Today’s guest blog comes from Daniel Collins, Advisor for the Lilly Global Health Programs.
I recently took part in the TB Innovation Workshop in Dubai hosted by the new Harvard Center for Global Health Delivery. There I had the privilege of sharing two new projects in the Lilly MDR-TB (multidrug-resistant TB) Partnership. Each addresses a specific but important element in stopping the ravages of TB: ensuring patients have access to quality assured medicines.
Most of the focus on the TB epidemic in low- and middle-income countries is appropriately placed on finding and properly treating the “missing” 3 million people who are infected but un- or under-treated. Anyone who’s worked in TB knows that the “finding” part of the equation is complex. The “properly treated” part, however, is equally complicated if not more so. These challenges are in play: limited TB education among health care providers, low treatment adherence within the most difficult living conditions, tenuous local supply chains, questionable local manufacturing quality, and more. Without addressing these problems, finding the missing millions will be for naught and exacerbate the spread of this deadly disease.
As many people know, the Lilly MDR-TB Partnership has been closely involved in addressing health care providers’ capacity building and patient treatment adherence in the highest burden countries. What many don’t know is that we are also working diligently with global health partners to ensure all patients have access to quality-assured MDR-TB drugs.
The two projects I presented at the workshop are just the latest examples of how we are doing this, and will hopefully encourage others in the corporate sector to lend their expertise to these drug access challenges.
One project addresses the clear gap in many countries’ ability to manage their TB drug supplies and forecasts their future drug needs. Without these skills, drug supplies can run out, putting patients at even greater risk. Accurate demand forecasts are critical to manufacturers as well. To incentivize the highest quality suppliers to enter and stay in the relatively small MDR-TB market, they need assurance of accurate forecasts to manage their business effectively. The KNCV TB Foundation is leading this effort in partnership with Management Sciences for Health and local TB authorities to provide 10 countries the knowledge and tools necessary to manage their drug supplies.
The second project involves India’s huge private health care segment. In India, many of those missing TB patients likely choose to seek care from this highly diverse and mostly disconnected set of providers. Unfortunately, how these patients are treated, if at all, is just as diverse. Finding incentives for the private providers to appropriately diagnose and treat TB patients with quality assured medicines is the goal. In our Lilly MDR-TB Partnership programs in India and elsewhere, we start at the local level. In this case, it is the city of Chennai, highly burdened by TB. For this effort to succeed, it’s key not to tell private health care providers what they need to do. That doesn’t work. The key is to collaborate with them to understand their concerns and needs, and find cost effective ways to help them properly care for their patients. KNCV and India-based REACH will work with the local government on this effort.
The data-driven learnings from these projects will, we believe, offer the evidence needed to expand quality drug access in and across countries. While a high-quality drug supply is just one piece of the MDR-TB puzzle, it’s a critical piece of the solution we are committed to supporting.