Tuberculosis (TB) is the world’s deadliest infectious disease. Despite being preventable and—with timely diagnosis and appropriate treatment—curable, an estimated 1.6 million people die of TB every year. Approximately 95% of these deaths occur in low- and middle-income countries.5
Growing resistance to the most commonly used TB drugs is compounding this challenge. Multidrug-resistant TB (MDR-TB) is a persistent and growing threat; in fact, the World Health Organization (WHO) estimates that nearly half a million new cases of MDR-TB occur worldwide each year,6 and drug-resistant TB now accounts for one third of all deaths due to antimicrobial resistance (AMR).7
In 2012, Johnson & Johnson brought forward SIRTURO (bedaquiline), the first novel TB antibiotic in nearly half a century. Since then, we have partnered extensively in high-burden countries to provide access to and ensure appropriate use of our treatment and to raise awareness about TB more broadly.
As part of this effort, in 2015, Johnson & Johnson launched a four-year donation program with the U.S. Agency for International Development (USAID) and JSC Pharmstandard, one of the leading Russian pharmaceutical manufacturers. We originally committed to donate 30,000 courses of bedaquiline to up to 110 eligible low- and middle-income countries; however, in response to high demand, we more than tripled our commitment. In 2018, we also further consolidated our partnership with Pharmstandard with a Memorandum of Understanding to enable Pharmstandard to manufacture and globally export bedaquiline.
Several notable events in 2018 have begun to broaden the use of bedaquiline globally. In June 2018, South Africa became the first country to recommend an injection-free, bedaquiline-containing regimen for all eligible MDR-TB patients. This decision was based on programmatic data showing reduced mortality and improved patient outcomes for patients on bedaquiline-containing regimens. Later in the year, the WHO issued new guidelines recommending the use of bedaquiline as a core drug for inclusion in conventional (long-course) regimens unless its use is contraindicated.8
To enable a more rapid scale-up of bedaquiline to MDR-TB patients, Johnson & Johnson announced a not-for-profit price in July 2018. This offer was extended to more than 130 eligible countries procuring through the Stop TB Partnership’s Global Drug Facility, including all previously donation-eligible countries.
Catalyzing TB innovation
In the lead-up to the first-ever UN High-Level Meeting on Tuberculosis in September 2018, Johnson & Johnson co-hosted the landmark TB Innovation Summit with the Stop TB Partnership, the World Economic Forum, the United Nations Foundation, and the Global Fund to Fight AIDS, TB and Malaria. The Summit focused on the urgent need for innovation—both in the lab and on the ground in high-burden countries—to drive progress toward the shared goal of ending TB. Paul Stoffels, M.D., Vice Chair of the Executive Committee and Chief Scientific Officer, Johnson & Johnson, spoke on a panel and highlighted the important role of the private sector in driving innovation. To support the Sustainable Development Goal target of ending TB by 2030, he also announced our comprehensive 10-year TB initiative, with the goal of saving an estimated 1.8 million lives and preventing 12 million new infections. Through this initiative, we will work with partners to improve detection of undiagnosed cases of TB, broaden access to bedaquiline, and accelerate R&D to discover next-generation TB medicines and multi-drug regiments.
Expanding access in South Africa and China
At the TB 2018 Conference in July, Johnson & Johnson announced a landmark collaboration with South Africa aimed at scaling up access to bedaquiline by offering the medicine to South Africa—and to more than 130 additional eligible countries—at a not-for-profit price. This commitment was made in recognition of South Africa’s unparalleled leadership in the fight against MDR-TB. Earlier in 2018, South Africa became the first country in the world to recommend replacing injectable drugs with bedaquiline for the treatment of MDR-TB.
Johnson & Johnson is supporting the Chinese government in its efforts to end TB, including by improving case detection, training healthcare professionals to manage TB and MDR-TB more effectively and, appropriately, raising awareness and reducing stigma among the public, and accelerating access to effective treatment in collaboration with partners.
Since 2016, Johnson & Johnson has been partnering with China’s National Health Commission (NHC), Bill & Melinda Gates Foundation and the Chinese Center for Disease Control and Prevention (China CDC) to undertake a New Drug Introduction Program, aimed at ensuring appropriate access to our MDR-TB treatment.
Additionally, in 2018 we launched a collaboration with the NHC, China CDC and diagnostic manufacturer Cepheid aimed at accelerating TB and MDR-TB patient finding in poverty-stricken regions in China.
Advancing progress toward a TB-free India
India has the highest burden of TB and MDR-TB in the world. Last year, Indian Prime Minister Narendra Modi announced a bold vision for a TB-free India by 2025—also outlined in Government of India’s National Strategic Plan for TB Elimination. In support of this, we are collaborating with the Government of India and other partners to tackle TB by supporting their efforts to increase access to treatment, improve diagnostic capacity, train healthcare providers, and raise awareness of TB at the community level.
Ending pediatric TB in Vietnam
TB remains the leading cause of mortality among all infectious diseases in Vietnam. Children are hard hit by TB, as the disease is harder to detect and also progresses more rapidly in this population. Less than 50% of children with TB in Vietnam receive the preventive therapy that could reduce their risk of developing the active form of the disease.9
To help address this public health crisis, in 2016, the global health nonprofit PATH and Johnson & Johnson formed a unique partnership, known as Breath for Life. The goal was to work with local partners to improve the detection, diagnosis and management of TB in a heavily burdened area in Vietnam-Nghe An. Two years on, there are indications of progress that the number of pediatric TB cases detected in Nghe An and the number of eligible children receiving preventive therapy have significantly increased. Also, Breath for Life supported hundreds of health workers receiving specialized training in pediatric TB detection and treatment.