newsletter

VOL.39 / 2023.10.13

편집자 한마디!

국내외 결핵(TB)뉴스

STOP-TB한국사무국 소식

질병관리청 에 의하면, 매년 감소하던 결핵 환자 수가 증가폭은 크지 않지만12년 만에 증가세로 돌아설 조짐을 보이고 있다고 합니다. 주된 요인으로는 코로나19 사태 진정과 고령화로 인한 노인 인구 증가 등을 들 수 있습니다. 이러한 조짐은 선진국에서도 나타나고 있으며, UK Health Security Agency 에 따르면 영국의 결핵환자는 2022년 같은 기간에 비해 2023년 상반기에 7% 증가했다고 합니다. 결핵 발생률이 낮은 선진국에서 최근 몇 년간 결핵 퇴치를 향한 노력이 정체되어 나타난 결과라고 분석했습니다. 이를 답습하듯 국내에서도 내년도 결핵 예방을 위한 예산이 23년 대비 24.3%나 삭감되었다고 하니, 결핵 발생률을 2027년까지 20명 이하로 떨어뜨리는 것이 요원해진 듯하여 심히 우려스럽습니다.

The World Health Organization (WHO) Global TB Program is providing secretariat support to the TB vaccine accelerator council, which was recently established to facilitate the development, licensing and use of safe TB vaccines that are impactful in halting the TB epidemic. Civil society representatives with relevant expertise and experience are invited to respond to a call for expression of interest to be engaged in the leadership group of the Council. The deadline to apply is 18 October 2023. For full details about the call, click here

The Stop TB Partnership Working Group on New TB Vaccines (WGNV) released a newsletter with the latest updates related to the TB vaccine research and development. It features information about a new free online course on research and development of new TB tools (diagnsotics, drugs, and vaccines); an overview of the TB vaccine-related events held at the 78th United Nations General Assembly and the High-Level Meeting on TB; a summary of the TB vaccine-related activities at the upcoming Union World Conference on Lung Health to be held in Paris, France on 15-18 November 2023; important advocacy resources and an opportunity for action inviting people with TB and TB survivors to complete a global survey on Community Perspectives on New TB Diagnostics.

The World Health Organization (WHO) provided the latest logistical information regarding the upcoming UN High-Level Meeting on TB to be held on 22 September 2023 in New York City. It can be accessed here together with various advocacy materials.

The Global Fund to Fight AIDS, TB and Malaria announced a new collaboration with Danaher to reduce the price of Cepheid's Xpert® MTB/RIF Ultra diagnostic test cartridges for TB with 20% in low- and middle-income countries, from $9.98 to $7.97 per test, allowing to procure five million additional tests. Danaher stated it will provide the test cartridges at its own cost and will earn no profit from these sales. Advocates acknowledged the announcement but stressed that this 20% price reduction falls short of community and civil society demands for $5 TB tests and does not apply to Xpert MTB/XDR (used to diagnose the most severe forms of TB) or assays for other diseases (HIV, HCV, HPV, COVID-19, and Ebola). Advocates demanded as well that Danaher allow an independent third party to review the cost of production and validate the claim that $7.97 is truly 'at cost' pricing.

On 19 September 2023, the Stop TB Partnership launched its Coalition of leaders against TB initiative which is meant to lead global efforts to end TB at an event at United Nations Headquarters. The launch came at the start of the UN General Assembly high-level week. The Coalition will support high-level national engagement and accountability by the respective countries and regions as they strive to end TB by 2030. Leaders of the Coalition are expected to continue demonstrating their leadership on TB efforts while serving as regional and global champions in the movement to end TB by 2030.

The Stop TB Partnership's Global Drug Facility (GDF) announced new, reduced bedaquiline prices. The new prices are valid through December 2024 and present price reductions up to 55% compared to the previous price of US$289 for a 6-month treatment course of bedaquiline. In August, Médecins Sans Frontières, Partners In Health and Treatment Action Group sent an open letter to Johnson & Johnson requesting detailed responses to questions and concerns regarding the deal with GDF, announced on 13 July 2023, to supply generic bedaquiline to low- and middle-income countries that excludes South Africa, 10 Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, and Ukraine), and China.

