After decades of relying on old medicines, new drugs designed specifically for the treatment of tuberculosis (TB) are finally on the market. While these medicines represent a major advancement in the fight against TB, ensuring equitable access for patients is still an enormous challenge. At the 45th Union World Conference on Lung Health, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program collaborated with the Stop TB Partnership Global Drug Facility (GDF) to host a full-day workshop addressing common hurdles to treatment access, as well as available solutions.
The SIAPS program focused on three common challenges in medicines availability: quantification, public-private mixes, and medicines safety. Quantifying the TB medicine needs for an entire country requires that national TB programs undertake complex calculations to project the number of future patients; this information must then be reconciled with available funding and country-specific operations for importing medicines. SIAPS has developed an approach to address both of these requirements, engaging regional technical advisers to partner with countries to manage medicine needs using an electronic tool called QuanTB. Within the first six months of implementing this approach, six countries reported to SIAPS on their use of QuanTB for medicines tracking and the decisions made based on QuanTB data; the percentage of countries that reported a stock-out of at least one TB medicine dropped from 100% (6/6) to 17% (1/6).
In addition to ensuring the availability of medicines, SIAPS also presented on its work promoting early diagnosis and careful follow-up of patients on treatment regimens. In Pakistan, SIAPS is partnering with private pharmacies to identify clients with TB-like symptoms and refer them to diagnostic centers for evaluation. After early success, SIAPS is now supporting the creation of a partnership between the national TB program and pharmacy schools to help make TB training part of the pharmacist curriculum. Lastly, SIAPS shared Swaziland country experience implementing active surveillance for TB and HIV medicines. Given that all medicines carry risks of side effects, a systematic collection of local adverse event data provides health care workers with insights into the tolerability of TB and HIV medicines in their communities. As a result, treatment can be tailored to the country context.