Home » Infectious Diseases » Multidrug-resistant tuberculosis revives the urgency for action

Abhijit Barve

Chief Medical Officer, Viatris

Maria Beumont

Chief Medical Officer, TB Alliance

With cases of multidrug-resistant tuberculosis on the rise across the globe, there is an urgent need to leverage newly available treatments.

Developing new drug treatments and educating patients on their correct use are critical in the fight against tuberculosis (TB). This is particularly the case for multidrug-resistant tuberculosis (MDR TB), where the bacteria is resistant to certain medicines.

Figures show that TB remains one of the world’s deadliest infectious diseases, primarily among those who are marginalised, economically and socially excluded or impacted by conflict.

Multidrug-resistant tuberculosis

Abhijit Barve, MD, PhD, Chief Medical Officer of Viatris — one of the largest suppliers of medicines globally, including HIV medications to low-to-middle-income countries (LMICs) — also emphasises that simply developing new drugs is not enough. Treatments need to be accessible to those who need them, along with education on completing the course of medication.

“There are around half a million cases of MDR TB annually, growing at about 3% a year, resulting in close to 200,000 deaths a year, but only about one-third of these patients are receiving treatment for MDR TB for various reasons,” he says.

“MDR TB is the prime example of how antimicrobial resistance (AMR) is impacting people today. How we combat MDR TB is central to our ability to get ahead of AMR.” Untreated, TB can spread from person to person through the air, potentially spreading resistant strains.

Underlining the importance of education, he emphasises that patients need support in continuing to take the medication for several months after symptoms ease to avoid further serious health issues.

Empowering patients through education

Most TB drugs were developed decades ago, and it is only recently that newer drugs are becoming available. Older treatment regimens can be nine months or longer while new, shorter-duration therapies have become available.

As most patients see their coughing and wheezing symptoms ease during initial months of treatment, many stop their medicines. “But that has been the biggest problem because the bacteria is still sitting in their system, and it mutates to cause drug resistance,” says Barve.

Underlining the importance of education, he emphasises that patients need support in continuing to take the medication for several months after symptoms ease to avoid further serious health issues.

Collaborating on shorter treatment courses

Key to resolving this challenge is the need for shorter treatment courses. Barve outlines how the company is advancing access to shorter treatment courses and drugs specifically for MDR TB. In 2019, Viatris joined TB Alliance as its global commercialisation partner — aiming to improve access to a cost-effective treatment in LMICs and advance research.

“Diagnosing early is essential,” he adds. “Better diagnosis; introducing newer drugs specifically to address MDR TB; improving access to treatment; and increasing funding for education and adherence support are important.”

He highlights the value of multisectoral partnerships, such as between Viatris and the TB Alliance. “Collaboration with multiple partners is critical, bringing our diverse skills to the table to develop solutions,” continues Barve.

TB Alliance Chief Medical Officer Maria Beumont says: “TB demands action from a range of partners around the world. TB Alliance collaborates closely with private sector partners, governments, academia, advocates, civil society organisations, people with TB and others to achieve our vision of a world in which no one dies of TB.”

Progress being made

Beumont says there has been progress against fighting drug-resistant TB as new, shorter-duration anti-TB treatments are being made accessible to patients.

“TB is a deadly infectious disease that is difficult to treat even under the best circumstances,” says Beumont, “but national TB programmes can now be better equipped to help patients as the all-oral shorter-duration regimens are now prioritised by the World Health Organization for appropriate patients. This approach, pioneered by the TB Alliance, has been shown to be effective in both clinical trials and real-world settings.”

Moreover, she underlines the importance of medicines reaching vulnerable patients. “We will continue to advance access such that every patient in need is able to access the best possible treatment.”

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