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Anti-TB drugs : We could save more lives

tuberculosis (TB) is currently the most deadly infectious disease worldwide. 1.6 million people died of 2017 to the disease, far more than half a Million people are affected in the same year, a drug-resistant Form of TB. The treatment in these cases is particularly difficult. You can take up to two years, painfully and with massive side effects such as depression or hearing loss. And even worse: Only half of the people treated will be cured.

Effective, sure - but too expensive

For the hundreds of thousands of people who are suffering from resistant TB, could be the drug Bedaquiline to the rescue. Developed by the U.S. pharmaceutical company Johnson & Johnson (J&J), it is one of only two new antibiotics against TB, which have come in the past 50 years on the market. Bedaquiline is in the application of effective and safer than the previously used active ingredients. It allows for a shorter and easier to be administered at the end of therapy. The Problem: Only nearly 30 000 people were able to receive Bedaquiline until the end of 2018 – a fraction of those in need of therapy with the drug.

Last week, the head of research at J&J, Paul Stoffels said in an Interview with the daily mirror, it was realistic, "to keep tuberculosis at a very low Level". That would be more than desirable. But it is also necessary that J&J is contributing to this accordingly.

It begins alone, with the fact that Bedaquiline is not registered in the 18 most affected countries and, therefore, there is not on the market. How can that be?

Publicly-funded research

Indeed, J&J offers Bedaquiline in poorer countries at a reduced price. But $ 400 for a six-month treatment are often still too expensive for the countries that are most affected by resistant TB, such as countries in Africa, Eastern Europe and Central Asia. The announced price reduction to be implemented by the J&J furthermore, since July of 2018 so far. Recent studies show that Bedaquiline could be for prices between 8 and 16 dollars per month and profitably sold produced. On the advantage the price of J&J, this throws a very different light.

in Addition, large sums are invested public funds in the development of Bedaquiline, for example by the US-American Ministry of health or the TB Alliance. Important clinical trials of the drug were carried out by several public actors, and of the "Doctors without borders" – not only from J&J. these studies were the basis for the world health organization Bedaquiline recommended a few weeks ago as a core part of any treatment of resistant TB, as well as a massive expansion and the earliest possible treatment with the antibiotic. Against this Background, the question of why J&J does not acknowledge his responsibility in this case and why it is not, of course, is that the drug will be offered at prices that are affordable.

objective: tuberculosis by 2030

stop Quite to the contrary, J&J tried, instead, especially in India, to apply for additional patents on Bedaquiline, to block the production of more affordable generics by other companies for years to come. This has, in particular, a macabre connotation, if one remembers that India is the country with the world's largest burden of disease due to TB. Two young former TB patients who have lost as a result of a treatment with the old TB drugs, your hearing, offer J&J courageously face and since last week against this attempt to the public. We very much hope that the two of them have success. We could save more lives if Bedaquiline would be really for all the people who need it, accessible and affordable. Only then is it realistic to reach the goal of the United Nations, to end tuberculosis by 2030.

research used although urgently – only happens if you bring in a lot of money? Drugs, which are sold at such high prices that those who need it urgently, you can not afford? There's a bug in the System that needs to be tackled swiftly. Here, governments must intervene by funding more research and incentives. So far I agree with Mr Stoffels. In contrast to him, I think that these public investments must then also be of benefit to the General Public, and not the main objective should be to increase the profit of pharmaceutical companies. It is exactly the medicine products have to be developed and are urgently needed – and even if none of the huge revenues or huge sales volumes, waving. At prices that are affordable for people all over the world.

More about

multi-drug resistance tuberculosis

Jana Schlütter

The author, a dangerous directs the medicines campaign "Doctors without borders".

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