Drug resistant TB levels described as alarming by new international study

A large, international study published in The Lancet reveals alarming levels of tuberculosis (TB) that are resistant to both first-line and second-line drugs.

The findings show high prevalence of resistance to at least one second-line drug (43.7%) among multidrug-resistant (MDR) TB patients from eight countries in Africa, Asia, Europe, and Latin America. Worse still, the study found higher than expected overall levels of extensively drug-resistant (XDR) TB.

Extensively drug-resistant tuberculosis (XDR-TB) is a form of tuberculosis caused by bacteria that are resistant to some of the most effective anti-TB drugs.

In the Preserving Effective TB Treatment Study (PETTS), Tracy Dalton, the study’s lead author from the US Centers for Disease Control and Prevention (CDC), says that XDR-TB has been reported in 77 countries worldwide, but the exact prevalence remains unclear.

“Drug-resistant TB is more difficult and costly to treat, and more often fatal," Tracy Dalton explained. 

"Internationally, it is particularly worrisome in areas with fewer resources and less access to effective therapies.  As more individuals are diagnosed with, and treated for, drug-resistant TB, more resistance to second-line drugs is expected to emerge,” Tracy added. 

According to the study, XDR TB was detected in 6.7% patients overall, with prevalence in South Korea (15.2%) and Russia (11.3%) more than twice World Health Organisation's global estimates for the same time period (5.4%).

"There needs to be more investment in research and development for new vaccines, diagnostics and treatments for TB (and MDR-TB)," said RESULTS National Advocacy Director Kate Finch.

"After all, MDR-TB was originally caused by inappropriate or incomplete TB  diagnosis & treatment," Ms Finch added.

Among the study’s other key findings were that risk of XDR disease was more than quadrupled in previously treated patients, and previous treatment with second-line drugs was consistently the strongest risk factor for resistance to these drugs.

Further analysis also found unemployment, a history of imprisonment, alcohol abuse, and smoking as factors associated with resistance to second-line injectable drugs.

"The more cases of MDR-TB that are diagnosed and treated, the more resistance will occur to second-line drugs. This then leads to higher cases of XDR-TB, which is practically impossible to treat," continued Ms Finch.

Recently RESULTS has submitted advice on AusAID's new Medical Research Strategy, which is aimed to help poor countries increase access to health technologies that work, and emphasised the rates of MDR-TB in the Asian region.

"One of the first priorities for the strategy is investing in public-private partnerships for TB R&D," continued Ms Finch.

"This investment will need to be long term and sustained if new products are really to make it through the whole development cycle and to those most at risk.

"It is really encouraging to see AusAID invest in R&D with a focus on poverty-related disease at a time when other governments are pulling back," said Ms Finch.

Significant roundtable meeting on The Global Fund attended by RESULTS

On August 22 our National Manager,  Maree Nutt,  attended a roundtable meeting hosted by Bill Bowtell AO, Executive Director of Pacific Friends of the Global Fund and Andrew Hewett, Executive Director of Oxfam Australia.  Attending the meeting were Global Fund representatives Gabriel Jaramillo, General Manager, Dr Mphu Ramatlapeng, Vice Chair (and former Health Minister in Lesotho) and Dr Christoph Benn, Director, Resource Mobilization and Donor Relations of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Sr Jaramillo, Dr Ramatlapeng and Dr Benn visited Australia to meet with Senator Bob Carr, Minister for Foreign Affairs, other  Ministers and Members of Parliament, bureaucrats, research institutions, the community sector and business leaders to brief them on the Global Fund’s contribution towards preventing and treating HIV & AIDS, tuberculosis and malaria.  

On the Solomon Islands, newly qualified nurse Rose visits a family of 13, where one daughter died of tuberculosis, and three others received treatment and survived. Rose was trained in TB detection, testing and treatment as part of a national strategy to further reduce the TB burden in the Solomon Islands, with support from the Global Fund. Photo: The Global Fund / John Rae.

The Global Fund is a unique, public-private partnership and international financing institution dedicated to attracting and disbursing additional resources to prevent and treat HIV and AIDS, Tuberculosis and Malaria. This partnership between governments, civil society, the private sector and affected communities represents an innovative approach to international health financing. 

Since its creation in 2002, the Global Fund has become the main financier of programs to fight AIDS, Tuberculosis and Malaria, with approved funding of US$ 22.9 billion for more than 1,000 programs in 151 countries. To date, programs supported by the Global Fund have provided AIDS treatment for 3.6 million people, anti-Tuberculosis treatment for 9.3 million people and 270 million insecticide-treated nets for the prevention of Malaria. The Global Fund works in close collaboration with other bilateral and multilateral organisations to supplement existing efforts in dealing with the three diseases.

The roundtable meeting was an opportunity for Australian stakeholders to discuss the work of the Global Fund and what it means for Australia and the Pacific region.

