Better data has revealed more than half a million more tuberculosis (TB) cases than previously thought, according to a World Health Organisation (WHO) report released yesterday (22 October).
TB remains one of the world’s deadliest communicable disease and in 2013 killed about 16 percent of the estimated nine million people who developed the disease globally, according to the WHO’s latest Global TB Report.
However the report notes decreases in TB deaths and new cases globally, which South African Health Minister Dr Aaron Motsoaledi said was encouraging.
While South Africa has met Millennium Development Goal targets to reduce new TB cases, the WHO estimates that about one in every 100 South Africans will develop the disease each year. The country – like Africa generally – is also unlikely to meet international targets to halve TB-related deaths by next year.
Treatment gaps also persist. South Africa saw a slight increase in multidrug-resistant (MDR) TB cases diagnosed as compared to the previous year, less than half of the about 26,000 South Africans diagnosed with MDR-TB in 2013 were ever treated.
Pharma pulls back as world risks ‘post-antibiotic era’
South Africa’s MDR-TB burden ranks ninth in the world. Almost half the world’s countries have now recorded at least one case of extensively drug-resistant TB, which is more difficult to treat than MDR-TB.
As the world grows in dire need of new drugs, less money is being devoted to find them, notes a report released by the US health activist organisation Treatment Action Group (TAG) yesterday.
Globally, TB research funding has increased by about R441 million since 2012 but in its latest report TAG cautions that this increase only brings TB research funding in line with 2011 levels.
According to report author Mike Frick, increased investment masks a dangerous trend among companies that are halting infectious diseases research as part of what TAG dubbed the “the pharmaceutical industry’s long goodbye to TB research”.
“There’s been an erosion of pharmaceutical company investment in TB research,” said Frick, who added that historically the pharmaceutical industry has been well placed to initiate early clinical trials of new TB drugs albeit through public-private partnerships. “We’ve lost three companies in the past three years and we’re down to just three remaining.”
“When we finally have ambitious goals to eliminate TB by 2035, we’re not buying the research today that we are going to need to achieve them,” he added.
This week, drug regulator the Medicines Control Council approved the first new TB drug invented in more 40 years, bedaquiline, for MDR-TB treatment in HIV-negative adults.
While there are concerns about bedaquiline’s price, it should reach 9000 MDR-TB patients in the next two years.
Without pharmaceutical company investment in new drugs, Frick warns there are few new drugs in the pipeline to follow new drugs like bedaquiline and delamanid, which the country is expected to introduce following WHO-issued guidance.
Companies’ divestment in new antibiotics like these comes after WHO warnings that the world could ender a “post-antibiotic era” this century in which common illnesses could turn deadly as they become resistant to antibiotics.
South Africa leads BRICS in TB research funding
Meanwhile, South Africa leads the BRICS countries in funding TB research and in 2013 spent about R10 million on the field of study – about R413,000 more than Brazil. India is also funding similar work while not much is known about the investment of China and Russia, according to Frick, who added Brics should take a leading role in the fight against TB.
“We are scaling up because we believe that being one of the high burden countries with a lot of infrastructure for research, there is a lot of research to be done in South Africa,” said Motsoaledi while on a WHO teleconference yesterday. He added the country is planning to scale up TB funding for local bodies like the Medical Research Council.
South Africa also funds 84 percent of its TB programme. This level of funding is roughly consistent with the proportion of the country’s HIV programme that is domestically funded.
Source: Health-e