Short-course Treatment for Multidrug Resistant Tuberculosis Improves Treatment Success Rates by 88%: The need to scale up access to treatment

Abel Nkolo

Abel Nkolo, MSH’s Principal TB Technical Advisor for African Region, advocates for an improved global response to MDR-TB.

Every year, the Union World Conference on Lung Health brings together TB experts and organizations from around the world to share their achievements, challenges, innovations, and research related to tuberculosis (TB). This year, I was keen to learn what new information was available regarding multidrug resistant TB (MDR-TB), as this illness requires treatment with long and expensive drug regimes, making it difficult to control. Since nearly ten percent of the world’s TB-patients are already infected with MDR-TB, effective treatment is needed to keep this disease from spreading and potentially reversing decades of progress in TB control.

As Management Sciences for Health (MSH)’s Principal TB Technical Advisor in Africa, I interact daily with patients who are suffering from MDR-TB and unable to access treatment. I also see MDR-TB patients whose treatment has plagued them with severe side effects, including nausea and vomiting, joint pains, burning sensations, and hearing loss. Many of these patients default from the lengthy MDR-TB treatment course that requires them to take up to 20 pills each day for nearly two years.

In response to the devastating impact of MDR-TB, health professionals must advocate for improved MDR-TB care and prevention. These advocacy efforts could involve persuading donors and key stakeholders to fund and support shorter MDR-TB treatment regimens. As I learned at the Union Conference, one of these short-course treatment regimens currently being used in Bangladesh has reduced patient treatment time from over two years to just nine months. My colleagues’ presentation showed how this nine-month regime improved the MDR-TB treatment success rates by 88 percent among 206 patients. Today, others have followed suit and are implementing similar short course regimes in Cameroon, Benin, Central African Republic, DR Congo, Niger, and Swaziland.

The positive impact of these interventions cannot be ignored. The more countries we provide with these drugs and the more TB programs we help to roll out short course treatment, the more MDR-TB patients will be cured and prevalence rates will drop. Alternatively, the fewer resources we devote to treatment and the less attention we pay to these patients’ needs, the more MDR-TB will spread, mutate, and escalate as a public health crisis.

As a global health leader, MSH is advocating for an urgent response to the complex and threatening reality of MDR-TB. Through these efforts, we are targeting the nations in which we work and increasing awareness through national platforms, such as the upcoming World TB Day on March 24, 2014. We believe that, with timely action and realistic solutions, such as short-course treatment, MDR-TB can be controlled and eradicated.