Stop TB Partnership

The Union’s TREAT TB initiative moves into implementation mode

14 April 2011 - Paris - The need for improved diagnosis and treatment of tuberculosis has generated a wide variety of proposed new tools and approaches. But which is the most effective and under what conditions? Back in October 2008, the International Union Against Tuberculosis and Lung Disease (The Union) launched the TREAT TB initiative to analyze these issues and to identify and address gaps in available research.

Led by The Union, TREAT TB offers a platform for providing the information that policymakers need to decide why, when and how to adopt new diagnostic tools and patient management strategies.

In its first phase, TREAT TB focused on analyzing the evidence. Consultations brought together experts to debate topics such as the best regimen for the growing number of re-treatment cases and the utility of digital radiography as a diagnostic tool for high-burden TB countries.

Now, one national and two international research projects are underway:
In South Africa, TREAT TB and its local partner, the Desmond Tutu TB Centre (DTTC), are implementing a four-year Operational Research Assistance Project (ORAP) with funding from the USAID mission in South Africa.

The goal is to build the operational research skills of South African professionals at local, provincial, and national levels while carrying out much-needed research. For example, a study in Free State Province is examining the factors that contributed to a high two-month, non-conversion rate among treated new smear-positive tuberculosis patients. Similar ORAP projects have been launched in every province of the country, including the most affected areas of KwaZulu-Natal, Eastern Cape, Limpopo and Mpumalanga.

The PROVE IT study is an international effort to assess the impact of rolling out a new diagnostic tool, Line Probe Assays. Implementation is already underway or soon to begin in Brazil, Russia and South Africa.

The goal of PROVE IT - which stands for policy relevant outcomes from validating evidence on impact - is to provide a better understanding of the true costs and benefits associated with this and other new tools. In addition, TREAT TB is documenting the adoption of this impact assessment approach in three different settings using an e-tool that will help independent researchers who are interested in conducting similar research in the future.

The second international study is a clinical trial of a shortened, standardized treatment regimen of anti-tuberculosis drugs for patients with multidrug-resistant tuberculosis known as STREAM. STREAM will determine whether a nine-month regimen, used with notable success in Bangladesh, can be utilized in different settings with comparable results. The study will be implemented in four high-burden countries by the UK’s Medical Research Council, another partner in the initiative. It will involve approximately 400 patients and is set to begin this summer.

Through this combination of operational and clinical research, education, technical assistance and innovative use of technology, the TREAT TB initiative expects to provide essential information which advances global efforts to prevent, control and treat tuberculosis.

Funding for TREAT TB is provided through a Cooperative Agreement with the United States Agency for International Development (USAID).

For more information about TREAT TB and its partners, please visit the website.