28 Oct 2013

More work to be done to combat TB in the Pacific

6:22 pm on 28 October 2013

Médecins Sans Frontières says more work in combating tuberculosis in the western Pacific is needed - the third most infected area behind Africa and South East Asia.

Its medical co-ordinator, Dr Jen Cohn, says cases in western Pacific nations account for one fifth of all cases found globally.

She says a recent breakthrough in diagnostic technology has allowed almost twice as many drug-resistant tuberculosis cases to be diagnosed in 2012 than in 2011 globally.

But, as she told Johnny Blades, there is a lot more that needs to be done.

JEN COHN: There has been a significant breakthrough in terms of TB diagnosis and that is due to a machine called GeneXpert. It diagnoses both TB and Rifampicin resistance which usually signals that a patient has multidrug-resistant tuberculosis. This new technology has really yielded a huge amount of improvement. But we're not there yet. In fact we're pretty far from where we need to be. And there's only so much this technology can do. It still requires electricity, it still needs some technical support, so it can't be decentralised very, very far down into much more rural areas or areas that don't have dependable electricity. So we're really in need, still, of an even better diagnostic test - one that we can decentralise further, one that requires less training for the operators. We also need something that will be more affordable so more countries can actually begin to utilise this technological breakthrough.

JOHNNY BLADES: Which countries are looking at these things in the Pacific, or which agencies?

JC: There are significant numbers of new countries who are beginning to scale up GeneXpert. The WHO is soon likely going to come out with revised guidelines on how to use GeneXpert. It may be first-line diagnostics, not only for people who are suspected of having drug-resistant TB, but in certain programmatic cases countries may choose to use it as the first-line test for all patients who have suspected TB.

JB: Yeah, right, right. And in the Pacific region, the public health systems in many of these places are cash-strapped and resource-strapped and so forth, but do you see many efforts underway to really ramp up the fight against drug-resistant TB?

JC: One of the things that we're very concerned about is that international donor funding may be waning for TB and in particular for MDR-TB. It's particularly concerning. The majority of international funding for tuberculosis comes from the global fund to fight HIV, TB and malaria. And that's true for TB, but it's even more true for multidrug-resistant TB. In total, about three quarters of international funding came from the Global Fund for TB, but unfortunately in 2013 the amount of donor funding was only $0.8 billion, so this is is a fairly small amount for an incredibly dangerous and deadly disease. So really we recommend that the Global Fund be fully funded during its next replenishment round, which is coming up in a month and a half, and we really need to see donors speak out, as well as recipients in implementer countries speak out to say that this needs to be a priory.