Tuberculosis Drug Access and Management Can Save Millions

While a cure has been available for over 50 years, tuberculosis (TB) still kills more than 2 million people every year and nearly 9 million people will develop TB in 2005, according to the World Health Organization (WHO).

TB threatens the poorest and most marginalized groups, disrupts the social fabric of society, and slows or undermines gains in economic development. An overwhelming 98 percent of the 2 million annual TB deaths - and 95 percent of the new TB cases each year - occur in developing countries.

The main barrier to preventing and eliminating TB is infrequent and poor quality drug supply to TB patients. The Global Drug Facility (GDF) is tackling this issue. In fact, the facility has successfully treated 4 million patients in its first four years.

The GDF is an initiative to increase access to high-quality TB drugs. It is a project of the Stop TB Partnership, housed at the WHO.

As part of the Stop TB Partnership with its 350 partner governments and organizations, The GDF has reduced drug prices by approximately 30 percent compared with previous international tenders, to less than US$10 for a six to eight month course of treatment.

Most developing countries have been paying at least twice the prices obtained by the GDF – sometimes even three or four times higher, due to inefficient procurement mechanisms.

“The link between poor access to vital TB drugs and weak health systems, including pharmaceuticals, cannot be overemphasized,” said Susan Bacheller, TB team leader for the U.S. Agency for International Development (USAID) in Washington, D.C. “The GDF is a critical resource to addressing TB globally.”

USAID has provided developing countries access to its long-standing expertise and programs in improving drug management. Other critical components of USAID’s comprehensive TB strategy include developing effective pharmaceutical management systems and a cadre of trained TB experts.

The Agency is also committed to the expansion and strengthening of DOTS, a global program to directly observe that patients actually take their medicine daily until the full treatment is completed. This includes identifying tuberculosis patients, providing them with drugs, and ensuring uninterrupted supply of the drugs until the patient is cured. New USAID TB programs will start in 2005 in Mozambique, Namibia, Tanzania, and Zambia to expand and strengthen DOTS. These countries are also all focus countries for the President’s Emergency Plan for AIDS Relief.

Because HIV weakens the immune system, people with latent TB infection and HIV infection are at very high risk of developing active TB disease. TB is responsible for the deaths of one in three people living with HIV/AIDS, making it the leading cause of death among people infected with HIV.

According to WHO, between 50 percent and 70 percent of people with infectious TB die if untreated. The number of cases increases by three percent every year, largely because of the HIV/AIDS epidemic, inadequate investments in public health systems, and emerging TB drug resistance. Without this help, patients can die, remain chronically ill and/or spread drug-resistant disease.

On average, TB causes three to four months of lost work time and lost earnings of 20 to 30 percent of household income. For families of persons who die from the disease, the impact of TB is even greater as about 15 years of income is lost due to premature death.