Stepping up the fight against drug resistant TB

THIS WEEK, TB activist Phumeza Tisile departs for the annual World Health Assembly (WHA) in Geneva to urge world health leaders for better drugs & diagnostics for thousands of drug resistant TB (DR-TB) patients worldwide. Phumeza, a former extensively drug resistant (XDR-TB) patient who survived a harrowing two-year battle with the disease during which she became permanently deaf, and has since become a committed TB activist. “DR-TB is the man-made result of interrupted, erratic or inadequate TB therapy, and its spread is undermining efforts to control the global TB epidemic,” explains the Stop TB Partnership in Geneva. The World Health Organization (WHO) has issued a target of treating 80 per cent of DR-TB cases by 2015. However, this goal is not realistically possible without new, simple, and affordable treatments for DR-TB. In 2012, drawing on her personal experiences, Phumeza and Médecins Sans Frontières (MSF) doctor Jennifer Hughes helped co-author a public petition called the ‘DR-TB Manifesto’, on behalf of patients with DR-TB around the world. According to MSF, “this year’s WHA meeting is a very critical moment for DR-TB, as health ministers will discuss a long-awaited post-2015 TB strategy that will inform the next 20 years of global TB prevention, care and control”. Globally, nine million people get sick with TB every year but one third do not get the TB services that they need and deserve. According to WHO, “tuberculosis, or TB, is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.” Shaking someone’s hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes, or kissing does not spread TB. TB is common amongst individuals with weakened immune systems and HIV/AIDS sufferers. Statistics show that a person living with HIV is about 20 to 30 times more likely to develop active TB, resulting in 25 per cent of HIV-related deaths. TB is largely driven by factors related to poverty, poor access to healthcare services, and limited awareness and education. Many sufferers of TB live in the poorest and most vulnerable communities such as migrants, miners, prisoners, drug users and sex workers. The primary causes of DR-TB include inappropriate treatments, incorrect uses of anti-TB drugs and the use of poor-quality medicines. “We must invest in basic research and research and development for new tools - diagnostics, drugs and vaccines - in order to reach people faster, treat them more quickly and ultimately prevent them from becoming ill with TB,” describes Dr Luis Sambo, WHO Regional Director for Africa. Early treatment requires understanding the most common symptoms of TB. Active TB often presents with chest pains, weakness, weight loss, fever, night sweats and a cough with sputum and blood at times. A person should see a health care provider anytime they have a cough (especially with sputum) for longer than two weeks. An evaluation is needed in order to make sure that you do not have the actual disease. TB is a treatable and curable disease. Active, drug-sensitive TB is treated with a standard six-month course of four antimicrobial drugs that are provided with information, supervision and support by a qualified health care worker or trained volunteer. Today, treatment for DR-TB can take up to two years, and is so complex, expensive, and toxic that a third of all DR-TB patients die. Dr Couillard works in collaboration with the World Health Organization’s goals of disease prevention and control. Twitter: @DrCoryCouillard