03.23.17 By Sanofi Le Hub
World Tuberculosis Day on March 24 provides an opportunity to reflect on what is being done to treat the disease worldwide.
Tuberculosis (TB), a bacteria-based airborne infection, is one of the 10 leading causes of death in the world. In 2015 over 10.4 million people were diagnosed with TB, of which 1.8 million died (95% in low and middle income countries).
With both a latent and an active form, tuberculosis is a worldwide plague.
The World Health Organization (WHO) estimates that currently about a third of the world’s population is infected with latent TB; the dormant form of the disease.
The risk of developing active TB is much higher amongst people with a weakened immune system (human immunodeficiency virus, malnutrition, diabetes, etc.) and in children, especially the very young.
Although active TB is curable, treatment is long and complex, and good adherence is critical. Unfortunately, poor compliance not only puts a patient at risk of treatment failure and more serious disease, but also promotes bacterial resistance and the continued spread of the disease in the community.
Sanofi is at the forefront of devising new treatment options for TB. One of the key areas of focus is prevention.
Sanofi has been working with the U.S. Centers for Disease Control and Prevention (CDC) to simplify the treatment of latent tuberculosis and therefore help to prevent the development of active TB.
As part of this collaboration, Sanofi and the CDC propose that people with latent tuberculosis should follow a 3-month regimen of weekly doses rather than the previously suggested, more complicated, 6-9 months of daily treatment. This would mean 12 days instead of 180-270 days of treatment intake for patients. The collaboration research also seeks to simplify the regimen for the treatment of active TB when the tuberculosis strain is susceptible to first line drug treatment, which represents the majority of cases.
It is a crucial moment for tuberculosis research due to the emergence of strains that are resistant to current treatments. This is why Sanofi is working with a wide range of partners to maximize treatment outcomes.
For example, Sanofi is committed to the identification of new treatment options and thus working in partnership with the non-profit TB Alliance organization. Other initiatives include supporting academic institutes such as Weill Cornell Medical College in New York and their groundbreaking tuberculosis research.
Sanofi is also a key member of the Tuberculosis Drug Accelerator (TBDA) program, an initiative backed by the Bill & Melinda Gates Foundation that aims to develop solutions for tuberculosis control and to eliminate factors that allow the infection to persist. The work of Sophie Lagrange (Head of the Tuberculosis Research Unit at Sanofi’s Marcy-l’Étoile site, France) and her team has been personally recognized by Bill Gates.
Sanofi is also working closely with the WHO, which is implementing the End TB Strategy, for intensifying the battle against TB and putting an end to the global epidemic. This objective is part of the health-related Sustainable Development Goals by the United Nations General Assembly.
Sanofi’s involvement in fighting tuberculosis in South Africa
South Africa faces a double burden of high rates of Tuberculosis and Diabetes — in 2015, there were 454,000 new incident cases of all forms of TB, approximately 1% of the South African population develops TB disease every year and the estimated national prevalence of Diabetes Mellitus (DM) was 9.27%, or over 2.6 million people
According to the World Health Organisation (WHO) South Africa ranks the third highest in the world in terms of TB burden, after India and China. An estimated 80% of the South African population has latent TB. The highest prevalence of latent TB infection, estimated at 88%, has occurred among people in the age group 30-39 years in townships and informal settlements. The TB epidemic is worsened by poor adherence as a result of patients either not starting treatment, or not completing their course of treatment. As a result TB patients develop resistance to the “normal” treatments and they require more expensive and more complex forms of treatment.
Diabetes Mellitus (DM) triples a person’s risk of developing tuberculosis (TB). With an estimated prevalence of 7%, accounting for approximately 2.3 million people and more than half undiagnosed, South Africa (SA) has the highest number of people with DM in the region.
Patients with both DM and TB suffer worse treatment outcomes and higher rates of relapse and death than patients with only TB. In South Africa, service deliveries for DM and TB are vertical, and therefore patients are at risk with both diseases if they do not receive integrated care.
Knowing that Diabetes Mellitus (DM) increases the risk of contracting Tuberculosis (TB) and has been associated with a three-fold incident risk of TB, the need for an integrated model of care for both chronic and infectious diseases at all levels of the health system is becoming even more crucial
Sanofi in collaboration with its implementing partners, University Research Co., LLC and Aquity innovations, have been working on an Improved TB-DM Management Project in South Africa aiming at increasing early detection and management of patients with both conditions.
This project focuses on three main goals:
• Strengthening the skills of healthcare workers and practices for diagnosis and case management of TB and DM;
• Integrating TB and DM management into routine health services;
• Increasing patient awareness of the prevention and control of both conditions.
Both private and public services were involved in (or part of) the Improved TB-DM Management project across four provinces in South Africa.
These projects and many others provide new hope in finding innovative solutions in order to tackle one of the major health concerns facing the world today.
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