Rapid diagnostic tests, shorter treatment: TB programmes now must scale up to treat and cure all people affected by MDR-TB

13 May 2016 - Geneva, Switzerland - The TB community welcomes the new WHO recommendations that aim to speed up detection and improve treatment outcomes for multidrug resistant tuberculosis (MDR-TB) through use of a novel rapid diagnostic test and a shorter, cheaper regimen.

It is a crucial moment, as new tools and recommendations are promoted bringing hope that we can indeed End TB. However, in order to do so, stakeholders in countries with TB need to move rapidly, embrace the new recommendations, adjust the algorithms and policies, innovate in service delivery and scale up.

The current situation is completely unacceptable for an airborne disease -- out of the 480,000 new MDR-TB cases every year (not including the tens of thousands of chronic cases), only 23% were diagnosed and treated last year. Of those lucky enough to get on treatment, only 50% were cured. This is an immense tragedy and it is far away from the targets of the Global Plan to End TB 2016-2020 and WHO's End TB Strategy.

The new rapid diagnostic test -- called MTBDRsl -- is a DNA-based test that identifies genetic mutations in MDR-TB strains, making them resistant to fluoroquinolones and injectable second-line TB drugs. This test yields results in just 24-48 hours, down from the three months (or longer) currently required. The much faster turnaround time means that MDR-TB patients with additional resistance are not only diagnosed more quickly, but can be placed on appropriate second-line regimens.

At less than US$ 1000 per patient, the new treatment regimen can be completed in 9-12 months. Not only is it less expensive than current regimens, but it is also expected to improve outcomes and potentially decrease deaths due to better adherence to treatment and reduced loss to follow-up. Already over 20 country programmes are implementing this regimen in operational research settings.

"This is an awesome moment and an opportunity to take up a shorter MDR regimen and a new rapid diagnostic test. But I am afraid to celebrate because too often we are shy, reluctant, and slow in embracing and rolling out new tools and approaches. We now need to be daring, innovative risk-takers. We need to ensure that national policies and algorithms in place are aligned with the science. However, if we want to end TB, we need to seriously fund research for a point of care diagnosis, much shorter and affordable treatment, and a new vaccine," said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.