Unitaid Board approves new grants to prevent tuberculosis in high-risk populations and increase TB diagnosis in children

Geneva – Unitaid’s Executive Board has approved two new grants worth a combined  US$ 74 million to prevent the spread of tuberculosis (TB), the world’s leading infectious killer, in populations most at risk of contracting the disease and to increase TB diagnosis in children.

Through the first grant, Unitaid is investing US$ 59 million to ensure that people with latent tuberculosis infection (LTBI) – who are infected with the TB bacteria, but do not have symptoms and are not infectious – have access to new, shorter preventive TB treatment. The four-year grant will target people most vulnerable to developing active TB, including people living with HIV and children under age five.

“The detection and treatment of people with latent TB is an important part of fighting this disease and ultimately ending TB,” said Lelio Marmora, Unitaid Executive Director. “The shorter TB preventive therapy has the potential to be the game changer in the fight to end TB.”

About one third of the world’s population is infected with the TB bacteria. Only a small percentage become sick with TB, but people with weak immune systems, such as people living with HIV, are at considerably higher risk of falling ill. A person living with HIV is about 26 times more likely to develop active TB.

South Africa’s Aurum Institute, which is spearheading the TB prevention project, will work with the Clinton Health Access Initiative, KNCV Tuberculosis Foundation, Johns Hopkins University, and the Global Drug Facility – Stop TB Partnership, to implement the project in 12 countries in Africa, Latin America and Asia with high burdens of TB or TB/HIV. The target groups will receive a quality-assured, affordable short-course TB preventive therapy known as 3HP, to be taken weekly for a duration of three months.

“TB infection remains the seedbed of the TB epidemic. Scaling up new, safer, shorter regimens for the programmatic management of latent TB infection has the potential to accelerate progress to ending the TB epidemic,” said Professor Gavin Churchyard, Group CEO of the Aurum Institute.

The second grant totaling US$ 15 million aims to improve the diagnosis of TB in children, particularly those also affected by HIV, malnutrition and severe pneumonia. The University of Bordeaux will work with health partners and academic institutes in France, Cambodia, Cameroon, Côte d’Ivoire, Mozambique, Sierra Leone, Uganda and Zambia to implement the TB-SPEED (Strengthening Pediatric TB Services for Enhanced Early Detection) project.

Critical progress has been achieved recently with the launch of the first child-friendly TB medicine as a result of a Unitaid-funded project implemented by the TB Alliance and WHO. However, the TB detection rate remains low, due to challenges with diagnosing TB in children as they are less likely to produce sputum, the main laboratory sample to detect TB.

TB-SPEED proposes an easier way of detecting TB in children through rapid battery-operated molecular tests in local health centers, optimized chest radiography, and simpler specimen collection. “We are hopeful that TB-SPEED will succeed in preventing children from dying of TB by increasing TB diagnosis and access to treatment,” said Mr Marmora.

“While tuberculosis remains one of the top 10 causes of death worldwide, it is a great  opportunity for the University of Bordeaux to contribute to the Sustainable Development Goal of ending the TB epidemic by 2030”, said Dr Tunon de Lara, President of the University of Bordeaux.

 Unitaid

Unitaid invests in new ways to prevent, diagnose and treat HIV/AIDS, hepatitis C, tuberculosis and malaria more quickly, affordably and effectively. It brings the power of new medical discoveries to the people who most need them. And it helps set the stage for the large-scale introduction of new health products by collaborating with governments and funding partners such as PEPFAR and the Global Fund.

Landscape for HIV rapid diagnostic tests for HIV self-testing – 3rd edition – July 2016

Unitaid publishes its latest TB Diagnostic Technology Landscape

Tuberculosis (TB) continues to be a major public health threat despite being a curable disease. Latest figures from the World Health Organization (WHO), in 2015, indicate an estimated 10.4 million people had TB, and 1.8 million people died (1.4 million HIV negative and 400,000 HIV positive). Of further concern is that 480,000 cases of multidrug-resistant (MDR) TB* and a further 100,000 that were estimated to be rifampicin-resistant (RR) TB have occurred in the same period. Of those eligible for MDR TB treatment, only 125,000 people (20 per cent) were enrolled in treatment programmes.

