The largest ever roll-out of Xpert MTB/RIF, a rapid tuberculosis (TB) diagnostic, began today, aiming to save 62 000 lives and prevent the spread of drug-resistant strains of the disease.
The TBXpert project, funded by UNITAID and coordinated by the World Health Organization (WHO) and the Stop TB Partnership, is worth US $25.9 million and will see more than 220 Xpert machines and 1.4 million test cartridges delivered to 21 countries in Africa, Eastern Europe and Asia.
The Stop TB Partnership’s TB REACH programme is supporting 14 of these countries through grants that promote innovative ways to increase access to diagnosis and treatment for people with TB, including the deployment of the Xpert diagnostic. TB REACH and the Stop TB Partnership’sGlobal Drug Facility are responsible for procuring all the Xpert machines and test cartridges that will be delivered through the TBXpert project.
The Xpert diagnostic, endorsed by WHO in 2010, can deliver a TB test result within two hours. Older tests can take weeks or months to complete. The Xpert test can also detect resistance to rifampicin, one of the first-line drugs most commonly used to treat TB, and detect TB among people living with HIV.
Thanks to an agreement reached by UNITAID with the Xpert manufacturer Cepheid, 145 countries—including all 21 in the TBXpert Project—are now benefitting from a 40% price reduction on cartridges. Results now show that the reduced prices have helped to achieve cost savings of more than US$ 15 million globally.
This global price reduction has allowed other countries who are not directly supported by UNITAID, such as South Africa, to test more people with the funds that they have available. The US President's Emergency Plan for AIDS Relief, the United States Agency for International Development, and the Bill & Melinda Gates Foundation joined UNITAID in negotiating this price reduction.
"The roll-out of this innovative test will bring accurate diagnosis to some of the most vulnerable people in the world and save many thousands of lives. This will accelerate our efforts to find the three million people who are not reached with TB care every year," said Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership.
Until recently, the only TB diagnosis technique available to most laboratories in developing countries is more than a century-old and involves detecting the bacteria using a microscope. Testing for MDR-TB requires another cumbersome method: growing the bacteria in laboratory cultures, a process that can take months and requires extensive infrastructure. During this time period, drug-resistant strains can spread from person-to-person.
"Detecting TB rapidly and identifying drug resistance on the spot are essential to improve care of affected people and avoid transmission in the community." said Dr Mario Raviglione, Director of the WHO Global TB Programme. "Wide introduction of new molecular diagnostic tests, such as through the TB Xpert project, is the best way we have today to ensure early and accurate TB diagnosis."