New TB drug inaccessible to many South Africans

Doctors Without Borders (MSF), other treatment providers in South Africa and globally have found that the first new drugs in half a century to be developed for treating drug-resistant tuberculosis (DR-TB) are offering new hope to patients — but significant challenges remain to improve availability and affordability of these treatments.

Current treatment regimens for DR-TB involve thousands of pills taken over two years, which can have devastating side effects and ultimately only work for 50% of people with multidrug-resistant (MDR) TB and 26% of people with extensively drug-resistant (XDR) TB.

Access to new drugs bedaquiline and delamanid along with ‘repurposed’ drugs — not specifically developed for TB but that have shown efficacy in treating TB — could be a significant step toward finding a shorter, more tolerable DR-TB regimen in the future.

This is good news for South Africa, which has one of the highest burdens of multidrug-resistant TB (MDR-TB) in the world, with 30,000 new cases each year, over 18,000 people diagnosed and over 11,500 put on treatment in 2014.

Only 3,000 patients worldwide have been treated with bedaquiline, and fewer than 200 with delamanid – only 2% of the 150,000 people around the world that could benefit.

“MSF is treating some of the lucky few people in South Africa — and in fact the whole world – to receive access to strengthened treatment regimens including bedaquiline and delamanid,” said Dr. Jennifer Hughes of MSF in South Africa. “South Africa’s Department of Health has been a leader in accessing new DR-TB drugs, with over 1,750 patients receiving bedaquiline nationally since 2013.

Patients receiving bedaquiline in South Africa had 77% ‘culture conversion’ rates from TB-positive to negative, which is a promising sign that their treatment may ultimately be successful. Additional information from South Africa showed similar safety and efficacy even when bedaquiline was given together with antiretroviral therapy (ART) to TB/HIV co-infected people, another sign that this drug has the potential to transform DR-TB treatment in coming years.

Delamanid, however, is not yet as widely available in South Africa.

“TB is curable, yet it is now the infectious disease that kills the most people in the world,” said Dr. Grania Brigden, TB Advisor for the MSF Access Campaign. “We desperately need treatment that is easier for people to tolerate, that cures more people, and that is more available and affordable, otherwise it’s just deadly business as usual.”

*Article supplied by Doctors Without Borders (MSF). Follow them on Facebook and Twitter for more groundbreaking initiatives.