Europe failing to respond to global TB threat
MSF report reveals insufficient and badly designed funding for research
Brussels – 12 November 2008 – New analysis from international medical humanitarian organisation Médecins Sans Frontières (MSF) shows how the European Commission is failing to pay its fair share towards discovering and developing new tuberculosis (TB) vaccines, diagnostics and treatments.
MSF is calling on the European Commission to increase its funding five fold into research for medical tools to fight TB in the face of a global epidemic that claims 1.7 million lives a year.
“Because the tests and drugs we use today aren’t anything like effective enough, MSF teams responding to the epidemic in Africa and Asia are faced with an almost impossible task,” said Dr. Tido von Schoen-Angerer, Director of MSF's Campaign for Access to Essential Medicines. “We desperately need new vaccines, drugs and diagnostics for TB. This will only happen with more research.”
This is ever more urgent given TB’s rapid spread among people living with HIV and the rise of drug-resistant strains of the disease which do not respond to many of the commonly used treatments.
On a global scale, around 1.45 billion euros needs to be spent on TB research and development (R&D). MSF estimates that the European Union’s (EU) fair contribution would be 409 million euros a year. But MSF’s report shows that the European Commission spent a mere 18.7 million euros on TB R&D in 2007.
“Europe’s responsibility here is clear,” said Dr. von Schoen-Angerer. “Countries right on Europe’s doorstep – and even within the European Union – are struggling against resistant strains of the disease. But the research budgets remain pitifully low. Tuberculosis is knocking loudly on the door, but the European Commission is playing deaf.”
And member states are not making up the shortfall. An earlier MSF analysis found that Germany, the EU’s largest economy, was only contributing 7.5 million euros in 2007. “The European Commission cannot pass the buck on to the member states and vice versa”, said Dr. von Schoen-Angerer.
MSF’s analysis also shows how the European Commission (EC) funding is badly tailored to suit the needs of developers of vaccines, drugs and tests. The EC largely ignores new alternatives to the traditional patent-based research model, such as non-profit partnerships and prize funds. By eliminating the need for high drug prices to recover research and development costs, these innovative approaches could overcome the neglect of research into diseases that do not attract sufficient investment from industry, such as tuberculosis.
While it focuses on TB, MSF’s analysis also looked at other diseases: in 2007, only 17.1 million euros were spent on research and development for malaria. Not a single euro went into research for other neglected tropical diseases such as Leishmaniasis or Chagas, although these affect millions of people in developing countries.
MSF treats almost 30,000 people with tuberculosis in 39 countries worldwide.
NOTE TO EDITORS:
The report entitled “Cough up for TB! - The Underfunding of Research for Tuberculosis and Other Neglected Diseases by the European Commission” is being released in the run-up to a EC conference on poverty-related diseases in Brussels on 13 and 14 November 2008.
<media 2190 - cw_details>To download the report click here</media>
For more information, please contact:
Stephan Grosse Rueschkamp, Médecins Sans Frontières, +41 79 293 02 70
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Child-Adapted Medicines, Diagnostics, and Treatment Strategies Urgently Needed
Mexico City, 5 August 2008 -- Treating children and adolescents living with HIV effectively in resource-limited settings is possible, but adapted medicines, diagnostic tools, and treatment strategies are urgently needed to prevent more deaths, according to Médecins Sans Frontières (MSF). In "Running in Place," a briefing document released by MSF this week at the XVII International AIDS Conference in Mexico City, MSF exposes the formidable challenges the organization still faces in treating over 10,000 children under 15 years of age on antiretroviral therapy (ART) in over 50 projects around the world.
Over the last five years, MSF started nearly 4,000 children under five years of age on ART in 20 countries. An analysis of all children enrolled in these programs from April 2002 to January 2008 showed that 79% were still on treatment. Unfortunately, children less than 12 months of age in these programs were much less likely to survive, showing the critical need for earlier access to exposed infants.
"Children are not only fighting against AIDS, they are fighting against time. Without treatment, half of the children born with HIV will die before they reach their second birthday," said Dr. Fernando Parreño, a pediatrician for MSF in Zimbabwe, where MSF is treating more than 1,700 children on ART. "As long as we are still struggling to implement more effective prevention of vertical transmission strategies, it is imperative that all children are diagnosed and started on treatment as early as possible after diagnosis, or too many children will continue to die."
In an MSF program in Homa Bay, Kenya, survival in children after three years of ART was similar to that reported elsewhere in adults. Despite this good result, viral suppression was not achieved in 50% of treated children. It is difficult to definitively attribute these specific results to poor adherence; however, there is no question that there is an urgent need for pediatric adapted fixed-dose combinations, and child- and context-appropriate adherence strategies.
"So few children are born with HIV in developed countries that research into pediatric formulations is not a priority for pharmaceutical companies," said Karen Day, Pharmacist Coordinator at MSF's Campaign for Access to Essential Medicines. "Most of the drugs currently available are ill-adapted for use in resource-limited settings as they are either powders that need to be mixed with water or bitter-tasting syrups that also require refrigeration. And for the newly approved drugs, we have no safety data for use in children.
The most positive outcomes in MSF's pediatric treatment programs have been where a complete package included treatment, care and specific measures for patient support, including treatment literacy, ARV preparation, counselling and social support. Positive outcomes have also been seen in decentralized, nurse-based pediatric HIV programs.
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"Medicines alone are not enough to keep children living with HIV/AIDS alive," said Dr. Helena Huerga of MSF in Kenya. "They and their caregivers need to receive psychosocial support along with their treatment and care, especially as they grow older and into adolescence and beyond."
MSF is providing ART to over 140,000 people in 27 countries, 10,000 of whom are children.
To read MSF's report "Running in Place: Too Many Patients Still in Urgent Need of HIV/AIDS Treatment" in English, Spanish and French, please visit www.msf.org.
MSF is also releasing the 11th edition of “Untangling the Web of Antiretroviral Price Reductions” at the Mexico City IAC, for Multilanguage versions, please visit www.msf.org or www.msfaccess.org.
