Taking action together to tackle TB
A week is a long time in politics, so the saying goes. In that case, 135 years must be an eternity in healthcare.
On March 24, 1882, German physician Robert Koch presented a paper at a medical conference which confounded the scientific and medical communities. He presented a discovery proving that tuberculosis (TB) is caused by a bacillus (a type of bacteria) and is passed between humans, refuting the long-held assumption that it was a genetic disease. Professor Koch’s findings kick-started a revolution in the diagnosis and treatment of TB, leading to a significant decline in mortality rates and bringing hope to millions of patients and their families.
Fast forward to 2017 and despite more than a century of progress in the fight against TB, we are still a long way from defeating the disease. The most recent World Health Organization (WHO) data estimates there were 10.4 million TB cases in 2015, with 1.8 million people losing their lives to the disease, including 400,000 who were also living with HIV1.
The harsh realities behind these numbers confront many people in Asia Pacific every day. Our region has the highest number of people living with TB and, in 2015, approximately 800,000 patients died from the disease2 – close to half of the global total. This represents a terrible toll for families and communities, many of whom already face health and economic challenges.
At Janssen, we refuse to stand still while patients are waiting. TB is an important part of our research and innovation strategy and we are committed to playing our part in the effort to end TB, not least through the introduction and appropriate use of bedaquiline, a drug for TB with a novel mechanism of action, which was discovered and developed by Janssen scientists.
Thanks to smart collaborations between our teams globally and across Asia Pacific, and together with government and non-governmental organizations, we have seen significant progress in our effort to increase access to the medicine, but also strengthen awareness, diagnosis and care for patients across the region.
Patients with multidrug-resistant TB (MDR- TB) are benefitting from access to bedaquiline thanks to a partnership between Janssen and the United States Agency for International Development (USAID), which will see 30,000 treatment courses provided to eligible countries by early 2019. MDR-TB patients in Bangladesh, Indonesia, Myanmar, Papua New Guinea, the Philippines, Thailand and Vietnam were provided with access to bedaquiline through the program last year. In 2017 we anticipate the first patients in China will begin treatment through the country’s New Drug Introduction Program, which will see bedaquiline provided to patients in China free-of-charge through a controlled access program at Government-run hospitals in select cities.
Bedaquiline was also introduced in India via a Conditional Access Program in 2016. We are seeing progress there in enrollment and look forward to working with the government further as that program expands. Alongside our commitment to enabling optimum access to bedaquiline in India, we are also engaged with a number of community-level TB programs to improve disease awareness and diagnosis and provide nutritional support to patients.
One example of this is our awareness-raising partnerships in cities including Mumbai, Patna, Nagpur and Hyderabad, which have led to major awareness campaigns being rolled out on public transport vehicles, including trains, buses and auto-rickshaws; mass media, such as radio broadcast and in movie theatres; and in the community through street plays and health camps.
In Vietnam, our team is working with Friends for International Tuberculosis Relief, a German non-governmental office (NGO) that is committed to tackling TB in developing countries, to support community-based TB healthcare workers in the Go Vap district of Ho Chi Minh City to increase case detection and provide end-to-end care for patients and their families.
The Proper Care program has already seen impressive results, increasing treatment success rate from 85.2 percent to 88.4 percent and reducing loss to follow-up from 7.2 percent to 0.5 percent3. Based on these successes we have taken the program into two additional districts in the city and have been working with the Government to expand the program to 12 districts in three cities across the country.
Working in partnership with international non-profit PATH, we are also providing targeted support to tackle childhood TB in Vietnam’s Nghe An province, through the Breath for Life project.
By working with the local government and health care workers, we are strengthening prevention, detection, and treatment procedures for children, with a strong focus on identifying those who are in close contact with someone who has been diagnosed with TB, and improving services at the primary healthcare level. The sustainable model developed by Breath for Life is now seen as best practice for tackling childhood TB in the four project districts in Nghe An. Efforts are underway to engage other provinces and national decision-makers to roll out this approach across Vietnam.
These programs offer a snapshot of the tireless efforts of Janssen staff and our partners in Asia Pacific, working together in partnership to tackle the scourge of TB.
To commemorate Dr. Koch’s far reaching discovery, we again observe March 24 as
World TB Day. The day provides an opportunity for all those who are determined to end TB to recognize the successes of the past year but also to recommit to accelerating progress. One hundred thirty five years is truly an eternity in healthcare and we recognize that no one organization can change the course of history alone. With millions of people still being infected each year, much more needs to be done if we are to end TB.
Today we recommit ourselves to this critical work.
3Internal figures but approved for use by Global Public Health team