Tuberculosis

Multidrug-resistant tuberculosis (MDR-TB) is on the rise worldwide and kills around 120,000 each year. The treatment of MDR-TB is very time-consuming and has prohibitively negative side effects. Many patients have difficulties remaining in treatment for up to two years and must at the same time endure the social stigma that comes with being infected by the deadly disease.

“I understand what other patients are going through because, after all, I am also a patient. I take a minimum of 15 pills each day just to fight against drug-resistant TB."

MSF doctor Hermann Reuter works in a tuberculosis (TB) project in a rural district of Swaziland called Shiselweni.

Swaziland in Southern Africa is on the brink of a major health crisis due to the killer twin epidemic of HIV-AIDS and TB.

Nikiwe, 30 years old, was diagnosed in early 2009 with drug-resistant tuberculosis (TB). Here, he talks about the daily struggle of being infected and the shame he feels living with his illness in a fearful community.

Stockholm, October 21, 2009 – The largest European countries are lagging far behind the United States in funding of tuberculosis (TB) research and development. As such they bear a responsibility for the painfully slow progress in finding new TB tests and treatments, according to a report released today by the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF). The report shows that all European countries in the analysis—with the exception of Sweden-- have failed to prioritize TB and are contributing to huge global underfunding at a time when 1.7 million people die every year from the disease.

Doctors Without Borders/Médecins Sans Frontières (MSF) is starting the process of gradually handing over its tuberculosis (TB) program in Chechnya.

Doctors Without Borders/Médecins Sans Frontières (MSF) has announced the closure of HIV/AIDS-treatment projects in Transnistria, a breakaway region of Moldova unrecognized by the international community.

On World TB Day this year, MSF focusses on the urgent need for TB tests to deliver faster and accurate results, for all patients, even in the remotest settings. Patients from Kenya, India and Georgia tell their stories of how TB tests today are failing them.

On March 17-18, 2009, MSF brought together a number of doctors, lab workers, community activists and test developers to answer this question. MSF Access Campaign Director Dr. Tido von Schoen-Angerer talks us through what is needed in a new TB test and explains why we can’t settle for anything less.

Amsterdam/Chisinau, February 24, 2009 — Today, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) called on the Moldovan and Transnistrian authorities as well as the international donor community to pay more attention to the health needs of the population of Transnistria.

After attempting for almost two years to reach an agreement with China’s tuberculosis (TB) control program, MSF has given up on its efforts to start a project in Inner-Mongolia for assisting people suffering from multi-drug resistant tuberculosis (MDR-TB).

In Zugdidi, Georgia, nine patients suffering from resistant forms of tuberculosis (TB) have completed their treatment after two years of adhering to a daily drug regimen. Jocelyne Madrilène, MSF head of mission in Zugdidi, explains why these recoveries are satisfying for the patients and the entire medical staff.

Every year, tuberculosis (TB) kills about 1.7 million people and 9 million develop active disease. TB is on the rise in countries with high HIV rates, particularly in southern Africa, which has the highest rates of HIV. Tuberculosis is one of the leading causes of death for people living with HIV/AIDS, and in the past 15 years, new TB cases have tripled in countries with high HIV prevalence. People living with HIV/AIDS are up to 50 times more likely to develop active TB in a given year compared with HIV-negative individuals, and roughly a third of the 33 million people living with HIV/AIDS worldwide are infected with latent TB. Yet, in 2006 less than one percent of people living with HIV/AIDS were screened for TB.

Every day the medical teams of Médecins Sans Frontières come up against the obstacle of inadequate or ineffective tools needed to treat, detect or prevent disease – especially those diseases that predominantly occur in poor countries, such as tuberculosis, malaria or other neglected infectious diseases.

In Tbilisi, the capital of Georgia, and Gori, Doctors Without Borders/Médecins Sans Frontières (MSF) program manager Filipe Ribero has conducted several evaluations at sites where displaced persons are living. In the field, Ribero reports, there is a sharp contrast between a massive influx of international aid and the limited opportunities—for now—to provide assistance.

