Tuberculosis (TB) remains a major cause of ill health and one of the top 10 causes of death worldwide. TB can affect anyone, anywhere – but it is also curable and preventable. World TB Day falls on 24 March, and Sanofi is proud to announce the launch, in partnership with the Department of Health, of an innovative TB prevention treatment called 3HP which is set to be a game changer for the South African market.
Thibault Crosnier Leconte, Country Chair of Sanofi South Africa says: “What makes this new treatment so exciting is that it need only be taken for a three-month period – one dose a week for 12 weeks – as opposed to the usual 12-month regimen required for standard TB therapy. The shortened duration of treatment will therefore mean better patient compliance, and ultimately better treatment outcomes.”
Through this public-private partnership, South Africa is set to experience significantly enhanced treatment coverage of persons with latent TB, by using the shorter and simpler 3HP regimen for the whole at-risk population.
Latent TB refers to when one has a TB infection, but the bacteria remain in the body in an inactive state and cause no symptoms. Latent TB isn’t contagious – but it can turn into active TB, so treatment is very important to help control the spread of TB. An estimated 2 billion people globally have latent TB, and up to 200 million of them may develop active TB disease if not treated. The World Health Organization (WHO) End TB Strategy recommends treatment of latent TB to end the TB epidemic.
The risk of latent TB progressing to active disease is considerably higher in individuals in specific high-risk populations, which includes people with HIV infection or recent contact with an infectious patient. Latent TB can be treated to prevent progression to active TB, thus resulting in a substantial benefit for both the individual and the community.
Despite treatment for latent TB infection having been available for a long time, few eligible individuals are started on it, and of those who are, many fail to complete their treatment. This could be because of the long length of treatment (12 months) or a lack of understanding of treatment benefits. The arrival of 3HP treatment is therefore set to have a major impact in this regard.
Says Crosnier Leconte: “The WHO has approved the use of 3HP as one of the alternative treatment regimens for latent TB. 3HP is as safe and effective as other latent TB treatments, with a significantly higher rate of completion of treatment due to its shorter, three-month duration.”
This is particularly pertinent given the burden of TB disease in South Africa. In 2020, the WHO estimated that the country had 360,000 cases of TB and 58,000 TB deaths.
South Africa is also one of the countries with the triple burden of drug-sensitive TB (DS-TB), multi-drug resistant TB (MDR-TB), and TB co-infected with HIV (TB/HIV). South Africa’s National Strategic Plan on HIV, TB and STIs 2017-2022 aims to intensify efforts on TB prevention, targeting TB household contacts as well as other vulnerable groups. This will include adopting the use of 3HP among other TB prevention treatment regimens, to reach 90% of those who are eligible by 2022.
The COVID-19 pandemic also threatens to reverse progress made in reducing the global burden of TB disease. COVID-19 has had an enormous impact on the number of people seeking and receiving healthcare for TB.
Says Crosnier Leconte: “The COVID-19 pandemic has resulted in patients defaulting on their treatments, including TB preventive therapy. However, it is vital that patients keep taking their medication during COVID-19, as we can’t afford South Africa’s TB outlook to worsen. Our hope is that the new 3HP treatment will address this by improving adherence to TB preventive therapy, as patients will need to access facilities fewer times.”
In 2019, Sanofi reached a volume-based agreement with Unitaid and The Global Fund, and announced a 66% discounted price for 3HP at the 2019 Union TB conference in Hyderabad. This enabled the Department of Health to include 3HP in the national TB preventive treatment guidelines and to finalise the roll-out plan, in line with Sanofi’s efforts to create better access to more affordable care.
Says Crosnier Leconte: “For more than 50 years, Sanofi has provided treatment and programmes that equip patients and their healthcare providers around the world to fight TB. We are incredibly proud to add 3HP to this portfolio, and partner with the South African government, to further help in the push to end TB.”
- World Health Organization. WHO Global Tuberculosis Report 2020 | USAID TB Project SA. Available at https://tbsouthafrica.org.za/resources/who-global-tuberculosis-report-2020. Last accessed 16 March 2021.
- Mayo Clinic. Tuberculosis. Available at https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250. Last accessed 16 March 2021.
- Bellissimo-Rodrigues, F., Passos, A.D.C. & Ruffino-Netto, A. 2013. Latent tuberculosis – the snake inside the egg. Revista da Sociedade Brasileira de Medicina Tropical, vol. 46, no. 6. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000600667. Last accessed 16 March 2021.
- World Health Organization. 2018. The End TB Strategy.
- World Health Organization. Latent tuberculosis infection (LTBI) – FAQs. Available at: https://www.who.int/tb/areas-of-work/preventive-care/ltbi/faqs/en/. Last accessed 16 March 2021.
- Skinner, D. & Claassens, M. 2016. It’s complicated: why do TB patients not initiate or stay adherent to treatment? A qualitative study from South Africa. BMC Infectious Diseases, vol. 16. Available at: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-2054-5. Last accessed 16 March 2021.
- World Health Organization. WHO Global Tuberculosis Report 2020 | USAID TB Project SA: Country Profile – South Africa. Available at country-profile-2020-final-web-min.pdf (who.int). Last accessed 18 March 2021.
- Let Our Actions Count. National Strategic Plan (NSP) on HIV, TB and STIs 2017-2022. Available at: https://www.gov.za/sites/default/files/gcis_document/201705/nsp-hiv-tb-stia.pdf. Last accessed 16 March 2021.
- Stop TB Partnership. 2020. The potential impact of the COVID-19 response on tuberculosis in high-burden countries: a modelling analysis. Available at: Modeling Report_1 May 2020_FINAL.pdf (stoptb.org) Last accessed 18 March 2021.