Sh10b needed to treat increasing multi-drug resistant TB cases

Mar 16, 2016

At least 90, 000 Ugandans have TB and millions are estimated to be incubating the virus that causes the airborne disease

At least sh10b is needed to treat the increasing cases of the deadly multi-drug resistant tuberculosis strains annually, the health ministry said Tuesday.

The fatal multi-drug resistant TB strains have continued to multiply in the country, with recorded cases currently standing at over 1000, up from about 600 two years ago, highlighting a new challenge for the health ministry.

Then, there is the extensive multi-drug resistant TB strain, currently estimated to be afflicting over 20 patients, which is also on a rise and takes over sh15m to treat a case.

But drug makers, including Japanese pharmaceutical company Otsuka, have refused to budge and bring down the drug costs.

"You need about sh10m to treat one MDR (multidrug resistant TB) case and sh15m to treat the extended MDR," Dr. Frank Mugabe, the National TB and Leprosy Programme (NTLP) manager said.

"Patients who have Pre-XDR TB have developed resistance beyond the MDR and need medicine combinations like bedaquiline and the new tuberculosis (TB) drug delamanid. But they are very expensive," the doctor said.

At least 90, 000 Ugandans have TB and millions are estimated to be incubating the virus that causes the airborne disease.

Ordinarily, TB takes about sh300, 000 to treat. And patients have a 98% chance of getting cured, Dr. Mugabe said. "But we are increasingly registering resistance and more recently, the PRE-XDR TB, which is hard and very expensive to treat, because of poor adherence."

"Because the disease is airborne, even the MDR and extended MDR strains can easily be spread if an infected person coughed near a group," the doctor said, highlighting a need to focus on prevention of MDRs.

Dr. Asuman Lukwago, the health ministry permanent secretary, said: "If we cannot prevent MDR, through taking drugs strictly as prescribed and encouraging early diagnosis and treatment, we are heading for disaster." he said.

Last month, Japanese pharmaceutical company Otsuka said that it would make delamanid available to some developing countries at a price of US$1,700 per treatment course. But the drug is very expensive. More than two years after it was approved, only 180 people globally have received it.

International medical humanitarian organisation Médecins Sans Frontières (MSF) has expressed concern at the high price announced for the new tuberculosis (TB) drug, advocating for a target price of $500 per treatment course for drug-resistant TB.

Lukwago said the ministry receives close to "adequate funding" from the Global Fund and other development partners for TB drugs, but said they needed to focus on treating the cases "completely".

The disease which commonly affects the lungs, causing its patients to cough profusely and have chest pains and excessive night sweats, evening fevers, and weight loss is caused by bacterium mycobacterium tuberculosis.

Uganda is one of the 22 high TB burden countries in the world. The country registers about 5000 deaths a year. Almost 50% of TB patients are HIV positive.

In 2014, the national TB reference lab at Mulago received a Supranational status, meaning it can now carry out rapid diagnosis of tuberculosis, including multi-resistant strands.

Dr. Moses Joloba, the labs head said it was going to be much easier to diagnose the disease with the new "equipment and necessary facilities and capacity" in place.

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