Costs, cost-effectiveness, and financing of tuberculosis treatment

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. The World Health Organization has estimated that antibiotic-resistant bacteria caused nearly 1.3 million deaths in 2019, a toll that will increase significantly in the coming years if effective action is not taken. To mark World Antimicrobial Awareness Week 2022 (18-24 November) we present a snapshot of MSF’s recent work on responding to this growing threat. Since many humanitarian settings lack laboratory capacity to diagnose these infections, MSF and partners have developed two new technologies with the potential to dramatically expand the availability of accurate diagnosis—allowing clinicians to then tailor antibiotic treatment accordingly. Other work from diverse contexts describes practices and challenges related to optimizing rational antibiotic use within health facilities and communities. Lastly, several studies characterize the patterns and prevalence of antibiotic resistance among MSF patients, from hospitalized neonates in Central African Republic to acute trauma patients in Haiti and Yemen.

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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.