Journal Article > CommentaryFull Text
Lancet Infect Dis. 2019 March 1; Volume 19 (Issue 3); 224-225.; DOI:10.1016/S1473-3099(18)30742-4
Acquah R, Furin J
Lancet Infect Dis. 2019 March 1; Volume 19 (Issue 3); 224-225.; DOI:10.1016/S1473-3099(18)30742-4
A universal regimen. At times this appears to be the Holy Grail in tuberculosis treatment. For decades, policy makers, public health specialists, and donors have argued that in order to control—and these days to “End TB”—a simplified approach that offers everyone the same regimen is our best bet. They argue that countries, programmes, and the people who work in them, are incapable of managing complexity when it comes to tackling tuberculosis. Fears abound that recommending anything other than a basic treatment algorithm will lead to mismanagement and a tuberculosis crisis worse that what we see now. Never mind that such an approach erases patient individuality and unique human treatment needs. “Keep it simple” remains the mantra in tuberculosis control to this day.
Journal Article > CommentaryFull Text
Int J Tuberc Lung Dis. 2020 November 1; Volume 24 (Issue 11); 1134-1144.; DOI:10.5588/ijtld.20.0330
Cox V, McKenna L, Acquah R, Reuter A, Wasserman S, et al.
Int J Tuberc Lung Dis. 2020 November 1; Volume 24 (Issue 11); 1134-1144.; DOI:10.5588/ijtld.20.0330
Rapid diagnostics, newer drugs, repurposed medications, and shorter regimens have radically altered the landscape for treating rifampicin-resistant TB (RR-TB) and multidrug-resistant TB (MDR-TB). There are multiple ongoing clinical trials aiming to build a robust evidence base to guide RR/MDR-TB treatment, and both observational studies and programmatic data have contributed to advancing the treatment field. In December 2019, the WHO issued their second ‘Rapid Communication´ related to RR-TB management. This reiterated their prior recommendation that a majority of people with RR/MDR-TB receive all-oral treatment regimens, and now allow for specific shorter duration regimens to be used programmatically as well. Many TB programs need clinical advice as they seek to roll out such regimens in their specific setting. In this Perspective, we highlight our early experiences and lessons learned from working with National TB Programs, adult and pediatric clinicians and civil society, in optimizing treatment of RR/MDR-TB, using shorter, highly-effective, oral regimens for the majority of people with RR/MDR-TB.