The Need for New TB Tools

After decades of neglect, there has been a recent upswing of activity in the development of new drugs and diagnostic tests to treat tuberculosis (TB). However, while the situation may improve in a few years, today there are still not enough new drugs available to adequately tackle this disease that has seen a dramatic resurgence in recent years in the places where we work.

Outdated, ineffective and toxic drugs

Today, we still have to treat patients with outdated drugs that take a long time to cure TB. Standard TB treatment takes six months. And for those patients infected with drug-resistant (DR-TB) strains of the disease, treatment can last as long as two years, with up to twenty pills per day plus a daily painful injection for the first several months. The treatment can also cause severe side effects, ranging from constant nausea to psychosis and deafness.

New drugs on the way

Several news drugs are expected to come out of the pipeline in 2012 and 2013.

Where these new drugs will fit into current TB treatment regimens is yet to be established. Can they be used to shorten the current first-line regimen, or are they better used to improve and possibly shorten the treatment regimen for DR-TB? As the studies commence to find the best role for these new drugs, it is important to continue to push for continued research and development of more new drugs to further improve the treatment options.

It is also important to ensure that new drugs are tested in people living with HIV who may be taking antiretroviral drugs to assess potential interactions and enable this at-risk group to have the best possible chance of recovering from TB, while still receiving treatment for HIV. Further, the importance of including children in any clinical trial needs to be stressed so that suitable regimens and formulations are prepared specifically for them.

Promising new TB test, but even simpler test needed

A new molecular test came to market in 2010 which can provide results in under two hours and could help many more people with the disease to be quickly and accurately diagnosed and put on treatment. MSF took part in the field testing of this device and is implementing the test in many of our projects.

Despite being very promising, the test has its limitations – it is expensive, requires an electricity supply and a laboratory infrastructure, which is not always widely available in the most resource-limited locations. There is an urgent need for a simple, affordable and easy-to-use point-of-care test that does not rely on sputum and can deliver results on the spot in even the most resource-limited or remote settings.

Last Updated: July 2011