Delivering TB Preventive Treatment
USAID Global Health Supply Chain Program-Procurement and Supply Management
Globally in 2022, Tuberculosis (TB) caused an estimated 1.3 million deaths, including 167,000 deaths among people with HIV[1].?In September 2023, at the second UN high-level meeting on TB, Member States committed to increase TPT coverage among contacts and people with HIV, reaching at least 90% (equivalent to 45 million individuals) by 2027[2].
Per PEPFAR’s FY2024 Technical Considerations, TB preventive treatment (TPT) can reduce incident TB among PLHIV, including CLHIV, by up to 89% when combined with ART and has been shown to reduce mortality independently. [3] Therefore, completion of TPT for all PLHIV (including eligible household contacts of PLHIV with TB disease) is a PEPFAR Minimum Program Requirement.
Previously, the preferred treatment regimen was 6 (6H) or 9 months of isoniazid (9H). Presently, three months of weekly high-dose isoniazid and rifapentine (3HP) is the preferred PEPFAR regimen for TPT for adults and adolescents.
In collaboration with international organizations such as the Unitaid , The Global Fund , Clinton Health Access Initiative, Inc. , and The Pan American Health Organization Pan American Health Organization, together with the USAID and GHSC-QA, GHSC-PSM started the procurement and supply of 3HP at the end of CY2020. Despite the manufacturing disruptions related to COVID-19 pandemic, as well as nitrosamine-related risk management activities requiring additional quality control measures, GHSC-PSM has delivered more than 1.8 million 3HP patient courses to 16 countries[4], supporting countries to reach and/or maintain 100% TPT coverage and targets, and reducing the risk for people developing TB disease.
Starting from November 2023, price for a pack of Isoniazid/Rifapentine 300/300 mg Film-Coated Tablet, 3 x 12 Strip Pack Tablets, which is the main medicine GHSC-PSM procures for 3HP regimen, went down from $14.25 to $9.99-$11.16, representing about 22% to 30% cost reductions. This enables us to operate more efficiently and help people live happier, healthier lives.
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[1] https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023
[4] Burundi, DRC, Cote d’Ivoire, Eswatini, Ethiopia, Haiti, Kenya, Lesotho, Mozambique, Namibia, Nigeria, Rwanda, Tanzania, Uganda, Zambia, Zimbabwe