MSF Access: Dear GAVI Campaign

MSF vaccinates millions of people each year and fully supports the introduction of new vaccines in developing countries. But negotiations between companies and the largely taxpayer-funded GAVI Alliance for the newest vaccines have not resulted in deeper price cuts that would help more children benefit. The lack of transparency by companies on vaccine manufacturing costs and their focus on profits above ensuring sustainable prices for vaccines for low-income countries are at the root of the problem.

Help MSF and send GAVI a message on Twitter asking for them to open up their lower prices to non-governmental organisations and humanitarian actors like MSF now.

CLICK HERE TO SEND A TWEET.

Test Me, Treat Me: A Drug-Resistant TB Manifesto

As the epidemic continues to spread, Drug-resistant TB becomes increasingly hard to tackle. The treatment is too long, too toxic, and too costly – the drugs alone cost at least $4,000 just to treat one person. We want to save many more lives, but we desperately need shorter, safer and more effective treatment to do so.

We, the undersigned people with DR-TB and those involved in their care, here raise the alarm about the devastating toll this disease is taking on us, our families and communities across the globe, and therefore make the following three demands:

1) We call for universal access to DR-TB diagnosis and treatment now.
2) We call for better treatment regimens: the TB research community, including research institutes and drug companies, must urgently deliver effective, more tolerable, shorter and affordable DR-TB drug regimens.
3) We call for more financial support to increase DR-TB treatment, and a commitment to support research into developing better treatment

Test Me, Treat Me: A Drug-Resistant TB Manifesto

We, the people infected with drug-resistant TB (DR-TB), live in every part of the world. Most of us were exposed and became infected with DR-TB because of the poor conditions in which we live. Undiagnosed, this disease spreads among us. Untreated, this disease kills. But in the countries in which we live, fast and accurate diagnosis is rarely available, and only about one in five of us actually get effective DR-TB treatment.

Those of us “lucky” enough to receive treatment have to go through an excruciating two-year journey where we must swallow up to 20 pills a day and receive a painful injection every day for the first 8 months, making it hard to sit or even lie down. For many of us, the treatment makes us feel sicker than the disease itself, as it causes nausea, body aches, and rashes. The drugs make many of us go deaf permanently, and some of us develop psychosis.

Test Me, Treat Me: A Drug-Resistant TB Manifesto

People with drug-resistant TB and their medical providers worldwide call for urgent change. To learn more about MDR-TB and the manifesto, visit msfaccess.org/TBmanifesto

Current treatment for dr-tb is complex and inadequate. For the first time in half a century drugs that could cure DR-TB are being tested, but the global health community needs to act fast.

Drug-resistant tuberculosis: we can stop this epidemic in its tracks
This article was originally published on The Guardian

DR-TB is a public health crisis that is spiralling out of control – the latest statistics from the World Health Organisation suggest more than 300,000 new cases every year among notified TB cases, a figure that Medecins Sans Frontieres/Doctors Without Borders (MSF) considers conservative based on the growing number of DR-TB patients in our projects. Once the preserve of people who had received incomplete or incorrect TB treatment, a growing number of people with DR-TB are presenting who have never had TB treatment before, which shows that DR-TB is becoming an epidemic in its own right.

Yet, the tools to tackle the disease remain woefully inadequate. People with DR-TB are forced to take up to 20 pills a day with excruciating side effects that range from deafness to nausea and psychosis. For healthcare professionals, the treatment is complex: individualised for each patient based on drug resistance patterns, and expensive, with drugs alone costing up to $ 6,000 (£3,962) per person for a treatment course. And even then, patients only have a 50% chance of cure.

However, after half a century of neglect there is a historic opportunity for change. The drug pipeline for TB is the best it has ever been, with 10 drugs in clinical testing. At the very end of 2012, the US Food and Drug Administration approved bedaquiline or Sirturo, the first dedicated new TB drug since 1963, while another drug, delamanid is currently undergoing review by the European Medicines Agency. Both drugs arecompletely new classes of antibiotics with no reported resistance, and represent an unprecedented opportunity to improve treatment for DR-TB.

So what do these developments mean for global health professionals – particularly those on the front-line treating TB in communities?

These new drugs could be game-changers and the TB community must urgently work out how best to use them. They offer the potential to make DR-TB treatment shorter, more effective and more tolerable, with fewer side effects. The first step is to make these new drugs available for research and ensure they are quickly registered in high-burden countries. The manufacturers must also make sure the drugs are affordable in low- and middle-income countries, eg through generic production.

The response of drug manufacturers to generic HIV drugs is perhaps the best incentive to do things differently with DR-TB: before the introduction of generic competition in 2001, antiretrovirals to treat HIV cost over US$10,000 per person per year and very few people in developing countries could afford that. As a result, millions of people died and the peak of AIDS related-deaths didn’t occur until 2005. Since 2001, the price has come down nearly 99% and people now have access to affordable medicines. With eight million people now on treatment, the curve of AIDS related-deaths has started to fall, but we still need to expand access to a total of 15 million people by 2015. New infections are also falling.