Dr Eric Goemaere, medical co-ordinator for MSF in South Africa, discusses diagnosing and managing HIV-TB co-infection.

Dr. Peter Saranchuk was the medical coordinator at MSF’s HIV/AIDS project in Lesotho. Here, he explains the reasons behind the dangerous relationship between TB and HIV.

Dr. Francis Varaine is coordinator of MSF’s tuberculosis working group. In this interview, he underlines the urgency of identifying new diagnostic means and treatments suited to MSF’s operating environment. He also discusses MSF's priorities for 2008.

New York, December 20, 2007 — People struggling to survive violence, forced displacement, and disease in the Central African Republic (CAR), Somalia, Sri Lanka, and elsewhere often went underreported in the news this year and much of the past decade, according to the 10th annual list of the “Top Ten” Most Underreported Humanitarian Stories, released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).

Johannesburg, November 6, 2007 — Drug developers can speed up the development of urgently needed new tuberculosis drugs by adopting a different strategy, the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) joins international experts in stating today. According to a report published today in the open-source medical journal PLoS Medicine, mimicking the approach used to test AIDS drugs would accelerate the research process, and get drugs to patients who most need them, faster.

For many patients in the joint MSF and Ministry of Health program in Armenia, MDR-TB treatment is often a complex issue. Treatment takes up to 24 months, and the patient needs to be admitted to hospital for the first several months for close clinical supervision. Following discharge, they have to continue daily medication for another 18 to 21 months via ambulatory or home-based care. This long and constraining treatment leaves many patients with the dilemma of whether or not to quit work and leave home for several months.

Doctors Without Borders/Médecins Sans Frontières (MSF) and the Ministry of Health opened Armenia's first and only treatment program for multi-drug resistant tuberculosis (MDR-TB) in the capital city Yerevan in September 2005, and the first MSF patient, N.L., has just completed treatment lasting almost two years.

MSF began treating MDR-TB in Kenya in May of 2006. With four patients enrolled at "Blue House" and three on the shores of Lake Victoria in a town called Homa Bay, MSF remains the only provider of MDR-TB treatment in the country today. Around Nairobi alone, it is estimated there are about 50 cases, but there is no capacity to absorb them.

In Karakalpakstan, a semi-autonomous region of Uzbekistan, MSF has been running a project treating multidrug-resistant tuberculosis (MDR-TB) since 2003. MDR-TB is a debilitating disease and requires lengthy treatment with a complex combination of toxic drugs, which often have appalling side effects.

New York, March 22, 2007 – The international medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) today released statistics showing that even under optimized conditions, treatment will succeed in barely more than half of patients with multi-drug resistant (MDR) Tuberculosis (TB). As insufficient research and development on new drugs and diagnostics has left health staff without the right tools to treat the disease, some patients will go on to develop extensively drug-resistant (XDR) TB regardless of the quality of care they are offered. The situation is particularly alarming when treating people co-infected with TB and HIV.

New York, January 12, 2007— Proposals to accelerate the development of tuberculosis (TB) drugs were outlined today at the conclusion of a two-day symposium titled "No Time to Wait," convened in New York this week by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontires (MSF) with the support of Howard P. Milstein and Weill Cornell Medical College's Abby and Howard P. Milstein Program in Chemical Biology. The symposium brought together more than 100 TB specialists, drug developers and regulators, policy makers, donors and activists to outline practical proposals to fill the gaps in TB drug research and development (R&D).

New York, January 9, 2007 — The staggering human toll taken by tuberculosis and malnutrition as well as the devastation caused by wars in the Central African Republic (CAR), Sri Lanka, and Democratic Republic of Congo (DRC), are among the "Top Ten" Most Underreported Humanitarian Stories of 2006, according to the year-end list released today by the international humanitarian medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF). The ninth annual list also highlights the lack of media attention paid to the plight of people affected by the consequences of conflict in Haiti, Somalia, Colombia, Chechnya, and central India.

