MSF and TB activists protest at 50th Union World Conference on Lung Health

Médecins Sans Frontières (MSF) joined tuberculosis (TB) activists to disrupt the opening ceremony of the 50th Union World Conference on Lung Health in Hyderabad today, urging pharmaceutical corporations to make improved drug-resistant TB (DR-TB) treatment affordable and available for hundreds of thousands of people around the world who desperately need it. For the first time in over half a century, there are three new DR-TB drugs – bedaquiline, delamanid and, most recently, pretomanid – that can offer people a better chance to be cured, but barriers to access including high prices are preventing their scale-up by countries. Only 20 per cent of people with DR-TB who need these newer drugs have been able to receive them.

According to the latest World Health Organization (WHO) Global TB Report, in 2018, an estimated half million people fell ill with DR-TB, yet only one in three started treatment. DR-TB cure rates remain unacceptably low: only 56 per cent and 39 per cent of people treated for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) were successfully cured, respectively.

“Bedaquiline, delamanid and pretomanid have shown the potential to cure more people of DR-TB with far fewer side effects than older toxic treatments that need to be injected and are still used in most countries,” said Sharonann Lynch, HIV & TB Policy Advisor for MSF’s Access Campaign. “It’s inexcusable that drug corporations continue to put profits over people’s lives, as if medicines were a luxury. It’s time to smash the status quo: all three newer TB drugs must be affordable to everyone who needs them so more lives can be saved.”

In July 2019, WHO Director-General Dr Tedros Adhanom Ghebreyesus called for countries to transition to all-oral regimens to treat DR-TB by World TB Day, 24 March 2020.

High prices and corporations’ unwillingness to license their drugs so generics can be produced are standing in the way of improved DR-TB treatment outcomes with these new drugs. Currently, the price of DR-TB regimens ranges from US$1,040 to $11,680, depending on the treatment length and combination of drugs needed. In order for more lives to be saved, MSF demands the following:
Bedaquiline:
Since it was approved for use in 2012, just over 37,000 people have ever received bedaquiline. Johnson & Johnson (J&J) must lower the price of bedaquiline to no more than $1 per day ($30 per month/$180 for a six-month treatment course) for everyone who needs it. MSF demands this price cut considering that bedaquiline is the result of a joint research and development effort by public and private entities, and the larger TB community—not by J&J alone. Substantial public investments and contributions to provide evidence on the drug’s therapeutic value have come from the US government; UNITAID; health ministries in countries with high rates of TB; the South African Medical Research Council; academic institutions; non-governmental organisations (including MSF); and a host of philanthropic donors. J&J should therefore not be the sole decisionmaker regarding who has access to the drug. Currently, the corporation charges at least double the $1 per day price MSF is demanding: the lowest price for bedaquiline is $400 for a six-month treatment course ($67 per month) for countries eligible to purchase the drug through the Global Drug Facility (GDF), an organisation run by the Stop TB Partnership that supplies TB drugs to low- and middle-income countries. And J&J charges far more in other countries. Additionally, many people require up to 20 months of the drug, raising the price of bedaquiline alone to $1,200 – and multiple additional drugs are needed to treat DR-TB. Researchers have calculated that the drug could be produced and sold at a profit for much less – as little as $0.25 per day* (l