Sluggish response risks squandering historic opportunity to tackle global DR-TB: MSF

By Joanna Keenan | 19 Mar, 2013

People with drug-resistant tuberculosis and their treatment providers at
Médecins Sans Frontières have signed a public manifesto - launched today -
demanding change for better treatment, for diagnosis and treatment to be
scaled up now, and for the appropriate financial backing from donors and
the Global Fund to be in place to achieve this.

See the text for the Test me, treat me manifesto and who signed it at by
clicking or visiting We
encourage you to share it via social media and for those working in the TB
community to sign it. Press release below.

 Sluggish response risks squandering historic opportunity to tackle global
                        drug-resistant tuberculosis

 People living with MDR-TB and their healthcare providers call for urgent

Geneva, 19 March 2013—If measures to tackle multidrug-resistant
tuberculosis (MDR-TB) are not significantly stepped up, including
addressing barriers that prevent both research into better drug
combinations and treatment scale up, MDR-TB rates will continue to increase
worldwide and a historic opportunity to improve abysmal cure rates will
have been squandered, medical humanitarian organisation Médecins Sans
Frontières (MSF) warned today. Two new drugs effective against MDR-TB must
be used to make treatment much shorter, more effective and less toxic. This
demand is among others made by people living with the disease and MSF
medical staff from around the world in a public manifesto launched today

Read the ‘Test me, treat me’ manifesto and see who signed it at:

“We have been waiting for half a century for new drugs that are effective
against tuberculosis. Must we wait another fifty years to seize this
historic opportunity to improve and roll out treatment for drug-resistant
TB?” said Dr. Erkin Chinasylova, TB doctor for MSF in Swaziland. “Getting
better treatment is beyond urgent, but we are not seeing anything like the
level of prioritisation required to make this a reality.”

MSF projects are seeing unprecedented numbers of people with MDR-TB around
the world, with drug resistance found not only among patients who have
previously failed TB treatment but also in patients newly diagnosed with TB
– a clear sign that MDR-TB is being transmitted in its own right in the
communities in which we work.

Left untreated, the infectious disease is lethal, but treatment today puts
people through two years of excruciating side effects, including psychosis,
deafness and constant nausea, with painful daily injections for up to eight
months. Barely half of people get cured.

After close to five decades of insufficient research and development into
TB, two new drugs - bedaquiline and delamanid - have recently been or are
about to be approved. Research is urgently needed to determine the best way
to use these new drugs so that treatment can be made shorter and more
effective, and rolled out to treat the growing number of people with
MDR-TB. People on MDR-TB treatment and their caregivers from around the
world outline these and other demands in the Test me, treat me manifesto,
and urge others to join their call for urgent action.

“It’s 2013 and I’m beginning a fourth year of living with TB, when I should
be in my fourth year at university,” said Phumeza Tisile, a 22-year-old
woman who receives treatment for extensively drug-resistant TB from MSF in
Khayelitsha, South Africa, and is one of the signatories of the manifesto.
“I’ve swallowed around 20,000 pills and received over 200 daily painful
injections since I started treatment in June 2010, and the drugs have left
me deaf. I wish I could take just two tablets a day for a month or so and
be cured.”

The number of people receiving MDR-TB treatment globally remains shockingly
low, at less than one in five. Greater political and financial support from
the international community is needed to address this gap.

“Right when TB should be the global priority, the trend we’re seeing is
that it is being deprioritised.  This is unacceptable,” said Dr. Manica
Balasegaram, executive director of MSF’s Access Campaign.

The Global Fund provides about 90% of international support for TB, but it
has recently reduced the share going to the disease.  Ahead of a key
replenishment meeting later this year, donors must ensure the Fund is
adequately financed so that countries have the support they need to
strengthen the MDR-TB response. With better treatment on the way, affected
countries should scale up efforts to diagnose and treat MDR-TB today, so
that robust programmes are in place once the new drugs are introduced.

See MSF infographics on TB – length of treatment, side effects, access to
treatment etc – at

Drug-resistant forms of TB are a neglected global health crisis: the World
Health Organization estimates there were 630,000 cases of MDR-TB in 2011.
MSF started providing treatment to people with MDR-TB in 2001. In 2011, MSF
provided treatment to 1,300 people with MDR-TB in 21 countries.

Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]



Vivian Huang, MD, MPH Replied at 3:27 PM, 19 Mar 2013

I applaud MSF's position demanding for change and also to increase the financial support to combat TB, however, the new drug that has been approved and the other in the process of approval may take time before it actually reaches the patients on the ground. What also needs to be done is for countries to advocate for shorter treatment regimens (Bangladesh 9 month study) that have been proven effective against MDR TB and for WHO to endorse shorter treatment regimens NOW. It will take time before the new drugs will be part of standard MDR TB treatment, and in the meantime, we already have regimens that work. Why not cut treatment time in half now for our patients? It would decrease the devastating side effects, increase adherence and would be cost-effective in the long run.