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Combatting Tuberculosis and Antimicrobial Resistance

Combatting Tuberculosis and Antimicrobial Resistance

By Adrian Thomas, M.D., Vice President, Global Market Access, Global Commercial Strategy Operations and Global Public Health.

The 68th Annual World Health Assembly, is currently taking place in Geneva. The Assembly, attended by delegations from all WHO Member States is the decision-making body of the World Health Organization (WHO) and focuses on a specific health agenda prepared by the Executive Board. A large part of this year’s agenda will be on addressing the pressing need for countries to increase efforts in overcoming antimicrobial resistance (AMR), which, as cited by the WHO, is now a major threat to public health .

Multidrug-resistant tuberculosis (MDR-TB) is one example of AMR, and this resistant bacteria, when left untreated, threatens the effective prevention and treatment of tuberculosis (TB), making TB more difficult and potentially impossible to treat. The World Health Assembly will also be dedicating a session on monitoring the achievements of the health-related Millennium Development Goals, set in 2000, parts of which focus on the global burden of TB and MDR-TB. TB cases have been declining over the past 13 years at an average rate of 1.5 percent per year. However, only half of the six WHO Regions have met or are on track to meet all of the targets (incidence, prevalence and mortality) set for this year to reduce their TB burden . Today, globally, TB is the second most deadly single infectious disease following HIV/AIDS . MDR-TB, along with other transmissible diseases, represents a major threat to global health security that needs to be addressed with urgency. With approximately nine million new cases of TB, and about 480 000 cases of MDR-TB in the world in 2013, the global TB burden is still very high and global meetings like the World Health Assembly bring us a step closer to forming collaborative approaches to ending the fight against this entirely preventable communicative disease.

At Janssen, we are committed to addressing the growing threat that AMR brings, particularly as it closely relates to our work around TB. In 2013 alone, MDR-TB claimed the lives of an estimated 210,000 people. As detailed in the UK All Party Parliamentary Group on Global TB (APPG TB) report , by 2050, MDR-TB could cost the global economy a cumulative $16.7 trillion, equal to the EU’s total annual output, and claim the lives of up to 75 million people. Part of the challenge is that MDR-TB is fast becoming resistant to the anti-TB drug regimens most commonly prescribed. We are dedicated to creating and implementing innovative strategies aimed at improving access to novel TB treatments and fostering collaboration with key global health partners worldwide.

It is in this vein that we are encouraged by the focus that AMR and TB will receive at the World Health Assembly following on from the First Eastern Partnership Ministerial Conference on “Tuberculosis and its Multi-drug Resistance” hosted by the Latvian Presidency of the Council of the European Union (EU) back in March. This earlier conference, organized in partnership with the WHO, the Stop TB Partnership, the Global Fund, the European Commission (EC) and the European Centre for Disease Prevention and Control (ECDC) welcomed leading government officials, health representatives from national and international organizations, academics, key research and healthcare professionals (HCPs) and various patient groups and TB activists. The ultimate objective of the conference was to derive a strategy to bring an end to TB by 2050. With more than 460,000 people infected and more than 38,000 dead as a result of TB in the WHO European Region , we are facing a major public health concern. At the Conference, delegates dedicated to combat TB by adopting the joint Riga Declaration, a policy document proposing an “End TB Strategy.” The Declaration targets a 75 percent reduction in the number of TB deaths and a 50 percent reduction in TB incidences by 2025 and aims to eradicate the disease from the continent fully by 2050.

Throughout my career, I have advocated for working in partnership with key stakeholders in the R&D, as well as patient advocacy space, and I truly believe that a cross-sectorial approach is key to maximizing outcomes. I am therefore delighted to see that the newly adopted Declaration sets out to strengthen collaboration and patient-centred approaches to TB prevention and cure. It is also encouraging to see emphasis on future investment in the development of novel therapies against TB/MDR-TB also prioritized on the discussion agenda. Increased investment in therapies, including TB antibiotics, means that more options will be available for communities where limited options existed previously.

Europe is home to 15 of the 27 countries the WHO considers as high-burden. At Janssen, recognizing the burden Eastern Europe faces, we are committed beyond our medication to educate vulnerable communities, HCPs and the general public living in high-burden countries about TB and its impact. We are collaborating with the Economist Intelligence Unit (EIU) to develop three reports focusing on the TB/MDR-TB landscape in Romania, Poland and the Baltic countries, Estonia, Latvia and Lithuania. These reports aim to raise awareness of TB/MDR-TB in the countries and at a European level, in order to explore ways in which innovation can be applied to healthcare policy. We aim to engage local policy makers, key organizations, governments, NGOs and patient groups to work collaboratively in meeting our common goal of eradicating TB from the continent by 2050. Additionally, our recent partnership with the United States Agency for International Development (USAID) aims to step up the global fight against the health threat of antibiotic-resistant bacteria. As part of the collaboration, we are contributing an estimated $30 million worth of TB-antibiotics, totalling 30,000 courses of the anti-TB drug, to countries with a high-burden of MDR-TB across the world.

Through well-coordinated action from all stakeholders, these and similar initiatives, aim to help educate and address AMR and more particularly TB/MDR-TB as the cross-border health threats that affect so many of the world’s most vulnerable communities. I look forward to the outcomes of the World Health Assembly discussions this week to further address this important cause in the fight against MDR-TB and other forms of AMR.