Both the Sustainable Development Goals and the WHO End TB strategy aim to end TB. To achieve this global goal, the rapid and accurate diagnosis of both active TB disease and latent TB infection is critical for the timely initiation of treatment and, ultimately, control of the disease. Of the 10.4 million people who developed TB in 2015, 4.3 million cases were not diagnosed or notified and only one quarter of RR/MDR TB cases (132,000) were detected and reported. The underdiagnosis and underreporting of TB may be due to limited or delayed access to appropriate diagnosis and care, large private sectors not reporting cases, and the lack of access to appropriate diagnostic tools due to geographic and/or financial barriers.

The report published today focuses on the status of current, emerging and potential technologies in TB diagnosis. Many countries still rely on tools such as sputum-smear microscopy but new diagnostics are slowly changing the TB diagnostics landscape. Since our last publication, the WHO has made policy guidance statements for five new or improved TB diagnostic products. Further changes are expected, with unmet needs identified and articulated in target product profiles, and a technology pipeline promising new products to address these needs. Several of these are currently undergoing evaluation in field studies. This edition of the Unitaid Tuberculosis Diagnostics Technology Landscape report is intended to complement earlier reports, and presents a comprehensive overview of TB diagnostic technologies that are commercially available or close to market.

*TB strains that are resistant to rifampin (RIF) and isoniazid (INH).

Read the full report: “Tuberculosis Diagnostics Technology Landscape“ report — Unitaid, July 2017.

End-of-project evaluation: STEP-TB

End-of-project evaluation: TBXpert

Global malaria diagnostic and artemisinin treatment commodities demand forecast 2017 – 2020: Policy brief (May 2017)

Appel d’Unitaid pour trouver des moyens innovants pour accélérer l’accès à des traitements plus courts et de meilleure qualité pour la tuberculose multirésistante

Genève, le 21 mai 2017 – Unitaid a lancé ce jour un nouvel appel à propositions dans le but de susciter de nouvelles idées judicieuses pour accélérer l’accès à des schémas thérapeutiques et à des diagnostics innovants afin de combattre la tuberculose multirésistante (TB-MR).

La TB-MR constitue une crise de santé mondiale qui menace les progrès réalisés dans la maîtrise de la tuberculose. Les disparités en matière de détection et de traitement continuent de compromettre la riposte contre la maladie. En 2015, 580 000 personnes nécessitaient un traitement contre la TB-MR et seulement la moitié des 125 000 patients ayant bénéficié d’un traitement ont été guéris.

Les traitements existants pour la TB-MR sont longs, toxiques et provoquent souvent de graves effets secondaires tels qu’une psychose aiguë et une surdité. « Compte tenu de la menace persistante de la TB-MR, nous devons développer des traitements plus courts, plus simples et moins toxiques pour la combattre de manière efficace, » a déclaré Lelio Marmora, Directeur exécutif d’Unitaid, à l’occasion d’un événement de haut niveau Unitaid/Partenariat Halte à la tuberculose sur la lutte contre la résistance aux antimicrobiens par l’innovation, qui s’est tenu la veille de la 70e Assemblée mondiale de la santé. « Unitaid a d’ores et déjà investi US $60 millions pour accélérer l’accès à de nouveaux médicaments et tester leur efficacité dans des conditions de ressources limitées. »

Récemment, l’Organisation mondiale de la santé (OMS) a recommandé un schéma thérapeutique plus court pour le traitement de la TB-MR, d’une durée de 9 à 12 mois avec 4 à 6 mois de médicaments injectables. Les patients ne bénéficiant pas de ce schéma thérapeutique plus court doivent encore subir un traitement de 18 à 24 mois, incluant 8 mois de médicaments injectables. À l’heure actuelle, la gamme d’options de traitements disponibles fragmente le marché des traitements contre la tuberculose résistante, ce qui réduit l’incitation commerciale à l’innovation et au développement.

