis...