Multi-Drug Resistant Tuberculosis (TB) treatment a Global threat

The World Health Organisation (WHO) and the Global Fund to Fight AIDS, TB and Malaria says that strains of tuberculosis with resistance to multiple drugs could spread widely and highlight an annual need of at least $1.6 billion in international funding for treatment and prevention of the disease.

Dr. Margaret Chan, director-general of WHO, and Dr. Mark Dybul, executive director of the Global Fund, said that the only way to carry out the urgent work of identifying all new cases of tuberculosis, while simultaneously making progress against the most serious existing cases, will be to mobilize significant funding from domestic sources and international donors.

With the overwhelming majority of international funding for tuberculosis coming through the Global Fund, they said, it is imperative that efforts to raise money be effective this year. Growing alarm about the threat of multi-drug resistant TB, also known as MDR-TB, is making that even more pressing.

“We are treading water at a time when we desperately need to scale up our response to MDR-TB,” says Chan. “We have gained a lot of ground in TB control through international collaboration, but it can easily be lost if we do not act now.”

WHO and the Global Fund have identified an anticipated gap of $1.6 billion in annual international support for the fight against tuberculosis in 118 low- and middle-income countries on top of an estimated $3.2 billion that could be provided by the countries themselves.

Filling this gap could enable full treatment for 17 million TB and multidrug-resistant TB patients and save 6 million lives between 2014-2016.

“It is critical that we raise the funding that is urgently needed to control this disease,” says Dybul. “If we don’t act now, our costs could skyrocket. It is invest now or pay forever.”

Chan and Dybul spoke to the media in Geneva in advance of World TB Day on March 24, which commemorates the day in 1882 when Dr. Robert Koch discovered the mycobacterium that causes tuberculosis.

Read more on TB Research in the European Respiratory Journal

H1N1 Pandemic Flu and Ineffectiveness of Tamiflu

If the behaviour of the seasonal form of the H1N1 influenza virus is any indication, scientists say that chances are good that most strains of the pandemic H1N1 flu virus are resistant to Tamiflu, the main drug stockpiled for use against it.

Many researchers, including the Ohio State University, have traced the evolutionary history of the seasonal H1N1 influenza virus, which first infected humans during the 1918 pandemic. It is one of three seasonal influenza A viruses that commonly infect humans. The others are H1N2 and H3N2.

Within H1N1, two strains of virus circulate in humans: a seasonal form and the pandemic form of influenza known as swine flu, which has recently sickened millions and killed hundreds of people since it first emerged in North America last spring.

Over time and in line with normal virus behaviour, the H1N1 strain of seasonal influenza develops mutations that have caused it to become resistant to oseltamivir-based agents. Tamiflu is one of these oseltamivir phosphate.

It is a safe bet that whatever pressure is in the environment, excessive use of Tamiflu or something similar, driving seasonal influenza to become resistant to treatment, is also going to apply to pandemic influenza. It is happening already.

Tamiflu was never the long term solution nor was it as effective as it was claimed to be. The world awaits a more effective and better product to replace it.