With the acknowledgement that tuberculosis that is not effectively confronted anywhere poses threats to public health both globally and domestically, the White House today released a plan setting specific treatment and disease impact targets in the U.S. and abroad as well as goals to build collaborative international responses and capacities to fight the disease.
The National Action Plan for Combating Multidrug-Resistant Tuberculosis also includes accelerated and focused research and development of new treatment, diagnostic and preventive tools to fight tuberculosis, but does not set specific targets or deadlines for development of those targets.
In contrast, in what is both a mandate for U.S. departments and agencies, and a global call to health ministries and organizations, the plan quantifies and sets deadlines for ramping up access to effective and appropriate treatment. It includes aims to “initiate appropriate treatment in 25 percent of patients with MDR-TB in 10 countries with the highest burdens of MDR-TB” by 2016 (with the plan released a week and a half before the new year, leaving what part of 2016 unclear), increasing that treatment target to 35 percent of patients with MDR-TB by 2018, and, by 2020, to:
- Reduce by 15 percent the number of cases of MDR-TB disease in the United States;
- Initiate appropriate treatment in 50 percent of patients with MDR-TB in 10 countries with the highest burdens of MDR-TB;
- Reduce global TB incidence by 25 percent compared to 2015 levels;
- Successfully treat at least 16 million TB patients in high-burden countries;
- Achieve and maintain treatment success rates of 90 percent for individuals in high-burden countries with drug-susceptible TB.
In response to the plan Médecins Sans Frontières released a statement urging expanded access to bedaquiline and delamanid, new treatments for tuberculosis that offered a new last resort for people with drug-resistant tuberculosis, but that have yet to reach more than a handful of the patients who need them be a benchmark of the plan’s success.
The response noted an issue also acknowledged within the plan itself — it will be futile, if not fully funded.