The World Health Organization (WHO) released an operational handbook on TB infection prevention and control, providing practical advice to complement its evidence-based guidelines.

Data from the UK Health Security Agency indicated that cases of TB in England increased by 7% in the first half of 2023 compared to the same timeframe in 2022, with 2,408 notifications compared to 2,251 in the first 2 quarters of 2022. While England remains a low-incidence country for TB, progress towards elimination has stalled in recent years.

The European Centre for Disease Prevention and Control (ECDC) released a report providing an overview of the dynamics and geographical distribution of rifampicin-resistant- and multidrug-resistant Mycobacterium tuberculosis strains in the European Union/European Economic Area (EU/EEA), focussing on the strains isolated in 2020−2022, and comparing this with whole genome sequencing data collected in 2017−2019 as a part of an EU/EEA pilot project on TB molecular surveillance.

Unitaid's latest call for proposals is aimed at driving demand for new TB medicines and accelerating the introduction of improved drug-resistant TB treatment regimens alongside complementary interventions such as improved diagnostics and adherence support. This package of care is intended to ensure people living with TB can get the medicines they need as quickly as possible while safeguarding against further resistance. Find out more about this latest funding opportunity here.

The Bill & Melinda Gates Foundation announced a long-term commitment of $100 million to Unitaid to bring faster access to health products in low- and middle-income countries. This funding doubles the foundation's previous commitment and will support Unitaid's work to accelerate the introduction and delivery of new lifesaving solutions at equitable scale, including those necessary to advance the global efforts towards ending TB.

Johnson & Johnson is being investigated in South Africa for allegedly charging 'excessive' prices for a key TB drug, the country's antitrust regulator said on 15 September. The Competition Commission said it opened the investigation based on information that the companies 'may have engaged in exclusionary practices and excessive pricing' of the TB drug bedaquiline, which is sold under the brand name Sirturo.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) released a report with cumulative results through the end of 2022 in the responses to HIV, TB and malaria, revealing a remarkable acceleration of programmatic results after losses from the COVID-19 pandemic. However, multiple challenges, including climate change and conflict, as well as deepening inequalities and growing threats to human rights, have put the target to end AIDS, TB and malaria by 2030 increasingly at risk. The report can be accessed here

Kyrgyzstan, Ukraine, and Uzbekistan – participants in the LIFT-TB project – have updated their National TB Clinical Guidelines to endorse the all-oral, 6-month BPaL /M (bedaquiline + pretomanid + linezolid ± moxifloxacin) regimen(s) as the national standard for treating most patients with drug-resistant TB (DR-TB). As part of LIFT-TB project, Kyrgyzstan, Ukraine and Uzbekistan each completed operational research of the BPaL regimen, where interim results for treatment success rates for DR-TB treated with BPaL ranged from 86% to 97%, in line with success rates observed in clinical trials and other countries in which operational research was conducted.

As international dignitaries and political leaders gather in New York City this week for the UN High-Level Meeting (HLM) on TB, a sobering new analysis from Treatment Action Group (TAG) showed that governments failed to meet previous commitments to fund TB research. Although the UN General Assembly pledged to mobilize $2 billion annually for TB research and development (R&D) at the previous HLM on TB in 2018 — a promise that if honored would have amounted to $10 billion for TB R&D over the past five years — TAG found that only $4.7 billion has been invested.

As world leaders prepare to meet next week for the High-Level Meeting (HLM) on TB, Médecins Sans Frontières is calling on US-based corporations Johnson & Johnson and Cepheid to publicly announce in time for the HLM on 22 September that they will take action to increase access to the lifesaving TB drug bedaquiline and GeneXpert tests, respectively, for people who need them.

