Outdated policies and practices risking further spread of drug-resistant TB: MSF

Outdated tuberculosis (TB) policies and practices were risking the further spread of drug-resistant TB globally, a 24-country survey has warned, urging a phase-out of mandatory hospitalisation and re-treatment regimens that contribute to drug resistance.

The report was released by Medecins Sans Frontieres (MSF) - also known as Doctors Without Borders, an international non-profit organisation - and Geneva-based Stop TB Partnership. The second edition of the "Out of Step" report is a comprehensive survey of policies and practices for use in the diagnosis and treatment of TB.

According to Dr Grania Brigden, MSF access campaign TB advisor, outdated policies for TB treatment that put people at risk of increased suffering and death, including re-treatment regimens that potentially increase drug resistance and mandatory hospitalisation during treatment, needed to be banished.

If countries were to meet globally-endorsed goals to reduce TB incidence and death by over 90 per cent in the next 20 years, aggressive efforts needed to be taken now to adopt and implement the 14 key policies and practices identified in the report.

"The use of rapid molecular tests that can effectively diagnose drug resistance hasn't yet reached the broad coverage needed. We won't be able to close the huge gaps in TB diagnosis and treatment unless the policies and practices known to reduce illness, death, and transmission, including the best use of every effective tool available today, are fully adopted and implemented in every country," Brigden said.

According to WHO, only one in four (26 per cent) of the 480,000 people estimated to have contracted multidrug-resistant TB (MDR-TB) in 2014 was diagnosed. Of the 111,000 people (23 per cent) who were started on treatment, less than half were successfully treated. Of the 24 countries surveyed for Out of Step, only about 30 per cent of countries (8 out of 24) had put in place policies to ensure that rapid molecular tests for detection of TB and drug resistance were used as the initial test for everyone being evaluated for TB.