MOSCOW, October 19 (RIA Novosti) - Colleen Daniels, Director for TB and HIV at the US-based NGO Treatment Action Group, says that stagnating investment into the treatment of tuberculosis has resulted in a great deal of unnecessary suffering, and could lead to a serious epidemic in the future.
Posting an op-ed in the online science journal LiveScience.com, Daniels notes that funding for the development of new vaccines and therapy aimed at dealing with tuberculosis has declined by 31 percent since 2011, noting that private sector funding in particular has been declining.
Daniels notes that while the Treatment Action group estimated that $2 billion US in research and development funds is needed to end the global epidemic, only $676.6 million was spent worldwide in 2013, 45 percent of it by the US National Institute of Allergy and Infectious Diseases and the Bill & Melinda Gates Foundation alone.
Among private companies, Daniels pointed out that one company –Japan-based Otsuka Pharmaceutical Co., accounted for over 60 percent of the $99.6 million US in private sector funding of TB research in 2013, with pharmaceutical giants Pfizer, AstraZeneca and Novartis shutting down virtually all their antibiotic development projects recently.
She noted that the problem lies in the fact that “pharmaceutical companies...are all searching for the next blockbuster drug that will bring in billions of dollars –those companies do not see [TB] antibiotics as having a good return on investment.” According to the WTO, over 95% of TB deaths occur in low- and middle-income countries.
Daniels argues that the decline in TB research spending is not only unacceptable, but also nonsensical, in light of the fact that up to one third of the world’s population may have a latent TB infection, 8 million people receive an active infection each year, and 1.3 million die from the disease. She believes the lack of attention is all the more alarming in light of the fact that only an estimated 1 in 6 of the 450,000 drug resistant cases estimated by the World Health Organization in 2012 were being treated.
Daniels noted that the current diagnostics and treatment regimens are old and often inaccurate, and that the current treatment model leads to unnecessary side effects, from deafness to psychosis. She also pointed out that the present methods are effective in treating only half of all drug-resistant cases.
“The current R&D Model is broken and failing TB patients,” Daniels wrote.
The Treatment Action Group, which was created in 1991, is a US-based research and policy think tank that is involved in efforts to increase research to fight HIV and other infectious diseases, including tuberculosis and Hepatitis C.
A Serious Problem
Tuberculosis is an illness traditionally known for affecting the poor, whose adverse living conditions facilitate the pathology. At-risk groups traditionally include the homeless, people who are incarcerated, those with drug dependencies, and people with HIV and other illnesses which leave their immune systems weakened. The disease is usually spread through close and sustained contact with people who are infected. Due to its association with poverty and the fact that it is an airborne contagion, the disease has a stigma associated with it. Today the spread of the disease is complicated by globalization and an increase in the movement of people from place to place, which increases the risk that young, generally healthy people will contract the illness.
Russia’s Fight to Deal with the Illness
Tuberculosis exploded in Russia and the former Soviet Union in the 1990s following the region’s economic collapse, societal disorganization and the decline of health care systems. The countries of the former Soviet Union continue to have among the highest tuberculosis infection rates in Europe.
Russia alone was accountable for 130,000 of Europe’s total of 353,000 cases of TB infection in 2012; up to 20 percent of them suffered from strains which were resistant to antibiotics.
In her interview with Rossiya Segodnya earlier this month, Health Ministry Official Teresa Kasaeva said that Russia faces a number of issues in dealing with the illness, due to migration flows as well as the country’s size: “The global reach of Russia, its heterogeneous territory, and differences in its climate affect the epidemiological situation of tuberculosis. Whereas the central and southern regions have a situation similar to that in Europe, the Siberian and Far Eastern regions still suffer from high infection and mortality rates from TB.” Kasaeva noted that the Ministry of Health is paying “particular attention to such regions,” and that overall “the figures have fallen” in recent years.
After having undergone a financial and organizational revival in recent years, Russia has “made a significant breakthrough in recent years,” according to Kasaeva. She cited figures noting that “the spread of tuberculosis in 2013 has decreased by 7.5 percent in comparison to that of 2012 and by more than 18 percent in contrast with that of 2007.” She also noted that “the tuberculosis mortality rate in 2013 has dropped by 9.6 percent compared to 2012 and by 38.6 percent when compared to 2007.”
Concerning efforts to deal with drug-resistant strains of TB, Kasaeva noted that the Ministry has concentrated its efforts, using funds from Russia’s federal budget, to supply hospitals and regional TB dispensaries with new lab equipment for measuring, monitoring and treatment purposes, especially in remote regions. She noted that over $100 million US worth of additional funding was allocated by the federal budget in 2013 to supplement regional second-line treatment funding for patients with multi-
drug resistant TB.
Russia has joined the WHO Assembly’s Stop TB strategy, which is set to dramatically reduce the impact of the illness in the coming years, and to eliminate the disease entirely as a public health problem by 2050. The country has also shifted recently from being a recipient of aid from the WHO’s Global Fund to Fight HIV, Tuberculosis and Malaria to becoming a donor.
