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Lilly invests an extra USD 50m in global tuberculosis partnership

US-based pharmaceutical company, Eli Lilly, has revealed it will invest an additional USD 50m in a global partnership to fight multi-drug resistant tuberculosis (MDR-TB)

US-based pharmaceutical company, Eli Lilly, has revealed it will invest an additional USD 50m (EUR 37.5m/ GBP 25.4m) in a global partnership to fight multi-drug resistant tuberculosis (MDR-TB).

The announcement, which was timed to coincide with World TB Day, further supports Lilly's TB initiative started in 2003, bringing the total investment made by the company to USD 120m (EUR 89.9m/ GBP 61m). The funding supports an increase in the supply and availability of effective drugs for treating emerging strains of MDR-TB, providing training for healthcare personnel and focusing global resources on prevention and diagnosis.

The Lilly MDR-TB Partnership is an international alliance of 14 public and private organisations, including businesses, humanitarian groups, academic institutions and professional healthcare associations. The partnership seeks to influence key MDR-TB policies around the world, including introducing new treatment protocols and convincing the global health care community that treating MDR-TB is just as important as treating primary TB.

More than 40 countries now have health policies addressing MDR-TB. Lilly manufactures two antibiotics used to treat MDR-TB, Capastat (capreomycin) and Seromycin (cycloserine). Since 2000, Lilly has supplied more than one million vials of capreomycin and more than five million capsules of cycloserine at concessionary prices through the World Health Organisation's (WHO) Directly Observed Treatment-Plus (DOTS-Plus) which has treated 26,000 MDR-TB patients.

A new report issued by WHO revealed that the rate of TB, or the number of infections per 100,000 people, levelled off in 2005. Worldwide, the rate of tuberculosis has stabilised at less than 150 cases per 100,000 people, while in Africa it is more than double, at nearly 350 cases per 100,000 people.

Dr Marcos Espinal, Executive Secretary of WHO's Stop TB Partnership, said: "This is a breakthrough. It's the first time we've had good news about the epidemic since 1993."

While the global rate of those infected with TB remains relatively steady, however, the actual number of people grew due to world population growth. In 2005, there were 8.8m new TB cases and 1.6m deaths, WHO said.

The emergence of a deadly version of the disease, known as extensively drug-resistant tuberculosis (XDR-TB), has also stymied attempts to control the illness. XDR-TB is resistant to most drugs used to treat TB. In Africa especially, high rates of HIV/ AIDS, which weakens the immune system, has helped the spread of TB in the country. The disease has only been reported in South Africa, which has documented 300 cases, with around 30 new cases every month reported. However, health agencies say that TB remained undetected in other African countries with less stringent monitoring systems.

The drug-resistant disease has also appeared in first world countries, with cases reported in all Group of Eight industrialised nations. Lack of access to existing treatments are a bigger killer worldwide than drug-resistant strains.

Table 1: drugs used for the treatment of tuberculosis:

First line drugs 

Second line drugs

Essential

Other

Old

New

New rifamycins

Isoniazid

Pyrazinamide

Ethionamide

Quinolones

Rifabutin    

Rifampicin

Ethambutol

Cycloserine

(ofloxacin)

Rifapentine   

Streptomycin

Capreomycin

(ciprofloxacin)

Amikacyn

(sparfloxacin) 

Kanamycin

Macrolides 

PAS

(clarithromycin)

Thiocetazone

(clofazimine)

(amoxycillin & clavulanic acid)

Health officials are now working to merge tuberculosis and AIDS treatment programmes. Of the 40m people worldwide living with HIV/AIDS, one third are estimated to also have tuberculosis. But in much of Africa, patients must seek out treatment separately. It remains unclear, however, whether countries are taking the international health community's advice. French doctors' charity, Medecins Sans Frontieres, say that only three per cent of tuberculosis patients in Africa are offered HIV tests.

Tuberculosis is also a major health problem in prisons, where drug resistant strains are spreading rapidly, the International Committee of the Red Cross (ICRC) said on 22 March 2007.

The Swiss-based humanitarian group, which provides aid in conflict zones and visits prisoners around the world, said the contagious disease is up to 100 times more prevalent in prisons than in the general public.

"This is often due to overcrowding, inadequate ventilation, ignorance of preventive measures and failure to supervise and ensure adherence to treatment," the ICRC said in a statement.

Prisons in the Caucasus, Central Asia and Africa have been fighting tuberculosis for several years, but an increase in cases of drug-resistant types of the disease has made eradication more difficult, the ICRC said.

27th March 2007

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