An Activist's Guide to TB Drugs
By Lindsay McKenna, Audrey Zhang, and Erica Lessem
Tuberculosis (TB) has been curable for decades, but a rise in the number of people living with MDRTB and TB/HIV coinfection challenges global targets of zero TB deaths, new infections, suffering, and stigma. Although TB and the people it affects have changed over the years, for the most part the drugs used against it have not. In 2012, bedaquiline, used to treat drug-resistant TB (DR-TB), became the first new TB drug from a new class to be approved by the U.S. Food and Drug Administration (FDA) in over 40 years; its approval was followed in 2014 by the European Medicines Agency’s (EMA’s) approval of another new drug, delamanid, for the treatment of DR-TB.
Bedaquiline, delamanid, and other new treatment options in development must be used in combination for the treatment of TB. They are currently being combined with existing drugs, for which significant knowledge and access gaps still exist. Research on the safety and efficacy of older drugs continues to be limited, especially in children and people with HIV. Issues beyond the sparsely populated research pipeline also impede effective treatment: patent restrictions, pricing issues, medication quality concerns, and poor supply management limit access to lifesaving drugs.
TB treatment must be shorter, simpler, less toxic, and more tolerable and affordable. Activists can contribute to the development and uptake of improved TB treatment by calling attention to research, quality of medications, and access priorities. This guide provides a brief summary of safety and efficacy data for those drugs currently in use for TB (many of which have been approved for other diseases but are used off-label for TB), and suggests advocacy points for activists. For a comprehensive overview of drug patent and pricing information, refer to Médecins Sans Frontières’ annual report, DR-TB Drugs Under the Microscope.
A recorded webinar from June 2014 provides an orientation to the Activist's Guide to TB Drugs and highlights key research and access issues for TB medicines.