Cooperation, Research and Innovation Key Drivers to Combat TB

Worldwide concerted efforts are being made, with renewed pledges on World TB Day (24th March), to rid this planet of the scourge of tuberculosis. The World TB Day theme for the year 2011 is Transforming the Fight Towards Elimination of Tuberculosis. On the national front, as part of the newly-launched Project Axshya, a Global Fund to fight AIDS, TB and Malaria (GFATM). CARE India has also launched an intensive mass awareness programme.

According to CARE India Chief Advocacy Officer Ms Alka Pathak, “Tuberculosis is one of the leading causes of mortality in India- killing two persons every three minute, nearly 1,000 every day.”

“In 2009, out of the estimated global annual incidence of 9.4 million TB cases, 1.98 million were estimated to have occurred in India, thus accounting for a fifth of the global burden of TB. Every year, on an average nearly 1.8 million people develop TB among which 0.9 million are infectious. Chhattisgarh district alone contributes about 51000 new TB cases per annum” said Alka Pathak.

“We are planning to reach to at least 50 lakh people in selected 17 districts of these three States through multi-level, multi-faceted campaign, reaching the villages and the grass-root levels through a week long program. Our aim is to make the people aware of this dreaded disease as the first step,” she said.

The campaign was launched on March 22 and would run till March 30. Sensitisation of service providers on case detection, referral and treatment adherence through ongoing ICDS and health sector meetings, village-wise campaign through tableau and audio presentations, community meetings, rallies of school children and health workers at panchayat levels, district-level joint programmes with RNTCP, distribution of pamphlets, posters, airing of radio jingles, and sending of SMS to the people will be part of the campaign.

The five-year Axshya initiative aims to improve the reach, visibility and effectiveness of Revised National Tuberculosis Control Programme (RNTCP) through civil society support by 2015 and to improve the access to quality DOTS services, with the support of the State Governments. It is estimated to reach about 22.5 million people, especially the vulnerable sections like TB-HIV patients, spending about 2 million dollars.

It intends to address the identified challenges like insufficient laboratory capacity for detecting and follow up of requisite drug resistance cases and funding gaps for procurement of second line drugs for all MDR-TB (multi-drug-resistant tuberculosis) cases planned to be initiated on treatment.

Worldwide, tuberculosis (TB) kills 1.7 million people every year. The economic burden related to TB is estimated at 0.52% of the world’s gross national income.

Cooperation, research and innovation remain the key drivers to eliminating this devastating disease from the face of the earth.

One such international initiative, managed by International Union Against Tuberculosis and Lung Disease (The Union) and funded by the United States Agency for International Development (USAID), is TREAT TB (Technology, Research, Education and Technical Assistance for Tuberculosis). In the words of Dr I.D.Rusen, TREAT TB Project Director, “TREAT TB works to identify and fill gaps in research related to global TB control and at the same time focuses on activities that have the potential to influence policy at global and local levels.”

TREAT TB seeks to contribute to new knowledge through field evaluations of diagnostic tools, clinical trials of priority research questions, and targeted operational research benefitting global, regional and country TB control efforts.

In its STREAM study, the Union is collaborating with TREAT TB partner- the Medical Research Council (UK) to evaluate a shortened, standardized drug regimen for MDR-TB. Enrolment for the trial will begin in 2011, and it will eventually involve some 400 patients in 4 countries.

TREAT TB is also partnering with the Liverpool School of Tropical Medicine (UK) and the National Taiwan University for building and linking operational and transmission models that will provide valuable guidance on the effectiveness of and challenges associated with the adoption of new diagnostic tools in high-burden, low-resource settings.

Another study, called The PROVE IT (Policy Relevant Outcomes from Validating Evidence on Impact) study, is assessing the costs associated with the roll-out of the new diagnostic tool Line Probe Assays, so that new diagnostic tools become affordable in high-burden, low-income countries. The study has already begun in South Africa and will begin in Russia and Brazil in May 2011.

In Paris, a meeting of European politicians, tuberculosis (TB) advocates and health advisers is being organized by Tuberculosis Vaccine Initiative (TBVI), Calouste Gulbenkian Foundation, Fondacion Merieux, Friends of the Global Fund Europe and the Stop TB Partnership, on World TB Day, to discuss an innovative financing model that would enable scientific discoveries to be translated into TB vaccines. On this occasion Joris Vandeputte of TBVI will present a new funding plan for tuberculosis vaccine: “Our governments are faced with a difficult question: how to reduce the deficit while maintaining a commitment to invest 3% of gross national income in research and innovation?”

“In our plan, European governments or agencies are asked to provide guarantees to take up money gradually from financial institutions, according to the progress of vaccine developments. Countries therefore do not have to provide any cash; the loan will be repaid through the profits of the final vaccines.”

A World Bank study on the economic impact of TB control estimated that the benefits of investing in scaled-up TB care and control outweigh the costs of treatment, on average, by 10 times. So governments have to be wary of counterproductive cuts to public health spending.

According to Mr Jorge Sampaio, the UN Secretary-General’s Special Envoy to the Stop TB Partnership, “Tuberculosis damages economies worldwide, destroys families and is keeping millions of people in poverty. So we need to avoid making the same mistakes from the past when, during economic recession times, irrational and wholly uneconomic decisions were made to cut health spending. We need to remember that health is an investment”. (CNS)