DR-TB drugs under the microscope 2019

Drug resistance is a major public health crisis thwarting the effective treatment and care of people living with tuberculosis (TB) – the world’s leading infectious disease killer. Declared a global health emergency by the World Health Organization (WHO) in 2014 and again in 2017, drug-resistant TB (DR-TB) affected an estimated half million people in 2018 yet only 1 in 3 started treatment.

Until recently, the standard DR-TB treatment regimens recommended by WHO – and still in use by many countries – have a high pill burden, long treatment duration (up to two years), painful daily injections, severe side effects and poor treatment outcomes. These regimens cured only 56% of people with multidrug-resistant TB (MDR-TB), and 39% of people with extensively drug- resistant TB (XDR-TB).

In March 2019, WHO released new DR-TB treatment guidelines, recommending more effective and easier-to-take all- oral drug regimens. In July 2019, WHO Director-General Dr Tedros Adhanom Ghebreyesus called for countries to transition to all-oral DR-TB regimens by World TB Day, 24 March 2020. By this time, 100% of people newly enrolled on treatment should be offered these optimal regimens.

This Issue Brief examines the current landscape of DR-TB drug pricing and access policies, and what needs to be done by governments, policymakers and health care providers to get these lifesaving medicines to the people who need them most.