Drug to crack resistant TB

There is "light at the end of the tunnel" for people with drug-resistant tuberculosis.

Florian von Groote-Bidlingmaier, medical director of Task Applied Science, a research unit collaborating with Stellenbosch University, told doctors yesterday about trials of new drugs that might offer a lifeline to patients with drug-resistant TB.

He was speaking at the World TB Day Symposium, convened by the National Institute for Communicable Diseases, in Johannesburg.

Half-a-million South Africans contract TB every year and one in 25 is likely to develop a form of the disease resistant to treatment. Drug-resistant TB kills at least one in five of the people who contract it.

Most TB drugs have been in use for at least 50 years, Von Groote-Bidlingmaier said, but the development of a new medicine took many years and could cost as much as R10-billion.

It can be years before patients gain access to a new medicine. For example, the drug bedaquiline was developed in 2005 but almost 10 years later it is available to only 200 patients in South Africa in a monitored programme with strict eligibility criteria.

Von Groote-Bidlingmaier said that delamanid, conditionally approved by the European Medicines Agency recently, was being tested at three sites in South Africa and abroad. The current trials, if successful, are the last step before the drug is registered.

"TB is not treated with a single drug. There is a need for further trials to test new drugs in combination to see if we can find a better treatment regimen."

South Africa is the world leader in the exploitation of the GeneXpert machine to detect TB much more quickly. But a study has shown that, though detection has improved, patients are no more likely to start and see their treatment through to completion.

The health system needed strengthening, Professor Lesley Scott, of the National Health Laboratory Service, said.