Médecins Sans Frontières (MSF) and the Stop TB Partnership today released the second edition of the Out of Step report, a 24-country survey of policies and practices used today to guide the diagnosis and treatment of tuberculosis (TB). If countries are to meet globally-endorsed goals to reduce TB incidence and death by more than 90% over the next 20 years, aggressive efforts must start now to adopt and implement the 14 key policies and practices identified in the report, which are currently recommended by World Health Organization (WHO).
TB is curable, but remains the world’s deadliest infectious disease, claiming 1.5 million lives each year.
“Outdated policies for TB treatment that put people at risk of increased suffering and death should be banished, including re-treatment regimens that potentially increase drug resistance, and mandatory hospitalisation during treatment,” said Dr. Grania Brigden, MSF Access Campaign TB Advisor.
“The use of rapid molecular tests that can effectively diagnose drug resistance hasn’t yet reached the broad coverage needed. We won’t be able to close the huge gaps in TB diagnosis and treatment unless the policies and practices known to reduce illness, death and transmission are fully adopted and implemented in every country, including the best use of every effective tool available today.”
In October, WHO revealed that only one in four (26%) of the 480,000 people estimated to have developed multidrug-resistant TB (MDR-TB) in 2014 was diagnosed, with 111,000 people (23%) started on treatment and less than half of them successfully treated.
Yet of the 24 countries surveyed for Out of Step, only about 30% of countries (8 out of 24) have put in place policies to ensure that rapid molecular tests for detection of TB and drug resistance are used as the initial test for everyone being evaluated for TB.
Despite the upfront financial challenges related to this strategy, countries should consider expanding access to rapid molecular diagnostics in order to ensure early diagnosis and early treatment initiation; reduce the chain of transmission; reduce cost implications in the long run; and reduce the emergence of drug-resistant TB cases and the overall global burden of TB.