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Expanding access to lifesaving new TB tools | Collections | MSF Science Portal

Many settings with a high burden of drug-resistant tuberculosis (DR-TB) lack access to advanced diagnostics and to groundbreaking new treatments. The Collection linked below spotlights work by MSF and collaborators to analyze barriers, identify gaps, and accelerate the roll-out of these tools to people whose lives hang in the balance.

Several reports examine price, regulatory, and patent obstacles that persist despite considerable public investment into developing many of these tools. Other authors examine critical remaining weaknesses in care pathways—especially in screening and diagnosis, and particularly in children. Several studies describe new strategies that could be part of the solution, from a pilot program in Tajikisttan that trains family caregivers to treat children with DR-TB at home, to a person-centered care model adapted to a conflict zone in Afghanistan. Lastly, initial findings demonstrate that pregnant women—another vulnerable population—can be effectively treated for DR- and multidrug-resistant TB, improving maternal outcomes without harming neonates.

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ASTMH Annual Meeting 2024
ASTMH Annual Meeting 2024

The American Society of Tropical Medicine & Hygiene (ASTMH) Annual Meeting is an international forum for the exchange of scientific and clinical advances in tropical medicine, hygiene and global health. The scientific content this year is 53% microbe focused, 15% clinically focused, 13% vector focused, 13% globally focused, and 6% intervention focused.

MSF and Epicentre are presenting on access and other challenges for children with visceral and cutaneous leishmaniasis, hurdles in malaria diagnostic testing, and ensuring equitable access to healthcare in conversations about financial sustainability.

This collection features research authored by the presenters and other topics highlighted at ASTMH.

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.
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...
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.
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Journal Article
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Short Report

Pregnancy and birth outcomes in patients with multidrug-resistant tuberculosis treated with regimens that include new and repurposed drugs

Lotia Farrukh I, Lachenal N, Adenov MM, Ahmed SM, Algozhin Y,  et al.
2024-01-25 • Clinical Infectious Diseases
2024-01-25 • Clinical Infectious Diseases
Among 43 pregnant women receiving multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment with bedaquiline and/or delamanid, 98% had favorable treatment outcomes. Of ...
Journal Article
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Research

Management of rifampicin-resistant tuberculosis in conflict-affected areas: The case of Iraq

Tesfahun HM, Al-Salihi L, Abdulkareem Al-Ani N, Mankhi AA, Mohammed A,  et al.
2024-01-19 • PLOS One
2024-01-19 • PLOS One
Since December 2019, the World Health Organization (WHO) has encouraged National Tuberculosis Programs to deprioritize the use of injectable-containing regimens and roll-out all-oral bed...
Journal Article
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Commentary

Reversing the neglect of children and adolescents affected by tuberculosis

Deborggraeve S, Casenghi M, Hewison CCH, Ditekemena J, Ditiu L,  et al.
2023-09-11 • Lancet Child and Adolescent Health
2023-09-11 • Lancet Child and Adolescent Health
Journal Article
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Commentary

Diagnostics to support the scaling up of shorter, safer tuberculosis regimens

Branigan D, Denkinger CM, Furin J, Heitkamp P, Deborggraeve S,  et al.
2023-07-31 • Lancet Microbe
2023-07-31 • Lancet Microbe
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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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
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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Research

Public investments in the development of GeneXpert molecular diagnostic technology

Gotham D, McKenna L, Deborggraeve S, Madoori S, Branigan D
2021-08-31 • PLOS One
2021-08-31 • PLOS One
BACKGROUND
The GeneXpert diagnostic platform from the US based company Cepheid is an automated molecular diagnostic device that performs sample preparation and pathogen detection wit...
Expanding access to lifesaving new TB tools

Expanding access to lifesaving new TB tools