Expensive drugs could threaten TB treatment access in Nigeria, worldwide

The number of multi-drug resistant tuberculosis cases is on the rise worldwide and health officials worry that the trend could reduce the effectiveness of first-line TB drugs and raise treatment costs.

Sam Igwe, a medical expert at a private hospital in Lagos, said that the poor management of TB in hospitals could cause a spike in resistant cases. He said that most cases result from improper clinical management, such as partial or inconsistent TB treatment, This Day reports.

"We are beginning to see cases of MDR-TB," Igwe said, according to This Day. "These are cases that are now resistant to the normal drugs we know to have worked in treating TB. If these cases are allowed to continue to develop and transmit infections, we are going to run into the problem of losing all the drugs that we have for TB and start going for second line drugs."

An attendant at Lagos University Teaching Hospital in Nigeria said that infectious disease hospitals that treat TB are functioning below optimal capacity. As a result, the hospital may settle for second-line drugs that are less effective and more toxic.

Drug costs for treating a TB patient with MDR-TB can be as much as 50 to 200 times more than treating a patient with non-resistant TB. Total costs include equipment diagnosis and labor costs.

While funding is an issue at the local level, it may be even more of a problem on a larger scale. Currently, there is a $1.4 billion funding gap for research and an additional $3 billion annual funding shortfall between 2013 and 2015, MedicalNewsToday reports.

"This gap threatens to hold back delivery of TB care to patients and weaken measures that prevent and control the spread of TB, with low-income countries at most risk," Katherine Floyd, the coordinator for the Global Tuberculosis Report 2012, said, according to MedicalNewsToday.

Mario Raviglione, the director of the WHO Stop TB Department, said that progress has been made in the fight against TB. In the last 17 years, he estimates that 51 million people with TB were effectively cared for and treated and 20 million of them would not have survived without the treatment.

Despite the progress, Raviglione warned that the fight is far from over.

"We are now at a crossroads - either we eliminate tuberculosis in our lifetime, or the disease evolves, becomes more and more resistant and harder to treat, and many millions more than expected will die," Raviglione said, according to MedicalNewsToday.

Approximately 3.7 percent of all new global TB cases are multi-drug resistant strains. Twenty percent of cases that in people who already received treatment are MDR-TB strains.