5BETTER, SHORTER TREATMENTS FOR DRUG-RESISTANT TB

Unitaid is supporting introduction of the first new drugs for drug-resistant TB in nearly half a century. The medications slash the time it takes to cure the disease from two years to 6-9 months.

To date, treatments for multidrug-resistant TB (MDR-TB) have been long and toxic, involving injections, and often with severe side effects. Only half of all people treated are cured.

New, more affordable regimens use pills, in fewer doses with fewer side effects. The new regimens, which replace dozens of existing combinations, will attract manufacturers who have been hesitant to enter a fragmented market.

In the last 25 years, deaths from tuberculosis have halved. Yet 1.7 million people still die from this curable disease each year.

In 2015, Unitaid launched a US$ 60 million project to increase access to better, shorter treatments for MDR-TB. The four-year endTB project to expand new drug markets for TB is being implemented by Partners in Health, Médecins Sans Frontières, and Interactive Research & Development. It plans to treat MDR-TB patients with the new drugs bedaquiline and delamanid as part of an observational trial. More patients will be enrolled in the clinical trial, part of an effort to establish shorter, simpler, less toxic treatment regimens.

Georgia was the first country to start enrolling patients in the observational study in 2015. As of December 2017, 16 of the 17 project countries had started enrolment in the observational study. Vietnam was added to the study in July 2017 and is expected to start enrolment in early 2018. The clinical trial for the regimens including the new drugs bedaquiline and delamanid began in February 2017 with Georgia, Kazakhstan and Peru currently enrolling patients. Kyrgyzstan, Lesotho, and South Africa are expected to start enrolment by March 2018. The implementing partners have worked with national TB control programmes in project countries to incorporate the principles of patient management with new TB drugs into the national TB guidelines, and have facilitated the dissemination of evidence to support the use of new TB drugs globally.

“I couldn’t stand up. I was always falling down. Two months after taking the new TB drug — bedaquiline — I felt better. I never thought I could survive this disease. It was very difficult financially while I was sick, but today anything is possible.” Robinzon “Ramaz” Ganjelashvili 34-year-old man from Georgia with extensively drug-resistant tuberculosis (XDR-TB)