- TDR catalyzes 44 countries to identify TB programmatic gaps and research priorities.
- Research priorities include studies for implementing modified shorter regimens for drug-resistant TB patients and addressing barriers to scaling up treatments for latent TB infection.
An unprecedented number of African countries convened in Benin to strengthen efforts to tackle drug-resistant tuberculosis (DR-TB) and latent TB infection (LTBI), two priority areas critical to the success of the End TB Strategy.
Of 47 countries in the African region, 44 were represented at a four-day workshop focused on identifying programmatic gaps in managing both DR-TB and LTBI and defining related operational and implementation research priorities. These will lead to research activities that will support effective implementation of new WHO guidelines on DR-TB and on LTBI.
The workshop was organized by TDR in collaboration with the WHO Global TB Programme, WHO Regional Office for Africa (AFRO), the West and Central African Regional Networks for Tuberculosis control (WARN-TB and CARN-TB), the Access and Delivery Partnership (ADP) and the Supranational TB Reference Laboratory of Benin.
“Bringing together representatives of all of these African countries and partners is a unique and valuable experience that strengthens our efforts to control the TB epidemic,” said Dr André Ndongosieme of WHO AFRO. Representatives from The Global Fund, USAID, the Union, Damien Foundation, Stop TB Partnership, and PATH also participated in the meeting.
“There is a huge need for more operational and implementation research to help us to scale-up the most effective strategies.”
Professor Dissou Affolabi, Benin National TB Programme Manager
TB is the leading cause of death from a single infectious agent, taking more lives than HIV/AIDS and malaria. Annually, an estimated 10 million people fall ill with TB. In addition, about 1.7 billion people are estimated to have a latent TB infection and are at increased risk of developing active TB disease during their lifetime. WHO estimates that 30 million individuals will need preventive treatment for LTBI by 2022. This was adopted as a target by UN Member States in September 2018 at the first ever UN high level meeting on TB.
Resistance to TB drugs is a major obstacle to effective TB care and prevention globally. Close to 600,000 new cases of multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) are estimated to emerge each year, with about 90,000 of these in the WHO African Region. Many more patients have isoniazid-resistant TB, the outcomes of which could be improved by timely detection and suitable treatment.
“In many countries the programmatic management of LTBI is still in its infancy and drug-resistant TB patients often do not receive appropriate treatment,” said Dr Jean-Pierre Baptiste, WHO Representative to Benin. The new DR-TB treatment recommendations by WHO could potentially help improve this situation. And recent advances in diagnostics and drug research have led to safer options for treatment of LTBI. However, levels of uptake of these innovations vary widely across the world.
The objectives of this meeting were therefore to share more widely new recommendations and best practices on the programmatic management of both LTBI and DR-TB; identify barriers to effective implementation of the new guidelines; and develop operational and implementation research questions that countries should address to overcome these barriers.
“TDR is particularly interested in strengthening countries’ capacity to study and address these barriers,” said Dr Corinne Merle of TDR.
New recommendations for the diagnosis, treatment and care of patients with drug-resistant TB and latent TB infection and best practices were also discussed.
“We shared widely and learned a lot,” said Dr Marie Sarr, national TB programme manager for Senegal. “There has been unanimous feedback from participants on the value of this type of workshop.”
“This meeting was a unique occasion to bring together national TB programme coordinators and heads of TB reference national laboratories,” said Prof Dissou Affolabi, Benin National TB Programme Manager and Executive Secretary of WARN-TB and CARN-TB. “There is a huge need for more operational and implementation research to help us to scale-up the most effective strategies.”
TDR, Global TB Programme, AFRO and partners will continue to support countries to facilitate implementation of the TB guidelines at country level and to address identified research questions. These include how to implement modified shorter regimens for DR-TB patients and how to address barriers to scaling up implementation of LTBI treatments.
For more information, contact Makiko Kitamura.