UNITAID rolls out rapid diagnostic testing for TB

GENEVA – The global response to multidrug-resistant tuberculosis (MDR-TB) is far off track with less than 25% of those estimated to have this hard-to-treat disease identified in 2012, according to the World Health Organization (WHO) in its newest Global Tuberculosis Report. UNITAID is at the forefront of efforts to address this issue with its recent roll-out of rapid diagnostic testing in the highest burden countries.

“The fact that the detection level is so low for MDR-TB means that the disease will continue to spread as undiagnosed individuals infect others with this airborne disease,” said UNITAID executive director Dr Denis Broun. “The only solution to stop the spread of MDR-TB is to rapidly identify infected individuals and put them immediately on treatment.”

Geneva-based UNITAID uses innovative financing to increase funding for greater access to treatments and diagnostics for HIV/AIDS, malaria and tuberculosis in low-income countries. It is the first global health organisation to use buy-side market leverage to make life-saving health products better and more affordable for developing countries.

In September 2013, UNITAID began the largest global roll out of the GeneXpert? machine. These state-of-the-art test machines for tuberculosis (TB) shorten the time to diagnose drug-resistant strains of TB from weeks to only a few hours. UNITAID funding has delivered 220 of these machines and 1.4 million test cartridges for 21 countries in Africa, Eastern Europe and Asia. Furthermore, price reductions obtained by UNITAID in direct negotiation with the device’s manufacturer resulted in a 40% price reduction for 145 low- and middle-income countries.

“Even countries not directly supported by UNITAID, like South Africa, have benefitted from our price reductions, allowing them to test more people for the same money,” added Dr Broun. “But we can do much better. We need new developers to enter the TB diagnostics market so there are more adapted, easier-to-use products.”

According to the WHO report, an estimated 450,000 people developed MDR-TB in 2012, with 170,000 deaths. MDR-TB has lower cure rates than normal TB, because treatment is expensive, long (two years) and extremely toxic. Unavailability of products is also an issue.  To address drug stock-outs, UNITAID finances a continuously replenished “rotating stockpile” of MDR-TB drugs, allowing countries to access emergency orders of medicines to avoid treatment interruptions.

“We need more affordable treatments that are less complex, without severe side effects,” concluded Dr Broun. “We hope increased and improved testing will create new incentives for manufacturers to invest in new MDR-TB medicines.”

The WHO Report also highlights the burden of paediatric TB, which is one of the top 10 killers of children with an estimated 530,000 TB cases among children and 74,000 deaths in 2012. Currently no adapted drugs are available for children, which contribute to this high number. In 2012 UNITAID committed funding for the development of child-friendly TB treatments, through a Air Jordan XXXI 31 Shoes