Il existe actuellement plus de 20 essais cliniques enregistrés portant sur la tuberculose résistante, dont la plupart concernent de nouveaux médicaments ou des médicaments reconvertis. « Des traitements plus efficaces et plus courts sont indispensables pour lutter contre la crise de la TB-MR, augmenter les taux de guérison et sauver des vies. Unitaid a un rôle majeur à jouer dans le déploiement des innovations à grande échelle et le développement du marché avec de nouveaux schémas thérapeutiques, comme cela a été démontré par ses précédentes initiatives pour étendre l’accès à de nouveaux tests rapides de dépistage de la TB-MR, » a affirmé le docteur Mario Raviglione, Directeur du programme mondial de lutte contre la tuberculose de l’OMS.

Avec cet appel, Unitaid souhaite accélérer le développement et l’adoption de nouveaux schémas thérapeutiques pour la TB-MR associés à des tests de dépistage de la tuberculose plus simples et plus rapides, répondre aux défis du marché et réunir les preuves nécessaires pour orienter les lignes directrices de l’OMS.

« Les médicaments actuellement disponibles pour traiter la TB-MR constituent un véritable défiquel que soit l’aspetc auquel on s’intéresse : effets secondaires dramatiques incluant une perte d’audition irréversible et un risque de dépression, coûts astronomiques, problèmes financiers, souffrances humaines et décès. De ce fait, nous ne devons épargner aucun effort pour garantir que nous disposons du traitement le plus court et le plus efficace à un prix abordable et pour le rendre accessible à tous, » a expliqué le docteur Lucica Ditiu, Directeur exécutif du Partenariat Halte à la tuberculose.

Lors de leur réunion à Berlin hier, les Ministres de la santé du G20 ont souligné la nécessité de “revigorer la recherche et le développement dans la science et l’industrie pour développer de nouveaux antimicrobiens” et l’importance des investissements d’Unitaid et d’autres partenaires de santé dans la lutte contre la résistance antimicrobienne.

  • Lire l’appèl à propositions ici

Unitaid soutient les efforts pour mettre fin à la tuberculose avec la mise au point de nouveaux traitements et outils de diagnostic

Geneva –  On World TB Day, Unitaid joins the World Health Organization in its efforts to mobilize countries and partners to “Unite to end Tuberculosis”. This year’s focus is on the stigma, discrimination and marginalization that many people with tuberculosis (TB) in low-income countries face.

By developing shorter, more affordable and effective TB treatments and more user-friendly diagnostics, Unitaid is helping patients to access care more easily and breaking down stigma at the same time.

Most TB cases are cured with standard antibiotics but drug-resistant strains are emerging across the world, which are much harder to treat. Unitaid is committed to fighting resistance by investing in innovation to develop treatments for multidrug-resistant TB (MDR-TB) that are simpler, shorter, less toxic, and more affordable. Currently only half of MDR-TB patients on treatment are cured.

Unitaid has also helped introduce a new diagnostic tool that spots resistance to standard anti-TB medications in a matter of hours, and is now widely available in more than 130 countries. Better diagnostics are essential to guiding effective treatment and to helping to overcome indiscriminate prescription of antibiotics and other drugs that can fuel resistance.

Ending TB by 2030 is one of the UN Sustainable Development Goal targets. To achieve this, the international community, governments, civil society and the private sector must do their part to fight the stigma and discrimination associated with TB, accelerate access to care and treatment, and tackle drug resistance.

Various high-level political events this year will put a spotlight on efforts to end TB, including the G20 Summit in July, and the first Global Ministerial Conference on TB, to be held in Moscow in November. And in 2018 the UN General Assembly will organize the first High-level Meeting on TB.

“The increased political commitment to end TB is a positive development, but it will need to be matched with larger investments to ensure that those most vulnerable to TB have access to appropriate care and treatment,” said Lelio Marmora, Unitaid’s Executive Director.

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