Chagas: Silent Killer

Vaccines: The Price of Protecting a Child from Killer Diseases

“Adding new vaccines to the national immunization program is like taking out multiple mortgages.”—Ministry of Health Official, Kenya

Each year, the lives of two and a half million children are saved because they are protected against killer diseases through vaccination. Vaccinating with new vaccines should save many more lives, but high prices could prevent this from happening.

Safe Delivery: Reducing maternal mortality in Sierra Leone and Burundi
Ensuring pregnant women have timely access to emergency obstetric care has reduced maternal deaths by as much as 74 percent in parts of two African countries 

The comprehensive emergency obstetric services at MSF hospitals in Bo and Kabezi is provided 24 hours a day, seven days a week. All services are free of charge. The total annual operating costs of the programs are equivalent to just under two dollars per person in Bo and $4.15 per person in Kabezi.

MSF’s data indicate that maternal mortality in Burundi’s Kabezi district has fallen to 208 per 100,000 live births, compared to a national average of 800 per 100,000 live births, a 74 percent decrease. In Sierra Leone, MSF figures for the same year indicate that maternal mortality in Bo district has decreased to 351 per 100,000 live births, compared to 890 per 100,000 in the rest of the country, a 61 percent reduction. MSF is the only emergency obstetric care provider in Kabezi and Bo.

Sierra Leone and Burundi both suffer from extremely high maternal mortality rates due to lack of access to quality antenatal and obstetric care, which are linked to shortages of qualified health staff, a lack of medical facilities, and health systems that have been shattered by years of civil war.

“Giving birth in Sierra Leone is often a life-threatening endeavor for many women,” said Betty Raney, an obstetrician with MSF in Sierra Leone. “In my 25 years as an obstetrician, I have never seen such a level of severity among the patients. Had they not had any access to care, many of them would die.”

Using the United Nations Millennium Development Goal (MDG) of reducing maternal mortality by 75 percent by 2015 as a point of reference, MSF’s estimates indicate that the maternal mortality ratio in Kabezi is already below the MDG level. MSF is confident that the mortality ratio will have dropped by 75 percent in Bo by 2015.

How MSF Works: Delivering Aid

MSF-Logistique is as a nonprofit humanitarian purchasing and distribution center. It is a licensed pharmaceutical institution, meaning we have permission from the French authorities to operate a business that deals with drugs. That’s why we have four pharmacists on staff. We are also licensed to hold materials in customs. All of our supplies are officially in transit because nothing in our warehouse is destined for use in Europe. With this status we avoid customs taxes, can store products for as long as needed, and can ship to the field right away, without worrying about clearing customs.

Bayer Attempting To Block Affordable Patented Drugs In India

German pharmaceutical company Bayer is challenging an intellectual property decision in India that allows more affordable generic drugs to be produced in the interests of public health. You can see the extent of the price differences in this image.

Learn more about the case.

Graphic by Will Owen

The Need For Urgent HIV and TB Treatment in Myanmar.

Tens of thousands of people living with HIV and tuberculosis (TB) in Myanmar are unable to access lifesaving antiretroviral therapy (ART), a dire situation exacerbated by the recent cancellation of a new round of funding from the Global Fund to Fight AIDS, TB, and Malaria.

“Lives in the Balance,” a report from Doctors Without Borders/Médecins Sans Frontières (MSF), outlines the situation for people affected by HIV and tuberculosis (TB), with a special focus on multidrug-resistant TB (MDR-TB), in Myanmar today. It calls for urgent funding and assistance to be made available by the international donor community to help Myanmar close the devastating gap between people’s need and people’s access to treatment for HIV and TB.

Infographic by Will Owen

Over the past three years, MSF teams have witnessed a rather astonishing rise in the number of malaria cases in Democratic Republic of Congo. For its part, MSF is now responding to outbreaks in six separate provinces in the east and north of the country, but a wider, more concerted effort is urgently needed to battle this potentially fatal disease that traditionally afflicts the young and the infirm. Learn more.

Infographic by will owen.

The Avoidable Crisis of Maternal Death

MSF makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. MSF teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

In a conflict or crisis, pregnant women are even more vulnerable because health services have collapsed, are inadequate, or are totally non-existent. But these women need access to quality emergency obstetric care whether they live in a conflict zone, in a refugee camp, or under plastic sheeting after a devastating earthquake.

In fact, they need the same help that all pregnant women facing a complication need: access to appropriate medical assistance—skilled medical staff, drugs, and equipment—to save their life and the life of their baby.

Conflict, epidemics, natural disasters, or the complete breakdown of a country’s health system are crises faced by MSF’s millions of patients around the world every day. But a maternal death: that’s the avoidable crisis.

Infographic by Will Owen