Millions still being diagnosed on obsolete TB instruments’

Johannesburg – According to the Start for TB 2020 report, millions of people are still being diagnosed and treated on the basis of outdated policies and the use of old instruments and approaches – affecting the TB response and achieving the UN’s TB targets agreed by heads of state in 2018.

The report reveals both progress and shortcomings in aligning national tuberculosis (TB) policies with the latest international recommendations. The STBP (Stop TB Partnership) report finds that significant policy gaps could undermine progress in the fight against one of the world’s leading infectious killers. And the situation exacerbated by the negative impact of the Covid-19 pandemic on people affected by TB.

In response to the Covid-19 pandemic, countries around the world have apparently adopted new laws and policies to prevent their spread, often at unprecedented speeds. However, in terms of TB policy, gaps are undermining progress against the best infectious killers in low- and middle-income countries. The new report calls on countries to urgently update their TB policies and recommendations as an important first step in ensuring the financing, scaling up and implementation of comprehensive TB responses.

“None of us want to be diagnosed and treated with things that are outdated and old. We all want access to the latest things, right? With Covid-19 things happen every day, so we have to get there with There There are also many resources online, because there was a large group of colleagues who developed these resources to see from this report, by region and by country, what kind of policy there is, what kind needs to be updated. “

“The report basically looked at the diagnosis of TB, treatment, preventative treatment as well as obtaining medication. In each of them there are things that are progressing very well, and you can see changes, but there are things that are not so good yet. is not and in the diagnosis, for example, it is surprising that 80% of the countries are after Rapid Molecular Diagnosis, “said Dr Lucica Ditiu, the executive director of Stop TB Partnership.

The report examines the national policies of 37 countries with a high burden of TB, and assesses the extent to which they are in line with the World Health Organization (WHO) guidelines and international recommendations. With an estimated 7.7 million people developing TB annually, these 37 surveying countries represent 77% of the global TB burden and 74% of the estimated burden of drug-resistant TB.

“It is not yet on a scale, but the policy is there in 80% of them – only six of the 37 countries say they are waiting for universal drug sensitivity tests to be available.” So a lot of people are still starting on medications that are not sure to work. The same for people with HIV, the diagnosis of TB can be done very simply and quickly using a test called lipoarabinomannan assay (LAM) from urine, which WHO has been recommending since 2015. “Five years later, we have a very small part of the countries that do not use this tool very easily,” said Dr Lucica Ditiu, executive director of Stop TB Partnership.

“As far as the treatment is concerned, it is very important that we have moved away from the injectables. In fact, everyone should now have access to oral treatment, especially for drug-resistant TB. We still have about 30% of the countries we surveyed that their injectable drug policy has not yet changed, so we are asking our partners for a change in this policy in such a way that by the World TB Day, which takes place in March 2021, all these countries will have their policies will change to exclude injectables as treatment for drug-resistant TB, ”said Ditiu.

According to Stop TB Partnership, TB prevention is finally recognized as a priority area in the fight against TB, after decades of neglect. Systematic screening for active TB, testing for latent TB infection among domestic contacts and provision of TB preventive treatment are now included in the national policies of all countries surveyed. Also, 81% of the countries surveyed, with more than 2.8 billion people, have policies that provide for a shorter scheme for preventive TB treatment. Of concern is the finding that almost half of the countries did not have policies on the provision of TB preventive treatment to domestic contacts of all age groups, although they were committed to achieving a specific UN goal by 2022. reach.

“We as people affected by TB believe that accountability should be strengthened and that it should be a priority if we are committed to ending TB. The report, if followed up, will be a critical tool “We are committed to using the findings and recommendations of the report along with our own recommendations to strengthen the national response to TB and to change the experiences of millions of people affected so that we can end TB by 2030,” he said. Maxime Lunga, a member of the Community Delegation Stop TB Partnership in the Democratic Republic of Congo.

According to Ditiu, Covid-19 has shown that the steps for obtaining medicine, diagnosis and treatment can be accelerated if necessary.

“Not only do you have to get the right medicine recommended, but you also have to make sure it is quality assured, wherever you buy these drugs. We have interviewed a large number of countries that still do not apply for pre-qualification. by WHO.It’s great that local manufacturers are used, but we need to ensure that the drugs taken are really of the right quality.

“The very important piece is this: we need to have the right policies in place. We have the right policies in place at international level – they need to be taken to the national level. From here, we need to make them accessible to all people in need. and it’s time for TB to work at the same speed as we see possible with Covid-19, but we never applied for TB, ‘said Ditiu.

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