Please click here for a full-report on the Global Fund's regional results report (2011)

Approximately a third of Australia’s total foreign aid funding goes to support multilateral organisations.  The effectiveness of these organisations were reviewed recently in the Australian Multilateral Assessment and though the Global Fund scored highly in the “Results and relevance” category there was room for improvement in “Organisational behaviour”.

Under the leadership of General Manager Jamarillo, the Global Fund has subsequently undergone significant reforms in order for it to be even more effective in its activities as it looks ahead to the next 10 years of operation. The Global Fund executives acknowledged the Australian government, the private sector and civil society organisations such as RESULTS for our partnership and ongoing support.

The Global Fund will be looking to Australia for leadership as it plans for the next replenishment meeting to be held in the second half of 2013. As part of our ongoing advocacy around the Global Fund,  RESULTS staff and volunteers will be raising this issue in meetings with Parliamentarians in Canberra on 29 to 30 October 2012. 

If you would like to join us please contact kate@results.org.au

The Grameen Bank, and Professor Muhammad Yunus, are facing a calamitous crisis

Both have been under attack from the Bangladeshi Government for the past 20 months.

Now the Bangladeshi Government has drafted changes to the ‘Grameen Bank Ordinance (Amendment) 2012' Law (the law that created Grameen Bank in 1983), giving the government the power to appoint the GB Chairman, remove both the current women borrower-owner board members as well as Yunus as Managing Director, thus giving the government total control of Grameen Bank.

Professor Yunus responded: “I request my fellow citizens who are as shocked as I am, to try to persuade our government to realise that this is a very wrong step they are taking; they should refrain from proceeding with this …The decision of the government would destroy this well known bank for the poor, the bank that has made the country proud.”

This innovative compassionate man, Yunus rightly won the 2006 Nobel Prize for pioneering the microfinance system. It offered the poorest around the world - especially women – hope in the form of a tiny loan, to generate an income. He is seen as one of the world's leading anti-poverty activists. We cannot let him be discredited.

As final recommendations and law changes will be released in late August 2012, your action – by this Friday, August 17 - is imperative.

Step 1: Sign this petition that will get sent to the Prime Minister of Bangladesh  

Step 2: Share the petition with your friends via email and social media

2012 RESULTS International Conference

THE RESULTS International Conference is held every year in Washington DC for RESULTS national and international delegates. With six of us from Australia, this was our largest delegation ever!

Because the conference also coincided with the biannual International AIDS conference, the speaker list at the conference was most impressive and included spiritual leader and best selling author, Marianne Williamson, Dr. Jeffrey Sachs (arguably the most influential economist in the world), Dr Mphu Rametlapeng (former Health Minister of Lesotho and current Vice Chair of the Global Fund to Fight AID, TB and Malaria)

(Click to view the full-agenda of the conference)

Some of the highlights for our Australian delegates were:

From Angela Cole, Hobart: 

I was totally inspired by Karen Sichinga from Zambia who said of women in Zambia, "Although HIV is her disease, she is plagued by a greater sickness - poverty. It is this which will kill her. Poverty cannot be treated with bandaids".

From David Bailey, Canberra:

How to describe the presentation at the RESULTS International Conference by Dr Jeffrey Sachs arguably the world's most influential economist?

It  was inspirational and dare I say it’s the best Sachs I have ever had!

From Lili Koch, Sydney: 

I was in a session where The Hon. Bob Bennett (a second generation US Senator from Utah, retired) said that 'RESULTS lobbyists are by far the best and most effective lobbyists in our political system'

This was livery nice to hear, especially when the U.S. spend over THREE BILLION DOLLARS every year on lobbyists and RESULT members do it for FREE!

From Mark Rice Brisbane:
"Overall, the Conference provided a reminder of how much respect the RESULTS Internationalpartnership has from development experts and parliamentarians from different countries.  A favourite session was hearing from first-term parliamentarians from the UK and Canada, who are taking advantage of the freedom of a backbench position to take action (which could also be an inspiration for Australian MPs!)"

Rachel Achterstraat, Sydney: 

The opportunity to connect with different people from all over the globe was an amazing thread woven through the entire International Conference and AIDS Conference.

We met with and heard from seasoned advocates, policy-makers and MP's, people affected by TB and HIV, an African pop-princess and world-renowned academics, all who shared our vision to end poverty and beat TB and HIV, together. 

As I hurried from a meeting at the World Bank to a street mobilisation of thousands of passionate community activists, I was reminded of the universality of our goal and that we must all play our unique part in the fight to end poverty. 

From Maree Nutt, Sydney:

It’s always fabulous to connect with the amazing RESULTS volunteers and staff from around the US and the world.  It’s a great reminder that our work here in Australia is so much stronger because we work together with our RESULTS and ACTION partners from places like Canada, Japan, the UK, Mexico, Zambia, France, India, Kenya and the US.

RESULTS advocates in the US