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UN declaration on TB ‘falls short’ on critical issues

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Civil society groups have criticised the UN declaration on tuberculosis (TB) ratified on the 26 September saying it “falls short” on critical issues in the fight against the world’s top infectious killer, reports Health-e News.

Groups including the Health Global Access Project, the Treatment Action Group and South Africa’s Section27 and Treatment Action Campaign said that TB declaration being ratified by UN member states “falls short on its response to the leading infectious killer worldwide and the leading cause of death for people with HIV”.

They said that to “get serious about ending TB” and “to finally confront an infectious disease killing 4 500 people per day”, countries need to commit to a number of concrete interventions. These include the rapid scale-up of a new TB test called LAM, used for hard-to-diagnose patients living with HIV that uses urine instead of sputum to detect TB.
HIV and TB

The report says according to the international non-profit organisation, the Foundation for Innovative New Diagnostics (FIND) up to 60% of people with HIV are unable to produce a sputum sample, leading to delays in TB diagnosis for these patients, which often proves deadly.

FIND, along with partners including Fujifilm, has developed a new TB LAM test that analyses urine samples. Following “encouraging” preliminary results in HIV positive people, FIND announced in New York on Wednesday that they are now inviting applications from potential clinical trial partners to evaluate performance of the test.

However, FIND’s head of communications, Sarah-Jane Loveday is quoted in the report as saying that “the manuscript reporting the results of this study is currently under journal review so data cannot be released at this time”. The test will be particularly useful in low-income settings, where the burden of HIV and TB is the highest, because it takes an hour to produce results, doesn’t rely on electricity and requires limited training for health workers.

Deputy director general for Health Dr Yogan Pillay is quoted as saying last year that a different TB LAM test, which costs just R40, had recently been introduced in South Africa and was being scaled up. The FIND/ Fujifilm LAM test has yet to be approved for widespread use, as regulatory bodies are awaiting trial data, but it is hoped to improve on the currently available test which has limitations.

The report says at a side-event of the UN meeting, president of the International Union Against Tuberculosis and Lung Disease (The Union) Dr Jeremiah Chakaya Muhwa also called on governments to take urgent action against TB. “We need a revolution in prevention… We must support efforts to get an effective TB vaccine,” he said.

Promising primary clinical trial results for a candidate TB vaccine have been published. The report says the candidate is the closest the world has come to developing a new TB vaccine in over 100 years. The number of people who developed TB was slashed in half in people who received the vaccine compared to those who did not.

The Union’s Dr Paula Fujiwara said that these results “are a major milestone in the development of a new TB vaccine”. “Leaders have committed to ending the global TB epidemic by 2030, and we need a new TB vaccine to have a shot at meeting that goal.”

Despite being preventable and curable, TB still killed around 1.6m people in 2017, the report says. Civil society groups laid some of the blame for this on the gap in funding allocated to TB research. They called on governments to recognise their “collective and individual failures” and commit to investing at least 0.1 percent of their annual expenditure on research and development in TB.

“Relative to other major killers, TB gets a pittance of research funding,” said Fujiwara, who added that there is an annual $1.2bn shortfall for what is needed.

“National leaders should interpret (the) new vaccine data as reason to double down on their research investments. The great thing is they’re committed to do exactly that at the UN this week. Now they need to follow through,” she is quoted in the report as saying.

Health-e News report

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