By Patience Saduwa
The efforts to prevent the emergence of new TB cases worldwide as a way of ending the TB scourge received a boost recently at the just concluded 50th Union World Conference on Lung Health held in Hyderabad, India.
This important breakthrough in the centuries-old fight against tuberculosis came as a result of a partnership between Sanofi, Unitaid and the Global Fund who announced a two thirds reduction in Rifampentine (Priftin), a critically important drug used to prevent tuberculosis (TB).
The agreement with Sanofi brings rifapentine (Priftin) 150mg tablets down from €13.60/pack of 24 tablets to a price of €4.62/pack of 24 tablets, a 66 percent discount. The discounted price, it was announced, will be available to the public sectors of low-income countries, lower-middle income countries, and upper-middle-income countries with a high burden of TB and TB-HIV.
Speaking on the development, Jose Luis Castro, Executive Director of The Union, noted: “If we are to end the TB emergency, we need a prevention revolution. It is indeed timely that we are seeing such promising movement on all facets of prevention – vaccines, drug prices and new drugs – now we need to ensure that going forward, preventing wherever we treat becomes the new normal.”
Meanwhile, results from a TB vaccine study, presented at the TBScience 2019 as part of the Union Conference, showed a sustained level of protection against active tuberculosis (TB) and a positive step towards ending the TB emergency.
The vaccine, known as M72/AS01E and developed by GlaxoSmithKline (GSK), contributed to preventing TB in 50 percent of people receiving it, representing a significant advancement towards ending the TB emergency. This would be the first new vaccine for preventing TB – the leading cause of death by infectious disease – in nearly a century. The only vaccine against TB currently available is BCG, which was developed in 1921 and does not provide proven and consistent protection in adults in TB-endemic countries.
Dr Paula I Fujiwara, Scientific Director of The Union said: “We are one more cautious, but exciting, step closer to a vaccine for TB.
“A vaccine is the ultimate prevention tool and the announcement today is welcome news, but as researchers discuss how to move the trial into its final phase, we simultaneously need to be doing all we can to prevent TB with medications that we already have at our disposal.
“TB is a disease that is preventable, treatable and curable, yet last year it killed 1.5 million people, more than HIV/AIDS. We cannot end the TB emergency unless we dramatically scale up prevention in those parts of the world where we are treating it. The cost of inaction is more unnecessary suffering and death”, said Dr Fujiwara.
The Phase 2b randomised, double-blind, placebo-controlled study was conducted at 11 sites in Kenya, South Africa and Zambia, in TB endemic regions. Final analysis, conducted after 36 months of follow-up, was published in the New England Journal of Medicine and presented at TBScience 2019, as part of the 50th Union World Conference on Lung Health. Now GSK will work with partners to build an end-to-end model to further develop the candidate vaccine ensuring it is progressed diligently.
Also at the press conference, the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health (NIH), reported that they had awarded US $30 million in first-year funding to establish new centres for immunology research to accelerate progress in TB vaccine development. Three institutions had been awarded the new contracts, which establish and provide up to seven years of support to determine the immune
At the first plenary of the Conference, entitled: ‘Ending the Emergency’, the panel looked to life after tuberculosis (TB), and called for more focus on the health and wellbeing of people after they are cured.
Dr Stellah Mpagama, of the Kibong’oto Infectious Disease Hospital, Tanzania, presented on ‘Optimising treatment to maximise health and wellbeing after TB’, pointing to evidence that the prevalence of depression in people with TB is three times higher than is seen with other diseases. Little is known about the burden of mental illness in post-TB patients, and Dr Mpagama emphasised the importance of understanding this burden, as an area for which new science is needed to guide action and mental health management strategies.
Speaking on her experiences as a patient with extensively drug-resistant TB (XDR-TB), 19 year old Manasi Khade from Mumbai, noted that she was heartbroken to receive the news and she experienced poor mental health during her period of home isolation. Manasi looked forward to getting back to normal life after she finished her treatment – but people continued to treat her as though she was sick long after she was cured, and even family members stopped visiting her.
“It has been almost two years that I’ve been cured – still I face this stigma,” she lamented.
Dr Jason Andrews of the University of Stanford also presented at the plenary, on Addressing the latent TB infection reservoir, examining methods to effectively target high risk individuals with TB infection for preventive
TB therapy – in the wake of the UN High-Level Meeting on TB in which commitments were made to provide preventive therapy to 30 million people over five years.
During the plenary, the Princess Chichibu Global Memorial TB Award was presented to Dr Amina Jindani of the University of London by Dr Kosuke Okada of the Japanese Anti-Tuberculosis Association. Dr Jindani received the award for her outstanding contribution to global TB control and prevention, and said: “We have a long way to go, but I’m still on the case.”
The Union World Conference is the world’s largest gathering of clinicians, policy makers, public health managers, researchers and advocates working to end the suffering caused by lung disease, with a focus specifically on the challenges faced by low- and middle-income countries. Some 3,500 delegates from over 80 countries attended the event held between 30th October to 2nd November in Hyderabad, India and which was inaugurated by the
Honourable Vice-President of India, Shri M Venkaiah Naidu, at the opening ceremony. Film and television actress Claire Forlani ambassador for The Union, Dr Ren Minghui, Assistant Director-General at the World Health Organization, senior representatives of the State of Telangana, and Nandita Venkatesan, a TB survivor also addressed delegates at the ceremony.
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