Key bottlenecks in M/XDR-TB control and patient care
Ensuring access to quality-assured anti-TB medicines
Not all countries are insisting on anti-TB medicines that are of proven quality based on WHO standards, or stringent regulatory authority standards, according to this paper. Fixed-dose combinations of first-line medicines are insufficiently used given that they are proven to be at least as effective as loose pills in curing patients of TB and in addition they offer significant practical and logistic advantages. If countries were truly averse to the risk of creation of resistance they would use them much more. WHO and the GDF offer several services to help national drug procurement. With respect to the second-line medicines, insufficient amounts are being produced, even for the relatively few patients enrolled for treatment. Pharmaceutical companies are not yet convinced that there is a return to be made from investing in this market. To break this cycle, governments should commit to scaling up treatment for MDR-TB, thus creating greater demand, enabling more accurate forecasts, and bringing more companies into the supply network.