MDR-TB scale up

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MDR-TB Scale-Up Initiative

Expand access to affordable quality MDR-TB treatment

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MDR-TB: An Intro

When people with drug-susceptible tuberculosis (TB) do not take their full treatment course, the tuberculosis bacilli become resistant to drugs, and the disease deteriorates into a difficult-to-treat form, known as multi-drug resistant tuberculosis (MDR-TB).  Most often it is the poor and most vulnerable populations that are affected by MDR-TB, because of issues in affordability and adherence.

Treating MDR-TB is a lengthy, expensive, and extremely challenging process. Patients must submit to an arduous daily regimen of pills and injections that carries many side effects and can last up to two years. But in reality, most of the estimated 630,000 annual prevalent cases of MDR-TB (2011) are not even diagnosed and the true impact of this disease burden remains hidden. Manufacturers are therefore reluctant to invest in better products.

Because demand is low, production for many MDR-TB medicines is on a “made-to-order” basis. This results in small production batch sizes, contributing to increased cost and long lead times.  The small market size limits competition. Hence, a second-line treatment regimen can cost more than US$ 2,400 while a first-line treatment regimen costs less than US$ 40.  The second-line TB drugs market is low-volume, high-price – a volatile combination. Price reductions for these medicines are dependent in part on countries ensuring that patients are put onto treatment and that treatment volumes are consolidated.

Please read the World Health Organization’s briefer on drug-resistant TB for more info.

MDR-TB Scale-Up Initiative

Through this project, UNITAID and its implementers are increasing the number of patients that have access to MDR-TB treatment to prevent the spread of MDR-TB. UNITAID’s market interventions aim to improve the price, number and quality of second-line TB medicines in order to increase the number of patients on treatment. It is also working to stabilize the market by increasing the number of manufacturers.

As part of UNITAID’s investment in MDR-TB treatment, the number of suppliers has gone up – from five in 2007 to 17 in 2011. Treatment delivery is on track according to the project country targets.

The second part of UNITAID’s MDR-TB response is the Strategic Rotating Stockpile for MDR-TB drugs. Please read our dedicated section on this project.