“An antibiotic used to treat severe bacterial infections showed promise at treating a highly drug-resistant and deadly form of tuberculosis [TB],” according to a study conducted by U.S. government and South Korean researchers and published in the New England Journal of Medicine on Wednesday, Reuters reports (Steenhuysen, 10/17). The “small study offers a bit of cautious optimism about the prospects for treatment of tuberculosis, … showing that adding a 12-year-old antibiotic called linezolid, brand name Zyvox, to existing treatments cured nearly 90 percent of patients with a form of tuberculosis resistant to both first- and second-line antibiotics,” NPR’s “Shots” blog writes (Knox, 10/18). “However, most of the patients [in the study] — 82 percent — experienced side effects while on the treatment, which tempered the findings, the team reported,” Reuters notes. “Researchers are desperately looking for new treatments for drug-resistant forms of TB, which threatens to derail progress in the global fight to eradicate the disease,” according to the news agency (10/17).
Number Of New TB Infections Fall, But Drug Resistance, Lack Of Funding Could Slow Progress, WHO Reports
“New tuberculosis [TB] infections dropped 2.2 percent worldwide last year, but with nearly nine million new infections, the World Health Organization said TB remains a massive problem that could worsen if countries shortchange funding to fight it,” Reuters reports (Steenhuysen, 10/17). “In a new report issued Wednesday, the U.N. agency estimated there were about 8.7 million new cases of TB last year, down from about 8.8 million in 2010,” and “[t]he number of deaths was unchanged at about 1.4 million — making it the second-leading killer among infectious diseases after AIDS,” the Associated Press writes (Cheng, 10/17). “The number of people becoming ill with tuberculosis has been falling steadily for roughly a decade after a surge in the 1990s,” but “those numbers are still huge, and only 19 percent of those infected with forms of the disease that are resistant to multiple tuberculosis drugs are being diagnosed, the WHO estimated,” according to the Wall Street Journal (McKay, 10/18). BBC News notes the report “warned of ‘persistently slow progress’ in treating tuberculosis which is resistant to antibiotics” (Gallagher, 10/17).
In a BMJ Group Blogs post, Caroline Robinson, global health advocacy manager for Results U.K., discusses the prevalence and treatment of tuberculosis (TB) and drug-resistant TB in Europe and provides the example of Romania. She writes, “[E]vidence brought to light in a new report [.pdf] released recently outlining the effect funding shortages will have on HIV and TB, including drug-resistant TB, in the European region suggests that Romania does not have the institutional capacity to ensure its citizens have the basic right to health. The country relies on grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which look set to end in 2013.” She continues, “[Global Fund] Board members should ensure that middle-income countries with epidemics among key populations can access critical Global Fund contributions and the E.U. and its member states must continue to provide the resources the fund requires to meet demand. Unless such support is given, countries like Romania will continue to fall further down the league tables in terms of treatment for this curable disease” (10/10).
South Africa “recently unveiled” a “newly reformed” South African National AIDS Council (SANAC), “coinciding with the announcement that the country has achieved universal access to HIV treatment,” PlusNews reports. Responding to a 2010 review of the body, SANAC “will now hold a new, annual meeting comprised of representatives from the research community, labor unions and people living with HIV,” at which “participants will discuss major policy issues and review progress on the country’s current national plan to address the twin epidemics of HIV and tuberculosis,” according to the news service.
Global Health Funding Cuts Threatening Fight Against HIV, TB In Eastern Europe, Central Asia, NGO Report Says
The fight against HIV and tuberculosis (TB) in Eastern Europe and Central Asia is being threatened by cuts in global health funding, according to “a report [.pdf] by leading European non-governmental health organizations,” Reuters reports. In the report, “experts called on the European Union to step in to fill the gaps left by global donors to countries within and neighboring its borders,” the news service notes. According to Reuters, “[c]ountries in Eastern Europe and Central Asia have some of the world’s fastest growing HIV epidemics,” and “Europe is also home to the world’s highest documented rates of drug-resistant TB” (Kelland, 9/18).
In this post in the Center for Global Development’s (CGD) “Global Health Policy” blog, Victoria Fan, a CGD research fellow, and Rachel Silverman, a research assistant for the global health team at the center, examine the future of UNITAID. “Perhaps due to its relative obscurity and late entry to a crowded global health field, UNITAID has proactively worked to differentiate itself through a focus on commodities, market shaping, novel funding sources, and innovation,” but, “as UNITAID celebrates its sixth birthday …, it stands at a potential crossroads,” they write. Fan and Silverman note that a five-year evaluation report on the future of UNITAID, commissioned by its Executive Board, is forthcoming, and they highlight a paper (.pdf) in which they “outline some contradictions and limitations of UNITAID’s current approach.” They write, “We hope that the imminent evaluation provides the impetus for UNITAID to turn inward and do something truly innovative: buck institutional inertia, change course as necessary, and reinvent itself as the solution to 2012’s biggest global health challenges” (9/17).
The board of the Global Fund to Fight AIDS, Tuberculosis and Malaria began a two-day meeting in Geneva on Thursday, “with one topic high on the agenda: a new funding model,” Devex’s “Development Newswire” reports. “The board will tackle aspects of a new funding model, which, according to Global Fund Director of Communications Seth Faison, ‘will change the way the Global Fund has made grants for 10 years,'” the news service writes, adding that the model, according to the International HIV/AIDS Alliance, “will see the Global Fund dropping its ’round’ grant-making process and replacing it with a ‘more flexible’ system.” In addition, “an ‘iterative dialogue process’ is also reportedly being explored,” Devex reports. “The proposed reforms seem good for the fund and its beneficiaries … [b]ut some have expressed their concerns on the funding model under consideration, specifically on the ‘historical disease application’ approach,” the news service writes (Ravelo, 9/13). According to an article on the Stop TB Partnership website, the new approach “would cap the proportion of funding available to tuberculosis (TB) projects at 16 percent,” and the proposal, “which is based on the proportion of grants awarded to TB in the past, met with strong objections from the community of people working on TB worldwide” (9/13).
After testing about 5,600 existing medications for their effectiveness against drug-resistant strains of tuberculosis (TB), researchers from Weill Cornell Medical College reported this week in the Proceedings of the National Academy of Sciences that oxyphenbutazone, “an anti-inflammatory medication marketed in the 1950s as Tandearil and still used in veterinary medicine,” killed both latent and active TB bacteria in test-tube experiments, the Los Angeles Times’ “Booster Shots” blog reports. The medication is inexpensive, estimated to cost two cents per day in developing countries, according to the researchers, but it needs to go through “a series of clinical trials in which researchers would flesh out, in a human population, the medication’s safety and effectiveness record at various doses, in different patient populations and at different stages of the disease,” the blog writes.
The Washington Post examines how the “discovery of an almost untreatable form of tuberculosis [TB] in India has set off alarm bells around the world and helped spur a dramatic expansion of government efforts to battle the killer lung disease.” The newspaper writes, “For the past decade, a nationwide tuberculosis program involving millions of health workers and volunteers has made slow but significant progress in battling the disease in India and has been hailed as a public health success story,” but “any sense of complacency was dispelled in December when a doctor in Mumbai, Zarir Udwadia, discovered a strain of the disease that did not respond to any of the 12 frontline drugs.”
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”