Historic UN TB declaration ‘falls short’ say activists

A paediatric TB patient. (Credit: The Global Fund to Fight AIDS, TB and Malaria)

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 United Nations (UN) member states “falls short on its response to the leading infectious killer worldwide and the leading cause of death for people with HIV”.

The statement was released ahead of the first-ever UN high-level meeting on TB in New York, which will see heads of state and political leaders commit to intensify efforts in tackling the disease.

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

According to the international non-profit organisation, the Foundation for Innovative New Diagnostics (FIND) up to 60 percent 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 told Health-e News 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 told Health-e News last year that a different TB LAM test, which costs just R 40, 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.

TB vaccine

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.

On Tuesday promising primary clinical trial results for a candidate TB vaccine were published in the New England Journal of Medicine. 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.

Funding for research

Despite being preventable and curable, TB still killed around 1.6 million people in 2017.

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 $1.2 billion 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 said. – Health-e News

An edited version of this story was published by Health24.com


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