OneWorld.net (U.S.)

OneWorld.net note: People in developing countries with multidrug-resistant Tuberculosis (MDR-TB) will now benefit from faster diagnosis and treatment tailored to their needs thanks to two new initiatives unveiled Monday by a coalition of global health groups.

• MDR-TB is a form of TB that does not respond to the two most common drugs used to treat the disease. Currently, only 2 percent of MDR-TB cases worldwide are being diagnosed and treated appropriately, predominantly due to inadequate laboratory services, says the World Health Organization.
• The first of the projects will make technologically advanced tests to diagnosis MDR-TB available in 16 countries worldwide alongside improved lab facilities and equipment to employ the new testing method. The second initiative will greatly increase the supply of anti-TB drugs to 54 countries and reduce the price of certain anti-TB drugs sold in developing countries by 2010.
• World leaders at a UN forum in early June called for greater investment in the control and prevention of TB, cited as one of the top 10 leading causes of death worldwide and the leading cause of death among people living with HIV/AIDS.

New rapid tests for drug-resistant TB for developing countries

From: World Health Organization

30 JUNE 2008 | GENEVA -- People in low-resource countries who are illwith multidrug-resistant TB (MDR-TB) will get a faster diagnosis -- intwo days, not the standard two to three months -- and appropriatetreatment thanks to two new initiatives unveiled today by WHO, the StopTB Partnership, UNITAID and the Foundation for Innovative NewDiagnostics (FIND).

MDR-TB is a form of TB that responds poorlyto standard treatment because of resistance to the first-line drugsisoniazid and rifampicin. At present it is estimated that only 2% ofMDR-TB cases worldwide are being diagnosed and treated appropriately,mainly because of inadequate laboratory services. The initiativesannounced today should increase that proportion at least seven-foldover the next four years, to 15% or more.

"I am delighted that this initiative will improve both the technologyneeded to diagnose TB quickly, and increase the availability of drugsto treat highly resistant TB," said British Prime Minister GordonBrown, who helped launch the Stop TB Partnership's Global Plan to StopTB in 2006 and whose government is a founding member of UNITAID. "TheUK is committed to stopping TB around the world, from our funding of TBprevention programmes in poor countries, to our support of cutting edgeresearch to develop new drugs."

In developing countries most TB patients are tested for MDR-TB onlyafter they fail to respond to standard treatments. Even then, it takestwo months or more to confirm the diagnosis. Patients have to wait forthe test results before they can receive life-saving second-line drugs.During this period, they can spread the multidrug-resistant disease toothers. Often the patients die before results are known, especially ifthey are HIV-infected in addition to having MDR-TB.

The initiative comes just one week after WHO recommended "line probeassays" for rapid MDR-TB diagnosis worldwide. This policy change wasdriven by data from recent studies, including a large field trial --conducted by FIND together with South Africa's Medical Research Counciland National Health Laboratory Services -- which produced evidence forthe reliability and feasibility of using line probe assays underroutine conditions.

"Five months ago, WHO renewed its call to make MDR-TB an urgent publichealth priority," said WHO Director-General Dr Margaret Chan, "andtoday we have evidence to guide our response. Based on that evidence,we are launching these promising initiatives."

Two projects

The new initiativeconsists of two projects. The first, made possible through US$ 26.1million in funding from UNITAID, will introduce a molecular method todiagnose MDR-TB that until now was used exclusively in researchsettings. These rapid, new molecular tests, known as line probe assays,produce an answer in less than two days.

Over the next four years -- as lab staff are trained, lab facilitiesenhanced and new equipment delivered -- 16 countries will begin usingrapid methods to diagnose MDR-TB, including the molecular tests. Thecountries will receive the tests through the Stop TB Partnership'sGlobal Drug Facility, which provides countries with both drugs anddiagnostic supplies.

As part of the project, WHO's Global Laboratory Initiative and FINDwill help countries prepare for installation and use of the new rapiddiagnostic tests, ensuring necessary technical standards for biosafetyand the capacity to accurately perform DNA-based tests. One country,Lesotho, is already equipped to start using these tests; Ethiopia isexpected to be ready by the end of 2008. The tests will be phased induring 2009-2011 in the remaining 14 countries.

Under a second, complementary agreement with UNITAID for US$ 33.7million, the Global Drug Facility will boost the supply of drugs neededto treat MDR-TB in 54 countries, including those receiving the newdiagnostic tests. This project is also expected to achieve pricereductions of up to 20% for second-line anti-TB drugs by 2010. All thecountries receiving this assistance have met WHO's technical standardsfor managing MDR-TB and already have treatment programmes in place.Some will use grants from the Global Fund against AIDS, Tuberculosisand Malaria to purchase the drugs.

"Through the US$ 60-million support provided by UNITAID, these projectsare expected to produce significant results in diagnosing and treatingpatients as well as reducing drug prices and the costs of diagnosis.These efforts illustrate the way in which innovative financing can bedeployed for health and development," said Philippe Douste-Blazy,Chairman of UNITAID's Executive Board.

Click here to learn more about initiatives to stem the spread of TB and to treat those already infected from the World Health Organization.