The Road To Ending TB
Introduction:
- In 1993, the World Health Organization (WHO) declared tuberculosis (TB) a worldwide health emergency. The response has been slow and methodical throughout the past thirty years, with little urgency. Although there is still ambiguity on what is meant by the word “end” and how it would be validated, the current goal is to eradicate TB by 2030.
About TB:
- The bacteria that causes TB is Mycobacterium tuberculosis. While some mycobacteria cause diseases like leprosy and TB in humans, other mycobacteria infect a wide range of animals.
- The most common organ affected by TB in humans is their lungs (pulmonary TB), however it can also affect other organs (extra-pulmonary TB). TB is a treatable and curable disease.
- TB can spread from one person to another through the air. When someone with lung TB coughs, sneezes, or spits into the air, the TB bacteria is transmitted.
- Chest pains, weakness, weight loss, fever, night sweats, and coughs that occasionally produce sputum and blood are all common symptoms of active lung TB.
Drug-resistant TB:
- The three primary subtypes of drug-resistant tuberculosis are MDR, XDR, and TDR.
- Multidrug-resistant tuberculosis (MDR) Isoniazid and rifampicin, the two most effective first-line anti-TB drugs, are not effective against the bacteria that cause this kind of TB. MDR-TB can be treated with second-line drugs and even completely eliminated.
- Extremely drug-resistant TB (XDR) is a more serious form of multidrug-resistant tuberculosis (MDR-TB) that is brought on by bacteria that do not respond to the strongest second-line anti-TB drugs, frequently leaving patients with no other options for treatment.
- total resistance to medication (TDR) When TB does not improve with ANY treatment, it is considered to have tuberculosis. That is tuberculosis’s last stage.
Global Fund:
- Following Kofi Annan’s original appeal made in 2001 at the G7 summit in Okinawa, Japan, and formalised at the next summit in Genoa, Italy, the Global Fund to Fight AIDS, TB and Malaria (GFATM) began disbursing the first batch of monies earmarked for the global TB epidemic in 2003. After 20 years, the Global Fund has more money available to fight TB globally than all other funding sources combined. The leaders of the three diseases for which the Fund was founded, as well as its donor constituencies, continue to hold it hostage through the zero-sum games they impose on it.
- The “End TB Partnership” obtained an official representation on the board of the Global Fund more than seven years after it was founded, with the responsibility to mobilise and marshal a wide range of participants towards the goal of eradicating TB. This week, on the same day as World TB Day, the Stop TB board meets in Varanasi, India (March 24).
- The HIV response has encouraged “engagement” of those who are living with the disease, and the use of molecular diagnostic tools—developed to address acts of bioterrorism 20 years ago—is the state of the art for diagnosing TB today. Despite challenges, the global TB response has been adapting to new circumstances.
- The utilisation of social safety programmes to address the poverty origins of the TB pandemic and by utilising the “mobile and computational data revolution” to improve treatment outcomes have both begun to impact the trajectory of international efforts to eradicate TB.
Moving ahead:
- There are still service gaps in three crucial areas. Without strengthening or radically rethinking them, there is a decreased chance of successfully eradicating TB by 2030. A impetus for coordinated action to end tuberculosis could be provided by India’s G20 presidency and its focus on health.
TB vaccination:
- Despite promising developments, the first area—the development and widespread use of an adult TB vaccine—is anticipated to take the longest to develop. The current one is 100 years old, given at birth, and is especially beneficial for children.
- Our experience with the COVID-19 vaccine development process has given us knowledge of accelerated vaccine development. Regarding avoiding the negative effects of unequal distribution seen with the COVID-19 immunisations, there should be no doubt.
Acquiring more advanced anti-TB medications:
- A few novel anti-TB drugs are already widely available, although limits on pricing and production capacity exist. The current standard of care for treating tuberculosis is for at least six months; transitioning to a shorter, all-oral tablet regimen without injections will improve compliance and reduce patient fatigue.
- The effort to develop a multitude of new therapies needs to accelerate so that we have newer treatments available when drug resistance to the most recently introduced meds arises. Drug-resistant TB statistics at this time are, at best, disheartening, and, at worst, alarming. Due to a lack of readily available modern medications, the failure of the past is being repeated.
Diagnostics:
- AI-powered handheld radiography with 90-second reporting and 95%+ accuracy for tuberculosis diagnosis has made major strides. This is a cutting-edge piece of technology, and its implementation is urgent.
- Confirmation diagnosis based on nucleic acid amplification is prone to failure. India brought the InDx diagnostics alliance together in Bengaluru for COVID-19. It is important to support these and other biotech companies in their efforts to create low-cost, high-quality innovations that can get around the challenges of molecular testing and financial constraints.
Conclusion:
- The United Nations High-Level Conference on TB in September of this year, the Varanasi StopTB board meeting this week, and India’s G20 presidency this year provide the perfect forums for India’s efforts to voice out loudly and will hasten the global eradication of tuberculosis.
