Political Leadership, Bi-Directional Screening, Saliva-Based Testing & More
TB in Tidbits News Scan
Credit where credit is due
In an op-ed piece for the New Indian Express, Stop TB Executive Director Lucica Ditiu praises India’s political leaders for prioritizing support for TB initiatives and gives them credit for their successes in recent years:
“India’s Prime Minister Narendra Modi has led this shift in political commitment to end TB. In March 2018, PM Modi made a firm commitment to end TB in India by 2025, five years ahead of global SDG (sustainable development goals) targets; and from that moment, there was no looking back at the progress in TB elimination efforts in India. His vision and ambition generated incredible efforts in India and served as an example and trigger for several other leaders, Heads of State and Governments from other countries.”
Ditiu goes on to applaud the Indian government’s efforts to integrate the perspectives of civil society organizations into project planning and notes the major gains India has made in the areas of diagnosis and screening, care delivery, and mortality.
Drug shortages undermining treatment efforts
Despite the political progress, the patient experience for many Indians remains challenging. Varsha Gowda has an illuminating writeup in the Deccan Herald on the horrendous predicament some Indian TB patients face as they try to work through their medication regimens amidst ongoing drug shortages.
For five months and twenty days, Kamala Devi* diligently took close to six pills, the prescribed fixed drug combination, determined to get rid of the spectre of tuberculosis from her life. The disease had caused considerable disruptions in her daily schedule, bearing an impact on her personal life and threatening her job as a custodian at a private hospital in Bagalkot.
The last week of treatment was pending when she returned to the Bagalkot General Hospital to get a refill of her prescription. “The pharmacist told me that the drug was out of stock. They asked me to come again next week. I have gone without the tablet for four days now,” she says. As a single mother and sole wage earner in her family of four, buying the medication out of pocket is out of the question.
Gowda notes that while previous shortages were tied to COVID-19 disruptions, the current stockouts were caused by procurement challenges. Looking ahead, she notes that TB activists argue that failure to swiftly restock pharmacies risks undercutting public faith in the government’s ambitious TB campaigns.
Tracking progress towards targets
Kaiser Family Foundation has shared an updated tracker showing the progress USAID TB countries have made towards TB targets. The tool also allows for tracking by several WHO and UNGA metrics.
In their annual report to Congress, published in January of this year, USAID flagged increased TB incidence rates as an area of concern.
“[E]stimated TB incidence increased by 3.4 percent in 2022 compared to 2021. This is 4.7 percent higher than the estimated incidence in 2019, representing a reversal of the downward trend sustained for many years until the onset of COVID-19 in 2020. The COVID-19 pandemic had negatively impacted access to TB diagnosis and treatment services, resulting in an increase in the number of people with undiagnosed and untreated TB and more community transmission, leading to an eventual increase in estimated TB incidence.
Overall program results, however, were still strong, with mortality figures down significantly in the 24 partner countries.
PATH finds success with TB & diabetes screening initiative in Myanmar
An innovative bi-directional screening effort is being implemented in Myanmar by PATH, as part of their ongoing PPIA-ISD campaign.
People with diabetes mellitus (DM) represent a vulnerable population at heightened risk of TB infection and complications. Recognizing this intersectionality, the PPIA-ISD project has integrated TB screening into routine DM care at participating health care facilities. PATH established a bi-directional approach which included (i) TB case finding among all patients with DM in the private sector through the PPIA-engaged providers; and (ii) screening for DM followed by referral linkage for all registered patients with TB who are over 40 years of age according to NTP’s guidelines.
This proactive approach not only facilitates early detection and treatment of TB among patients with DM, but also strengthens the continuum of care for both diseases. By addressing the dual burden of TB and DM through ISD, the project maximizes resources and improves health outcomes for this high-risk population.
The hope is that through the initiative, practitioners and health systems planners can make meaningful progress against both diseases.
Spit here, please
And in Denmark, a research team developing a new saliva-based screening test for tuberculosis has secured critical financial support.
Innovation Fund Denmark has announced a DKK 24.8 million grant to support research into creating and deploying the new tool. The effort is to be jointly led by Aarhus University researchers Christian Wejse and Birgitta Knudsen, alongside VPCIR Bioscience ApS.
The group hopes to create a lower-cost, scalable, and reliable alternative to current blood-based testing methods. In a LinkedIn post, the Aarhus University Health department noted the new technology would be initially piloted in Guinea Bisau.