Global TB report reveals rate of diagnosis for multi-drug resistant TB (MDR-TB) cases is heading in the wrong direction

According to the World Health Organization’s World Tuberculosis Report 2015, released 28 October, only one in four (26%) of the 480,000 people estimated to have developed multidrug-resistant TB (MDR-TB) in 2014 was diagnosed.  Worse, the total number of people diagnosed with MDR-TB globally in 2014 was actually lower than the previous year (123,000 in 2014 vs 136,000 in 2013), although the total estimated number of people who developed MDR-TB remained the same. In 2014, only 58% of previously treated MDR-TB cases were tested for drug resistance; while this marks an improvement over 2013’s rate of 17%, it’s far from the 100% target set for 2015 in the Global Plan to Stop TB (2011-2015). While the number of people put on MDR-TB treatment increased slightly from 97,000 in 2013 to 111,000 in 2014, the cure rate remains desperately low at 50%. 
 
Statement by Dr. Grania Brigden, Interim Medical Director, MSF Access Campaign:
“Yet another year of disheartening statistics, such as TB’s persistent annual 1.5 million death toll, should serve as a wake-up call that enormous work still needs to be done to reduce the burden of this ancient, yet curable disease. 
“When it comes to the deadlier forms of the disease – such as multidrug-resistant TB – the news is particularly bleak.  Despite progress in rolling out better diagnostics such as rapid molecular tests, fewer people were detected with MDR-TB in 2014 than in 2013, even though the estimated number of new cases remained steady.  
 
“We’re losing ground in the battle to control drug-resistant forms of TB, and without considerable corrective action, the vast majority of people with MDR-TB won’t ever be diagnosed, put on treatment, or cured.  Today, a person with multidrug-resistant TB has worse than a one in four chance of being properly diagnosed.  Diagnosis is just the first step: people who do access today’s standard treatment have only a one in two chance of being cured, while two newer drugs remain out of reach for the vast majority of people who need them.
 
“Drug-resistant forms of TB will continue to spread unless the gap is narrowed between people with undiagnosed TB disease and people who are diagnosed.  What’s needed is widespread rollout and optimal use of existing rapid molecular tests, while preparing for use of new diagnostic tools that can allow further decentralisation of services.  We need to improve access to, and scale up, drug-resistance testing with affordable point of care tests.”
 



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