World TB Day 2022—Progress on tools and care models amid global setbacks from Covid-19

On 16 May people from within and outside MSF will gather in London, joined by online participants from over 100 countries, for this annual ‘conference without borders’ showcasing medical research from fragile and conflict affected settings. All too often the populations MSF and others work with are excluded from the benefits of research. Yet they are the ones that often need these benefits most. So speakers will consider how MSF’s research has impacted the way our projects deliver care, how knowledge gaps can be pivotal to political gatekeeping and to triggering appropriate humanitarian responses, and how identifying best practices and funding innovation are key to improving our capacity to act. Here you can view abstracts for all scientific presentations, which focus on infectious diseases, outbreaks, vaccination, and mortality.

Viral hepatitis is a major cause of disease and death globally. To mark World Hepatitis Day (July 28th) we present a selection of recent MSF research exploring how to effectively deploy powerful medical tools that could turn the tide on hepatitis C and E—but now reach only a tiny fraction of people who desperately need them, especially in low-resource and emergency settings. For hepatitis C, where groundbreaking new antiviral drugs can cure nearly all patients, MSF is piloting simplified, community-based models of care that offer rapid screening, diagnosis, and treatment under one roof. Some programs focus on the complex needs of highly vulnerable, hard-to-reach populations, such as people co-infected with HIV or TB or who inject drugs. Turning to prevention, an ongoing vaccination campaign against hepatitis E in an outbreak setting is showing early signs of short-term protection. Final results from this South Sudanese refugee camp, where poor sanitation and water quality regularly lead to outbreaks, should help plug a key evidence gap that—along with other barriers discussed in a commentary article—impedes widespread uptake of the vaccine.

Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.