Innovative and groundbreaking initiatives have brought tuberculosis to a near standstill, with recent advancements finally gaining the upper hand in the fight against this age-old scourge and placing SA on the frontline in eliminating the disease once and for all, writes Bada Pharasi, CEO of The Innovative Pharmaceutical Association South Africa (IPASA).

Heeding the call to reduce the impact of TB in the country, the SA government, as a member of the United Nations, has pledged to the Sustainable Development Goal which aims to end the disease as an epidemic by 2030. SA is well on track to achieve this, committing to reducing TB cases by as much as 80%, and TB-related deaths by 90% by 2030 compared with 2015 levels¹. 

With the World Health Organization (WHO) setting a benchmark to reduce TB-related deaths by 50% by 2025, SA has already met and exceeded this. So much so that in 2022, 280 000 people in the country contracted the disease, down from 552 000 cases in 2015¹.  

According to reports by the government, new innovative medical interventions and developments have been linked with this success, including expanded screening activities with TB Health Check, the use of digital chest X-rays for TB screening, and the introduction of an SMS-based TB results notification system to improve a patient’s linkage to treatment². 

Since the initial discovery of the first tuberculosis cure in the 1940s, the pharmaceutical industry as part of healthcare has persistently endeavoured to enhance the standard of care for individuals affected by TB. 

In the past, the conventional approach to preventing TB among individuals exposed to the disease involved administering a medication called isoniazid daily for six months or longer. However, over the last decade, this approach has evolved with the introduction of new preventive therapy regimens, which can be taken for shorter durations, ranging from four to just one month³. 

While three new medicines developed to treat the disease have been registered in SA in the past decade, some presented side effects and the need for long-term use. Fortunately, findings from a study conducted in SA on a new experimental medicine, quabodepistat, have shown significant promise. Quabodepistat, when combined with bedaquiline and delamanid, has proven to be safe and efficacious in treating drug susceptible TB⁴.  

With the findings presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in the US last month, the experimental new medicine has performed well in a phase 2b/c trial, meaning that it can now proceed to a pivotal phase 2 trial⁴.  

While the eventual availability of these innovative medicines will bolster the fight against the disease with even greater efficacy, navigating through bureaucratic obstacles remains a significant hurdle for their realisation. 

To break through these barriers, there is a great need to foster an environment that encourages and supports pharmaceutical innovation. This includes increased public and private partnerships and investment into the research, development, and manufacturing process; the relaxation of policy, regulatory, and financing channels; and, finally, new approaches to bridge the gap between diagnosis and treatment.  

As we stand on the precipice of eradicating TB, there is no room for hesitation. As we forge ahead, with innovation illuminating our path and collaboration fortifying our efforts, the pharmaceutical industry possesses the power to conquer the disease and usher in a new era of universal health and well-being for all. 

REFERENCES: 

1. Tomlinson C. In-depth: What new WHO TB numbers mean for SA [Internet]. Spotlight. 2023 [cited 2024 Mar 16]. Available from: https://www.spotlightnsp.co.za/2023/11/10/in-depth-what-new-who-tb-numbers-mean-for-sa/ 
2. SA’s plans to reduce TB infections on track - Phaahla [Internet]. SAnews. 2023 [cited 2024 Mar 16]. Available from: https://www.sanews.gov.za/south-africa/sas-plans-reduce-tb-infections-track-phaahla 
3. Voigt E. Antibiotic slashes risk of drug-resistant TB in kids, finds major SA study [Internet]. Spotlight. 2023 [cited 2024 Mar 16]. Available from: https://www.spotlightnsp.co.za/2023/11/27/antibiotic-slashes-risk-of-drug-resistant-tb-in-kids-finds-major-sa-study/ 
4. Voigt E. New TB drug shows promise, but experimental vaccine disappoints [Internet]. Spotlight. 2024 [cited 2024 Mar 16]. Available from: https://www.spotlightnsp.co.za/2024/03/11/new-tb-drug-shows-promise-but-experimental-vaccine-disappoints/