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New Tuberculosis Drugs May Become Ineffective: Study

A doctor examines the x-ray of a TB patient in New Delhi. Credit: Bijoyeta Das/IPS.

UNITED NATIONS, Mar 24 2017 (IPS) - New antibiotics that could treat tuberculosis may rapidly become ineffective, according to new research published by the Lancet ahead of World Tuberculosis Day.

The rise in multi-drug resistant tuberculosis, which affected 480,000 people in 2015, could mean that even newly discovered drugs will soon be useless, the study found.

In total both drug resistant and non-drug resistant Tuberculosis (TB) killed an estimated 1.8 million people in 2015, making it the world’s deadliest infectious disease. The five countries where TB is most predominant are India, Indonesia, China, Nigeria, Pakistan and South Africa.

Multi-drug resistant tuberculosis reflects the meeting of an ancient and under-addressed disease – tuberculosis – with an emerging modern threat – antimicrobial resistance. The inappropriate use of antibiotics, including taking them without prescription or not following doctor’s orders closely is slowly rendering many antibiotics useless.

“Resistance to anti-tuberculosis drugs is a global problem that threatens to derail efforts to eradicate the disease,” said lead author of the Lancet report Professor Keertan Dheda from the University of Cape Town, South Africa.

“People with drug resistant TB who don’t have access to the two new drugs continue to be treated with older, more toxic regimens that cure only 50 percent of people treated and cause severe side effects ranging from severe nausea to deafness to psychosis,” -- MSF Access.

“Even when the drugs work, TB is difficult to cure and requires months of treatment with a cocktail of drugs. When resistance occurs the treatment can take years and the drugs used have unpleasant and sometimes serious side effects,” said Dheda.

Dheda added that it is important for improved diagnostic tests, which are currently being developed, to be made available in low-income countries “so as to inform treatment decisions and preserve the efficacy of any new antibiotic drugs for TB.”

The report was published in the Lancet Respiratory Medicine on World TB Day – 24 March.

Meanwhile, according to Medecins Sans Frontieres (MSF) Access Campaign fewer than five percent of people with multi-drug resistant Tuberculosis have access to new medicines, four years after these medications were released.

“It’s downright disheartening that, with hundreds of thousands of people living with deadly drug-resistant tuberculosis, only 4,800 people last year received the two new drugs that could dramatically increase the number of lives saved,” said Dr. Isaac Chikwanha, TB advisor for MSF’s Access Campaign.

“Our first major problem is that pharmaceutical corporations are not even registering important new drugs in some of the countries hardest hit by TB; The next major problem is their high price,” said Dr. Chikwanha.

“People with drug resistant TB who don’t have access to the two new drugs continue to be treated with older, more toxic regimens that cure only 50 percent of people treated and cause severe side effects ranging from severe nausea to deafness to psychosis,” said MSF Access.

Dr Margaret Chan, Director General of the World Health Organization recently told IPS at a press conference on antimicrobial resistance that “there is no denying the fact that TB is a top priority for the world.”

She says that there are two high level meetings planned in 2017 and 2018 to “shine a light on TB” and give it “the political attention and the investment in research and development that it deserves.”

However according to both MSF Access and the new Lancet study, research and development alone, though needed, is not enough to address the shortcomings in the global response to TB and Antimicrobial Resistance without a matching political response.

In a comment article published alongside the new Lancet study David W Dowdy from Johns Hopkins Bloomberg School of Public Health said that the difference between “a drug-resistant tuberculosis epidemic of unprecedented global scale” or “an unprecedented reversal of the global drug-resistant tuberculosis burden,” falls largely to whether there is “political will to prioritise a specific response to the disease.”

 
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