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The Director’s Corner

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A milestone for the TB community: a message from José Luis Castro

Today (12 May), the World Health Organization announced new recommendations for a nine-month shortened treatment regimen for multi-drug resistant tuberculosis (MDR-TB) patients.  Years of research and clinical studies from The Union and its partners have proved fundamental in preparing an evidence base for this ground-breaking announcement.

The current recommended MDR-TB standard treatment used in most regions worldwide is an arduous 24-month regimen involving a large quantity of antibiotics, many with terrible side effects, including permanent hearing loss.  The treatment is burdensome for clinicians to administer and extremely difficult for patients to endure.

The shortened regimen reduces the previous standard treatment by 13 months.  That is phenomenal when you think how that translates to the impact on the resources of health care systems, the lives of patients who have jobs, families and other demands on their time.  It is huge when looked at within the environment of low- and middle-income countries that face so many other challenges on their often-depleted resources and infrastructure.  It is remarkable when viewed in the context of a patient’s suffering.

WHO’s ratification of the nine-month shortened treatment regimen marks a historic milestone for the tuberculosis (TB) community and I am proud that The Union and its partners have been at the forefront of the studies that have provided the evidence that has made this announcement possible today.  Those researchers working on the frontline have surmounted financial and logistical challenges to deliver a treatment regimen that will ultimately revolutionise how we care for patients in communities worldwide.

MDR-TB is a public health emergency. Annually, 480,000 people contract MDR-TB – and the number is rising.  So this moment is the start of the process – not the end.  The onus is on us all to ensure that access to correct treatments, both for patients and health care providers, increases exponentially.  That is why our on-going studies into even shorter regimens will continue.  Research and evidence is fundamental to beating this disease.

Equally important is the impact of often systemic failures in basic TB control which have been fundamental in creating the explosion of MDR-TB. The international TB community must advocate for investment in the expansion of quality basic services and preventative care on the frontline where it matters most.  Only then can we stop this disease in its tracks.

José Luis Castro
Executive Director
The Union