FDCs the way to go
TB patients should ideally receive a six months fixed dose combination regimen at the cost of around US$26 per patient but in some countries this is not the case according to Falling Short: Ensuring Access to Simple, Safe and Effective First-Line Medicines for Tuberculosis. Quality-assured fixed dose combinations (FDC) reduce the number of drugs taken by patients and help improve their adherence to treatment.
However, in countries like China which accounts for 35 percent of the world’s TB population, fixed dose combinations are not widely used in the public health sector, the report said. In other parts of the world patients acquire their TB treatment from the private health care sector where they are prescribed single dose drugs. The report found that in half of the countries with a high burden of TB, treatment issued in the private sector was in the form of one drug.
Even in countries where FDCs were offered in the private health care sector lack of standardisation remained a problem. In India there are over 48 different dosages of FDCs offered in the private health care sector. Such situations show that even with FDCs serious regulations need to be enforced to ensure standardisation of FDCs, the report said.
Dr Nils Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease called the information a wakeup call to the TB community.
“All TB patients should have the right to consistent supplies of simple, quality-assured medicines when they need them. The world desperately needs to refocus on the most basic level of TB care or we risk returning to the time before antibiotics,” he said.
Once patients develop resistance to the standardised six months first line regimen they need to be put on a more intense and complex regimen lasting at least two years. This could cost between US$2,000 and US$9,000 per patient.
Even with access to FDCs patients continue to suffer due to stock out of important medicine in other countries.
Elizabeth Gardiner, Vice President of Market Access at the TB Alliance and a contributor to the report said: “Quality assurance, treatment formulations and stock-outs are all major issues, but issues that can often be resolved with relatively simple solutions. It will take renewed commitment and political will, but we cannot continue to gamble with the lives of TB patients.”
Speaking to journalists attending the journalist to journalist training workshop hosted by the National Press Foundation, Professor Lee Reichman, executive director of the New Jersey Medical School said drug resistant TB was a manmade disaster that could be averted by prescribing the correct treatment and putting in place proper infection control.
During the conference TB Alliance announced trials for treatment that could further reduce the duration of treatment for TB patients.