New York/Paris/Geneva, October 30, 2006 — Relying on the standard World Health Organization (WHO) TB strategies in the face of extensively drug resistant tuberculosis (XDR TB) will be fatal, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today. To respond to the XDR-TB outbreak, WHO will need to get newer drugs to patients as soon as possible by ensuring accelerated development of new drugs already in clinical trials. Existing TB drugs and diagnostics are not adequate to combat the disease, and a new analysis being released by MSF as the 37th Union World Conference on Lung Health begins this week in Paris shows that none of the TB drugs currently in development, however promising, will be able to drastically improve TB treatment in the near future. WHO must take the lead in ensuring there is major reprioritisation and increased funding of TB research.

With approximately 9 million people developing active tuberculosis (TB) every year and 1.7 million deaths annually, TB is far from under control. Human immunodeficiency virus (HIV) infection dramatically increases the risk of developing active tuberculosis and is driving the TB epidemic in Africa.

With tuberculosis (TB) killing 1.7 million people and newly infecting nine million each year, this curable disease is far from being curbed. The HIV/AIDS pandemic exacerbates TB's scourge through co-infection, as does the increasing emergence of drug-resistant TB. The standard TB treatment available today is long and complex. It relies on drugs developed over forty years ago and takes six months for patients to complete, and the last four decades have brought nothing in the way of improvement.

It is Brazilian nurse Gabriela Adao's fourth mission with MSF. At Island Hospital, Gabriela is developing alternative adherence tools to make sure that tuberculosis (TB) patients actually take their drugs properly, and ultimately recover.

Adrien Marteau is a doctor in the MSF tuberculosis (TB) treatment program at Gluprish Hospital in Abkhazia, located within the borders of Georgia in the Caucasus region. He shares his frustrations as a doctor treating drug-resistant forms of this illness.

MSF has supported the local branch of the national TB program in Abkhazia since 1996. Since 2001, the program has included treatment for multidrug-resistant TB (MDR-TB), one of the most frightening health scourges of former Soviet countries.

Each year, TB silently kills about two million people, almost exclusively in developing countries. Among the anonymous victims of the disease, children are literally excluded from international efforts against TB, even though they represent more than 20 percent of the affected population.

Head of MSF's tuberculosis unit, Dr. Francis Varaine, describes the difficulties involved in treating a disease that kills two million people each year. Current methods for diagnosing and treating the disease are outdated and not fully adapted to children, people co-infected with HIV, or those with multidrug-resistant forms of the disease.

The very costly and complex treatment for multidrug-resistant tuberculosis is only accessible to a very small minority among the millions of people affected by the disease worldwide.

"The Afar nomads were neither receiving quality TB treatment in the local health system, nor were they welcomed there, as they are a marginalized group with a different language and culture," says Dr. John Pratt, a Welsh general practitioner working at the Galaha TB center.

By Martha Bedelu

Geneva/New York, Tuesday March 22, 2005 – Without a simple, rapid test for detecting tuberculosis (TB), care providers in developing countries will continue to miss about half of all the people who need tuberculosis treatment. Efforts to control TB globally will be undermined, said the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).

Doctors Without Borders/Médecins Sans Frontières (MSF) has been confronted with tuberculosis since its first day of operation more than 30 years ago. In the past few years, MSF has expanded TB treatment to include patients in a growing number of projects, and the focus has shifted from disease control to patient care.

Paris/New York, October 26, 2004 - On the eve of the 35th Union World Conference on Lung Health in Paris organized by the International Union Against Tuberculosis and Lung Disease (IUATLD), the humanitarian medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) warns that millions of individuals in developing countries continue to die from this curable disease and that a radical change is needed in the way TB is tackled globally.

New Delhi/New York, March 24, 2004 (World TB Day) - The international humanitarian medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) today said that we are losing the battle against tuberculosis (TB) because we rely on archaic diagnostic tests and drugs. The HIV/AIDS pandemic has magnified this problem as TB often coincides with, and is made harder to treat by, HIV/AIDS. MSF calls for an urgent increase in worldwide investment in TB research and development.

Transcript of Press Teleconference Hosted by the Global Alliance for TB Drug Development.

On the occasion of the second Board of Directors meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), scheduled to take place in New York City, April 23-24, 2002.