In 2017, Treatment Action Group (TAG) and partners introduced the 'fair share' funding targets for TB research calling for each country to spend at least 0.1% of its overall research and development (R&D) expenditures on TB R&D in order to meet global TB research funding goals. In August, TAG released an updated Information note providing details on the new 0.15% fair share funding targets for TB research, and the methodology and sources of data behind them.

Ahead of the High-Level Meeting on TB, Médecins Sans Frontières conducted a webinar on 8 September 2023 to provide information about the next phase of the Time for $5 Campaign, calling on the diagnostics company Cepheid and its parent corporation Danaher to reduce the price of the GeneXpert test cartridge to $5. Full webinar recording can be accessed here. A countdown campaign to the High-Level Meeting on TB is underway. The campaign communications package can be accessed here. Some additional materials are available here. See also John Green's video with a very special message for the targeted corporations.

Researchers examined ways in which existing tests to diagnose drug-resistant TB (DR-TB) could be improved, and also characterized the programmatic emergence (non-clinical trial patients) of bedaquiline resistance in high-risk patients. They emphasized the need to optimize established molecular DR-TB tests and development of new DR-TB tests to monitor resistance to new drugs like bedaquiline to curb the delayed diagnosis and ongoing transmission. Source: Stellenbosch University.

A webinar, co-hosted by Stop TB Canada and Results Canada, provided an overview of the research & development (R&D) landscape for TB, including an assessment of how global TB R&D investments compare to the financial need identified in the new Global Plan to End TB. Watch the webinar recording here.

Researchers found a way to tweak immune cells to better fight TB. In a study published in Science Advances, they identified the genetic signatures of TB-susceptible and TB-resistant white blood cells, called macrophages, and then tested the ability of different compounds to transform vulnerable cells into more resilient ones.

AN2 Therapeutics, Inc. announced that it has received a research grant from the Bill & Melinda Gates Foundation to discover novel, boron containing small molecules for the treatment of TB and malaria. Funding from the Gates Foundation will support the discovery of novel inhibitors of aminoacyl-tRNA synthetases using AN2's proprietary boron chemistry platform. Source: AN2 Therapeutics, Inc.

The rates of TB recurrence and mortality in people with HIV in Eastern Europe remain concerningly high and continue to be a clinical and public health challenge, according to a paper, published in AIDS. In the first study to report on long-term follow-up of TB/HIV co-infected patients in Eastern Europe, one in seven people had TB again and over half died.

In a study published in The Lancet Microbe, researchers evaluated the diagnostic accuracy of upper respiratory tract samples for active pulmonary TB compared to standard sputum or gastric aspirate testing.

As the High-Level Meeting on TB approaches, a new report from the Lancet Commission on TB released recommendations, providing a path forward to turn the tide on this preventable, treatable and curable disease.

An editorial, published in the International Journal of Tuberculosis and Lung Disease, elaborated on the need to advance child-friendly medications to treat pediatric drug-resistant TB.

A comment, published in The Lancet Microbe, laid out key steps for expanding access to TB diagnostics to support the implementation of shorter, safer TB regimens demanded by the 1/4/6x24 Campaign.

Researchers found that a higher dose of rifampicin given for a shortened treatment time of four months, compared to the standard six months, was safe with no increase in side effects or toxicities.

Mass screening is more effective than passive detection for identifying TB infection in older adults, primarily due to higher detection rates among asymptomatic individuals and those with limited health care access. These study results were published in Clinical Infectious Diseases.

The International Union Against Tuberculosis and Lung Disease released the October 2023 issue of the International Journal of Tuberculosis and Lung Disease (IJTLD). It includes TB-related research publications.

The International Union Against Tuberculosis and Lung Disease released the September 2023 issue of the International Journal of Tuberculosis and Lung Disease (IJTLD). It includes TB-related research publications.

RESIST-TB released its September 2023 newsletter with the latest updates and research publications on drug-resistant TB.