Blog Posts by Emily Delmotte

 {Photo credit: Warren Zelman}The MSH-led Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program is co-hosting the Global TB Conference 2015: Building the Post-2015 Agenda with the Stop TB Partnership Global Drug Facility.Photo credit: Warren Zelman
The US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health (MSH), in collaboration with the Stop TB Partnership Global Drug Facility, will host a technical conference titled, “Building the Post-2015 Agenda: Novel Approaches to Improving Access to TB Medicines and Pharmaceutical Services” from March 2-6, 2015 at the Conrad Bangkok Hotel in Bangkok, Thailand.

The invitation-only conference will feature country experiences using tested approaches to prevent tuberculosis (TB) medicine stock-outs, increase TB case detection through private sector engagement, and ensure patient safety during TB treatment. National TB program (NTP) managers or deputies; NTP procurement and supply management leads; monitoring and evaluation leads for TB/data managers; donors; and World Health Organization and Stop TB Partnership partners are expected to attend.

 {Photo credit: Damien Schumann, via ScienceSpeaks Blog}Busisiwe Beko.Photo credit: Damien Schumann, via ScienceSpeaks Blog

Cross-posted with permission from Science Speaks Blog.

The Value of Patient Support

Eight years ago Busisiwe Beko was undergoing treatment for multidrug-resistant tuberculosis (MDR-TB) when, after months of waiting to see a pediatric specialist, her daughter was diagnosed with the same illness. The five-month-old baby was admitted to a TB hospital where she would receive treatment for seven months; Busisiwe, however, was turned away due to lack of space. Today, both mother and daughter are healthy. And, their experience with MDR-TB didn’t stop at their cure. Busisiwe went on to join Médecins Sans Frontières as a counselor for MDR-TB patients in her community, providing the support and medication counseling that she wished she had received during treatment.

{Photo credit: Mark Tuschman.}Photo credit: Mark Tuschman.

This post originally appeared on the SIAPS website.

After decades of relying on old medicines, new drugs designed specifically for the treatment of tuberculosis (TB) are finally on the market. While these medicines represent a major advancement in the fight against TB, ensuring equitable access for patients is still an enormous challenge. At the 45th Union World Conference on Lung Health, the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program, led by Management Sciences for Health (MSH), collaborated with the Stop TB Partnership Global Drug Facility (GDF) to host a full-day workshop addressing common hurdles to treatment access, as well as available solutions.

The SIAPS program focused on three common challenges in medicines availability: quantification, public-private mixes, and medicines safety.

 {Photo credit: Mark Tuschman.}A pharmacy in Kenya.Photo credit: Mark Tuschman.

Guaranteeing that patients have uninterrupted access to anti-tuberculosis (TB) treatment begins with national TB programs (NTP) making complex calculations about how many cases to expect in the future.  Vigilant stock management, accurate number of cases started on each type of treatment along with forecasting the expected number of patients that will be enrolled on treatment, are vital to ensure that medicines are available to all patients who need them.

To promote a systems-strengthening approach to TB medicines management, the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program developed QuanTB—a downloadable, desktop tool that transforms intricate calculations into a user-friendly dashboard displaying key quantification and supply planning information.

 {Photo credit: © 2011 Arturo Sanabria, Courtesy of Photoshare}A health care provider dispenses TB drugs for Directly Observed Treatment (DOTS) at Tete's Urban Health Center, Mozambique.Photo credit: © 2011 Arturo Sanabria, Courtesy of Photoshare

Successfully combating the tuberculosis (TB) epidemic requires that national TB programs (NTPs) prevent new infections and ensure that current patients are cured. Although the treatment for drug-sensitive TB is very effective, curing the disease requires that patients adhere to a strict daily regimen of multiple pills for six to nine months. Adding to the challenge is the fact that treatment for drug-resistant TB is longer, more toxic, and less effective.

All medicines carry some risk of adverse events, and anti-TB medicines are no exception. In addition to threatening the health of patients, adverse events, if not well managed, may also result in individuals stopping their treatment early. Patients who prematurely discontinue treatment may remain sick, develop resistance to the medicines, and spread TB to others in their community.

To support NTPs and health professionals efforts to meet treatment goals and improve the safety of anti-TB medicines, the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program developed the first guide of its kind on minimizing risks associated with anti-TB medicines.

"At the Duka" tells the story of a Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) project to increase early detection of tuberculosis in Tanzania.

SIAPS partnered with the Tanzanian National Tuberculosis and Leprosy Program to train drug dispensers on the symptoms of TB, so that they could refer clients with these symptoms to TB diagnostic and treatment centers for follow up.

The video is narrated by David Mabirizi (SIAPS Principal Technical Advisor), and features Gabriel Daniel (SIAPS Principal Technical Advisor), Edmund Rutta (SIAPS Senior Technical Advisor), and Salama Mwatawala (SIAPS Senior Technical Advisor).

Watch video

Patients wait in a well-ventilated area outside the TB clinic in Homa Bay, Kenya. {Photo credit: A. Kwiecien and A. Salakaia / MSH.}Photo credit: A. Kwiecien and A. Salakaia / MSH.

The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).

So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines. As compared with the 6 month treatment regimen for drug-sensitive (DS)-TB, DR-TB requires 18-24 months of treatment with medicines that are less effective, can cause sometimes severe side effects, and can cost up to 300 times more.

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