November 18, 2023

Stop TB: Transform evidence into practice

Clinical HIV Research Unit

With the fast-approaching World Health Organisation target to end Tuberculosis (TB) by 2030, the TB Union called on the global TB community that attended the World Conference on Lung Health in Paris to ensure that science drives meaningful action to arrest the burden of TB, especially in low and middle-income countries. Under the conference theme ‘Transforming Evidence Into Practice’, some 3,650 delegates from over 155 countries, including South Africa, shared their research and experience in improving the prevention and treatment of TB, as well as the challenges that they are addressing.  

The Clinical HIV Research Unit’s (CHRU) Deputy Director, Dr Mohammed Rassool, and Senior Medical Officer and Investigator, Dr Pauline Howell, represented CHRU at the event.

Reflecting on the conference, Dr Rassool says, “AI has emerged as a powerful tool in TB control efforts by assisting with early detection, drug resistance predictions and treatment adherence. It is encouraging to see how AI is informing x-ray reading and cough sample technology. It is also helping to map out the best treatment regimens for patients based on the TB resistance patterns, where they live and what medicines are available.”

Results of the TB-CHAMP and V-QUIN trials which showed that levofloxacin can reduce the risk of  TB infection to multidrug-resistant TB (MDR-TB) contacts. “This has the potential to not only safeguards against the social and financial burdens associated with drug-resistant TB but also mitigates the risks to physical health,” says Rassool.

“I was pleased to learn of the novel TB drugs and novel regimens that are in the pipeline which promise to work more efficiently, have less toxicity and slash treatment time down to four, three and two months. This will undoubtedly improve adherence and treatment completion,” he adds.

Scientists also focused on new biomarkers for treatment success. Rassool explains that, “Currently, the standard is to look at culture, yet it can take up to six weeks for a result. Biomarkers could deliver a far quicker result and are set to help streamline the clinical development of new TB cures.” There is definitely a need to find new biomarkers.

Post-TB lung disease was underscored as a research priority. “Post-TB lung disease is still not fully understood,” says Rassool. “Scientists at the conference discussed finding new biomarkers and interventions to limit post-TB lung disease.”   

Smoking damages the lungs and impacts the body's immune system, making smokers more susceptible to TB infection. Rasool says that many scientists focused on the negative role of tobacco use on TB. “Similarly, the role of poor socio-economic conditions which see people living in homes or dwellings with poor ventilation and/or using coal and wood fires in driving lung disease was also underscored.”

Dr Howell presented the key successes of the BPAL programme in tackling drug-resistant TB. South Africa has been a global leader in introducing innovation to the field of Rifampicin-resistant tuberculosis (RR-TB) and the work done in the country has had a significant impact on global policy. Rassool adds that, “While the BPAL regimen definitely works, we need to be cognisant of the emergence of Bedaquiline resistance.”

Rassool adds that he was also pleased to learn about the development of TB vaccines given their pivotal role in TB control. “However, study outcomes will only be known in two to three years.

“Delegates also shared their experiences in addressing asymptomatic TB, given how it is compromising the TB response.”

The final results of the cutting-edge TB PRACTECAL research project implemented by Medicines Sans Frontiers that CHRU took part in was celebrated at the conference.

Speaking after the conference, President and Interim Executive Director of The Union, Guy Marks, said, “Working together, through The Union, we can be the catalyst for such change, by prioritising science and evidence-based policy in our mission to end TB and lung disease. In 2023, we saw many commitments made and renewed by world leaders, but without meaningful actions we will inevitably continue to miss our targets to end TB.”


ENDS