World Tuberculosis Day 2022: A longstanding threat, tuberculosis is once again in the crosshairs of medical innovation
March 24, 2022
According to the World Health Organization, 1.5 million people died from tuberculosis complications in 2020. On World Tuberculosis Day, we highlight some medical innovations that are tackling this centuries-old challenge.
World Tuberculosis Day is observed on March 24 to commemorate the day in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB) - once thought to be hereditary. In modern times, close to 10 million people contract TB annually.
Although TB had been endemic in urban populations since the 18th century, no pharmacological treatment existed until 1944, when streptomycin, an antibiotic, was discovered. Until that time, patients infected with TB were treated with various non-chemical treatments, with limited success. With the subsequent discovery of isoniazid in 1952 and rifamycins in 1957, tuberculosis became a curable disease.
Despite significant progress, the treatment regimen for TB remains burdensome, requiring drugs to be taken regularly for several months. The long duration of the treatment has caused adherence problems and the emergence of drug-resistant bacterial strains.
While new (and simpler) treatments for TB are needed, some important innovations have been achieved during the past decade.
Recent medical breakthroughs
One of these innovations is bedaquiline, an orally administered drug used to treat multidrug resistant tuberculosis (MDR TB). Previous injectable drugs had a range of side effects, including hearing loss. Before bedaquiline was approved in 2012, no new anti-tuberculosis drugs had been developed in 40 years. A study in South Africa, which accounts for more than 66% of global bedaquiline use, showed a 41% increase in treatment success and three-fold reduction in deaths.
Another recent innovation, GeneXpert, has revolutionized the diagnosis and management of mycobacterium tuberculosis infections. This new diagnostic tool detects both mycobacterium tuberculosis as well as resistance to rifampicin- a treatment of first call for tuberculosis.
In addition to innovation in health technologies, market-shaping strategies can increase the availability and access to existing innovations. One successful case of market-shaping interventions in tuberculosis has been the creation of a global market for quality-assured second-line tuberculosis drugs. So-called “second-line” drugs are used when more common “first-line” treatments fail. Since 2000, the Green Light Committee Initiative enables countries to purchase large volumes of high-quality, low-cost, second-line drugs at a discounted price. This strategy reduced the price of second-line drugs by up to 90%, and increased the population enrolled for treatment by a similar percentage.