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Expanding access to lifesaving new TB tools | Collections | MSF Science Portal

Many settings with a high burden of drug-resistant tuberculosis (DR-TB) lack access to advanced diagnostics and to groundbreaking new treatments. The Collection linked below spotlights work by MSF and collaborators to analyze barriers, identify gaps, and accelerate the roll-out of these tools to people whose lives hang in the balance.

Several reports examine price, regulatory, and patent obstacles that persist despite considerable public investment into developing many of these tools. Other authors examine critical remaining weaknesses in care pathways—especially in screening and diagnosis, and particularly in children. Several studies describe new strategies that could be part of the solution, from a pilot program in Tajikisttan that trains family caregivers to treat children with DR-TB at home, to a person-centered care model adapted to a conflict zone in Afghanistan. Lastly, initial findings demonstrate that pregnant women—another vulnerable population—can be effectively treated for DR- and multidrug-resistant TB, improving maternal outcomes without harming neonates.

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Snake envenoming: a neglected crisis
Snake envenoming: a neglected crisis

Every year 2 million or more people fall victim to snakebite envenoming, mostly in poor, rural communities of Africa, Asia and Latin America. Between 83,000—138,000 of them die, while hundreds of thousands more suffer debilitating long-term complications or disabilities.


Although some antivenom medicines are highly effective when used promptly and appropriately, many snakebite victims get no treatment at all. Those who do may receive antivenoms which don’t work against the type of snake that bit them, or were not rigorously tested for safety and effectiveness.


To mark World Snakebite Awareness Day on September 19th, the Collection linked below brings together recent MSF work on this highly neglected disease. Several articles and conference presentations help fill evidence gaps on the burden of disease and its impacts or on treatment outcomes with specific antivenoms in specific regions. Others examine how to tackle the formidable challenges of availability and affordability, the absence of regulatory oversight for making, testing and registering antivenoms, and the anemic R&D pipeline for new products—all of which impede access for patients to safe, effective treatment tailored to local snake species.

Mini-Lab—MSF's simplified bacteriology laboratory for low-resource settings
Mini-Lab—MSF's simplified bacteriology laboratory for low-res...
Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.
Safe abortion care at MSF
Safe abortion care at MSF

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

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Expanding access to lifesaving new TB tools

Expanding access to lifesaving new TB tools

Journal Article
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Short Report

Pregnancy and birth outcomes in patients with multidrug-resistant tuberculosis treated with regimens that include new and repurposed drugs

Lotia Farrukh I, Lachenal N, Adenov MM, Ahmed SM, Algozhin Y,  et al.
2024-01-25 • Clinical Infectious Diseases
2024-01-25 • Clinical Infectious Diseases
Among 43 pregnant women receiving multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment with bedaquiline and/or delamanid, 98% had favorable treatment outcomes. Of ...
Journal Article
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Research

Management of rifampicin-resistant tuberculosis in conflict-affected areas: The case of Iraq

Tesfahun HM, Al-Salihi L, Abdulkareem Al-Ani N, Mankhi AA, Mohammed A,  et al.
2024-01-19 • PLOS One
2024-01-19 • PLOS One
Since December 2019, the World Health Organization (WHO) has encouraged National Tuberculosis Programs to deprioritize the use of injectable-containing regimens and roll-out all-oral bed...
Journal Article
|
Commentary

Reversing the neglect of children and adolescents affected by tuberculosis

Deborggraeve S, Casenghi M, Hewison CCH, Ditekemena J, Ditiu L,  et al.
2023-09-11 • Lancet Child and Adolescent Health
2023-09-11 • Lancet Child and Adolescent Health
Journal Article
|
Commentary

Diagnostics to support the scaling up of shorter, safer tuberculosis regimens

Branigan D, Denkinger CM, Furin J, Heitkamp P, Deborggraeve S,  et al.
2023-07-31 • Lancet Microbe
2023-07-31 • Lancet Microbe
Technical Report
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Policy Brief

DR-TB drugs under the microscope 2022

MSF Access Campaign
2022-11-08
2022-11-08
TB was the leading cause of death from a single infectious agent until the COVID pandemic. The number of people newly diagnosed with TB in 2020 fell by 18% from the previous year due to ...
Journal Article
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Letter

Family directly observed therapy for children with drug-resistant TB

Rekart ML, Morshed T, Mulanda WK, Klieascikova J, Sitali N,  et al.
2022-08-01 • International Journal of Tuberculosis and Lung Disease
2022-08-01 • International Journal of Tuberculosis and Lung Disease
Journal Blog
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Perspective

6 months TB treatment for (almost) all

Berry C
2022-05-10 • PLoS Blogs
2022-05-10 • PLoS Blogs
Journal Article
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Commentary

Recently developed drugs for the treatment of drug-resistant tuberculosis: a research and development case study

Perrin C, Athersuch K, Elder G, Martin M, Alsalhani A
2022-04-19 • BMJ Global Health
2022-04-19 • BMJ Global Health
Two drugs with novel mechanisms of action, the diarylquinoline bedaquiline and the nitroimidazole delamanid—as well as pretomanid from the same class of drugs as delamanid—have recently ...
Journal Article
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Research

Person-centred care and short oral treatment for rifampicin-resistant tuberculosis improve retention in care in Kandahar, Afghanistan

Mesic A, Ishaq S, Khan WH, Mureed A, Mar HT,  et al.
2022-01-03 • Tropical Medicine and International Health
2022-01-03 • Tropical Medicine and International Health
OBJECTIVES
To describe the effect of adaptations to a person-centred care with short oral regimens on retention in care for rifampicin-resistant TB (RR-TB) in Kandahar province, Afgh...
Journal Article
|
Research

Public investments in the development of GeneXpert molecular diagnostic technology

Gotham D, McKenna L, Deborggraeve S, Madoori S, Branigan D
2021-08-31 • PLOS One
2021-08-31 • PLOS One
BACKGROUND
The GeneXpert diagnostic platform from the US based company Cepheid is an automated molecular diagnostic device that performs sample preparation and pathogen detection wit...