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[e-drug] World TB day 24 March and drugs

E-DRUG: World TB day 24 March and drugs
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dear E-druggers

Tomorrow is Global TB day. A good reason to review the drug related aspects.

The problem

Number of People who develop TB each day: 25,000

Tuberculosis (TB) is the leading cause of infectious death worldwide.
Despite a cure being available for over fifty years, TB kills more than 2
million people every year. Each day, nearly 25, 000 people develop active TB
and 5 000 die from their disease.

Number of people who will develop TB in 2005: 8,964,000

Without treatment, between 50% and 70% of people with infectious TB will
die. And the situation is getting worse: the number of cases is increasing
by 3% every year, largely because of the HIV/AIDS epidemic. It is estimated
that there will be 9 million new cases of TB in 2005.

"normal" TB

Prices of TB drugs have fallen dramatically over the last years: it now only
costs USD 10 (drugs only) to cure a TB patient. Countries and projects
approved by GDF can even get them free!  See the website of the Global Drug
Facility:
http://www.stoptb.org/GDF/drugsupply/Direct_procurement_process.html
The drugs available are at:
http://www.stoptb.org/GDF/drugsupply/drugs.available.html
The GDF procedure seems active and operational: some basic facts about GDF
at http://www.stoptb.org/GDF/whatis/facts_and_figures.html

MDR-TB

For MDR-TB, the situation is still grim. MDR-TB is still difficult to treat
(up to 2 years of treatment, cure rate max 60%), and costs remain relatively
high.

However, projects or countries can buy MDR-TB drugs at reduced prices
through the Green Light Committee (USD 500 - 1500 per treatment, depending
on the resistance pattern; compare this to USD 10-18,000 per treatment in
the rich countries private sector!). The strategy is called DOTS-PLUS:
http://www.who.int/gtb/policyrd/DOTSplus.htm

See a good review article on GLC at:
http://stoptb.org/Working_Groups/DOTS_Plus/GLC_Process_Nov02.pdf

For a database on MDR-TB research, see http://www.who.int/tb_search/en/

A procurement manual how to get MDR-TB drugs at lowest cost, see
http://www.who.int/gtb/publications/dotsplus/procurement/tb_2003_328.pdf

There is, however, not so much information as to how efficient the GLC
procedure is. How many patients are being treated with MDR-TB drugs through
the GLC-procedure?

E-drug welcomes more debate around TB drug issues!

Wilbert Bannenberg

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Wilbert Bannenberg, E-drug moderator
Email: wjb@planet.nl
Mobile +31-6-20873123
Tel +31-497-550713
Fax +31-497-550712

E-drug subscriptions/archives at http://www.essentialdrugs.org/edrug/

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