AN ACTIVIST’S GUIDE TO Tuberculosis Drugs 2016 Update
Tuberculosis (TB) has been curable for decades, but a rise in the number of people living with drugresistant TB (DR-TB) 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 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 accelerated approval was followed in 2014 by the European Medicines Agency’s (EMA’s) conditional approval of bedaquiline and another new drug, delamanid, for the treatment of some forms of DR-TB.
All treatment options for TB disease must be used in combination. While knowledge on how to best use the new drugs is incomplete, and only two percent of those who could benefit from them have access, several ongoing studies may identify optimal combinations that could improve outcomes and allow for treatment shortening. Issues beyond knowledge gaps also impede effective treatment: lack of country registrations and program guidance, patent restrictions, pricing issues, medication quality concerns, inadequate or inappropriate formulations, and poor supply management limit access to lifesaving drugs.
Since An Activist’s Guide to Tuberculosis Drugs was first published in 2014, updated guidelines, new findings, and other factors have shifted the research and access priorities for several TB drugs. Still, more research is needed to ensure that TB treatment becomes 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 and access priorities. This guide provides a brief summary of safety and efficacy data for those drugs currently in use for TB (some 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’ report, DR-TB Drugs Under the Microscope (complete citation listed under “Sources”). For a comprehensive overview of ongoing TB research and development work, refer to Treatment Action Group’s annual Pipeline Report (complete citation listed under “Sources”).