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Global financing and long-term technical assistance for multidrug-resistant tuberculosis: Scaling up access to treatment
Thomas J. Hwang and Salmaan Keshavjee
Oct. 2, 2014, 5:40 p.m.
Summary Points
Multidrug-resistant tuberculosis (MDR-TB) is a leading public health concern, particularly in low- and middle-income countries, necessitating coordinated international action to prevent its spread and effectively treat the infected.
The cost of treatment for MDR-TB is over 200 times the comparable cost for a drug-susceptible tuberculosis (TB) patient. Data show that prices for three of the currently most expensive drugs have increased dramatically since 2001, outpacing inflation.
Many of the high MDR-TB burden countries were ranked by WHO as being in the bottom 50% of health systems worldwide. Without sufficient technical, human, and organizational resources, weak health systems can pose a significant barrier to access to treatment.
In order to achieve the goal of eradicating MDR-TB, policymakers should implement a two-pronged intervention that pools donor resources for the coupling of market-oriented solutions to MDR-TB drug prices and targeted investments in health systems strengthening and innovative care delivery models. Innovative policy mechanisms piloted for other infectious diseases, such as pneumococcal vaccine, may offer lessons for the MDR-TB context.