“Intensified research and innovation” is the third pillar of WHO’s End TB Strategy, and TDR has been contributing expertise in research for implementation to optimize the impact of innovations for tackling TB. Research plays a critical role in saving the lives of millions suffering and dying from this preventable and curable disease.
The most recent Global TB Report informed us of the alarming figure that over a third of people with TB do not access quality care. And only one in four people with multidrug-resistant TB are put on treatment. Clearly, there are access barriers that need to be studied to optimize control programmes.
A regional network approach to supporting TB research
In recent years, TDR has supported a number of initiatives in line with this thinking. Last April, 11 national TB programmes in central Africa agreed to establish a TDR-supported Central African Regional Network for TB control (CARN-TB). The objective is to boost TB research in the sub-region. Since then, TDR has been training and supporting the national TB programme teams to enhance research in close collaboration with the WHO Regional Office for Africa and Global TB Programme; the West African Health Organization; The Global Fund; The International Union Against Tuberculosis and Lung Disease; the Damien Foundation; and European and African universities and research institutions.
CARN-TB replicates and builds on the experience and progress made through a similar regional approach in 16 West African countries (WARN-TB) since 2015.
WARN-TB and CARN-TB were in action in December, when TDR and the Global TB Programme collaborated with the networks to investigate the costs faced by patients and households affected by TB. Such costs can create financial barriers to accessing TB services and increase the risk of treatment failure. Participants from 24 countries developed protocols for national surveys and data collection tools on TB patient costs, in line with the methodology developed by the Global TB Programme.
And just last week, TDR, the Global TB Programme, WHO AFRO, and 44 African countries, including those participating in WARN-TB and CARN-TB, convened again in Benin to tackle latent TB infection and drug-resistant TB. Countries have now identified programmatic gaps and research priorities focused on drug-resistant TB (DR-TB) and latent TB infections (LTBI), two priority areas critical to the success of the End TB Strategy. This will now lead to research activities that will support effective implementation at the country level of new WHO TB guidelines published this week.
“Intensification of research and innovation is not only one of the key pillars of the End TB Strategy, it’s what we need to save the millions suffering and dying from TB- this preventable and curable disease,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “This is why WHO, based on a request from Member States, is developing a Global TB Research Strategy, working in close collaboration with countries, research networks and partners. Together with TDR, we are calling for all partners to support countries in rapidly putting innovations into practice, and to share data from operational research and clinical trials to enable updates of policies and guidelines.”
Building operational research capacity to improve performance of TB control programmes
TDR also coordinates the Structured Operational Research and Training Initiative (SORT IT), a global partnership-based initiative aimed at building sustainable operational research capacity to improve health outcomes. TDR has worked closely with TB control programmes, The International Union Against Tuberculosis and Lung Disease (The Union), and non-governmental organizations to support operational research on improving TB programme performance.
Approximately 800 researchers from 90 countries have participated in the SORT IT training course, resulting in the publication of more than 200 TB-related studies, of which 65% have had an impact on policy and practice.
For example, a study conducted in the Republic of Moldova compared treatment outcomes among new drug-susceptible TB patients registered for treatment before and after the introduction of incentives (such as cash, vouchers for food, and support for transportation). The researchers found that the incentives significantly improved treatment outcomes, prompting the National TB Control Programme to mobilize financial resources from the national budget and The Global Fund to finance incentives for TB patients.
“The Union and TDR have collaborated since 2012 – first in developing the SORT IT model and then scaling it up across the globe,” said Dr Ajay Kumar, Director of the Department of Research at The Union. “This has been a hugely productive model, with several alumni now leading these courses in their countries. This augurs well for the sustainability of the model.”
For more information, contact Makiko Kitamura.