Unitaid welcomes new data in the World Health Organization’s new global report on tuberculosis (TB) which shows a 30 percent increase in case detection of multi-drug resistant TB (MDR-TB) in 2013, much of which is attributed to the roll out of the Unitaid-funded EXPAND-TB and TBXpert projects.
Unitaid’s EXPAND-TB project enabled the installation of sophisticated testing platform technology in TB reference laboratories across 27 countries, bearing 40 percent of the MDR-TB burden. This provided the capability to detect MDR-TB for the first time for many countries.
The TBXpert project, launched in 2013, provided GeneXpert machines to 21 countries in the largest global scale up of the technology at the time. The technology reduces test result times from weeks to a few hours, including for drug-resistant strains and for HIV co-infected TB patients, enabling patients to be put immediately on treatment. The project signalled to other funders that such technology was both viable and essential in low resource settings to make significant strides in detecting cases.
Moreover, together with the Bill and Melinda Gates Foundation, PEPFAR and USAID, Unitaid negotiated a 40 percent global price reduction for the GeneXpert machine’s test cartridges for 145 countries. This has enabled all major funders such as the Global Fund and national programmes to benefit from the more affordable price indefinitely and has saved over $50 million so far for purchasers including Brazil and South Africa. WHO reports that as of June 2014, the technology is already in use by 108 countries with cartridge orders now reaching over a million per quarter.
“With $8 billion as the WHO’s estimated annual global need to tackle the disease, and an annual funding gap of nearly $2 billion, the introduction of ever-more effective diagnostic tools and medicines at affordable prices continues to be vital for the available funding to detect as many cases and successfully treat as many people as possible” said Lelio Marmora, Executive Director of Unitaid.
With an increase in diagnostics and monitoring, the WHO report highlights how more patients in need of treatment are being found, including for MDR-TB. Unitaid is already striving to scale up access to new world-class MDR-TB regimens that are less arduous and of shorter duration making it easier for patients to complete their courses and for the disease to be treated. These new medicines are estimated to drive a tenfold decrease in new infections. Unitaid also provides emergency access to MDR-TB medicines for all countries at risk through its Strategic Rotating Stockpile, essential to avoid treatment interruptions.
However, Unitaid’s analysis shows how, overall, the market for MDR-TB treatment is small and fragmented with up to 40 different regimens, posing a variety of difficulties and inefficiencies for access to MDR-TB treatment. Unitaid therefore continually works to improve this patchy and unpredictable market by exploring new ways for demand forecasting, treatment simplification, production stabilization, and improved purchaser coordination.
