Children and expectant women suffering from tuberculosis in middle-income countries including Kenya are expected to start accessing cheaper treatment.

The move comes after various partners, including Unitaid, Aurum Institute, the Clinton Health Access Initiative (Chai) and MedAccess under the IMPAACT4TB project announced plans to lower the cost of rifapentine (RPT)-based treatments to manage the highly contagious disease. 

Rifapentine is used in combination with other medicines to treat active or inactive (latent) tuberculosis.

In the deal, Kenya will benefit from Kes2.3 billion additional funding by Unitaid which will help identify the correct dosing and drug-to-drug interactions when children and expectant women living with HIV take three months of weekly isoniazid and rifapentineor 3HP combined with dolutegravir (DTG) based Anti-Retroviral Therapy.

“This announcement will help us prevent TB among more people by ensuring that there is enough supply to meet the needs of eligible countries. Ultimately, preventing TB is critical to our ability to finally end this deadly disease,” head of World Health Organization Global Tuberculosis Programme Dr Matteo Zignol said.

Similarly, the funding awarded to the Aurum Institute will focus on the evidence required to ensure that children and pregnant women, including those living with HIV and household contacts have access to the latest TB prevention regimens. 

Further, the project will invest in ensuring countries are aware of the need for medicines for children for TB prevention that are easier to swallow and with the appropriate dose.

Read also: Ministry rolls out new TB screening, diagnosis and treatment tools

The currently available 3HP tablets need to be swallowed whole, which is difficult for some children and needs to be broken into pieces to dose children appropriately, limiting access to TB prevention for children.

“In recent years, we have come a long way towards improving access, at an affordable cost, to tuberculosis-prevention treatments that are shorter and easier to take, but supply has remained a constraint,”  Dr Matteo said.

Under the initiative, 3HP, a three-month, once-weekly oral treatment for the treatment of latent TB infection will now be available at a ceiling price of $14.25 (Kes1,500), down from $333 (Kes36,000).

Rifapentine 300 mg single tablets, used in 3HP and 1HP (a one-month, once-daily oral treatment) will be available for $33.90 (Kes3,700) per 100 tablets.

Since its inception in 2017, the IMPAACT4TB project has focused on the introduction of shorter, rifapentine-based TB prevention treatment options that are associated with higher treatment adherence, completion, and outcomes.

Working with global partners and manufacturers, the project has helped to significantly reduce the access price of a three-month patient course of weekly rifapentine and isoniazid, from $72(Sh7,300) to below $15(Sh1,500).

“We expect this desperately needed child-friendly formulation to be ready for distribution by no later than the end of 2024,” Mike Frick from the Treatment Action Group said.

Kenya is one of the countries listed by WHO as struggling with a high burden of tuberculosis.

The Global Tuberculosis Report 2021 released in October last year showed that the disease continued to be a major killer with data estimating that at least 21,000 mortalities were reported among HIV-negative patients and another 12,000 among HIV-positive patients.

The total number of TB patients in the country in the same year was 139,000 with 35,000 cases being among HIV-positive people.

According to data by Unitaid and WHO, in 2020 alone, more than 1.5 million people died from TB, while around 10 million people fell ill from the disease globally.

About one-quarter of the world’s population is infected with a latent form of TB that causes no symptoms and is not contagious.

Without treatment, five to 10 percent of those infected will develop active TB, which causes severe illness and can be transmitted from person to person through the air.

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