Tuberculosis

Tuberculosis has become the world's leading infectious killer, despite the fact that it is completely preventable and curable. A lengthy treatment regimen is also driving the rise of drug-resistant strains. Working with The Union and other global partners, we will implement clinical trials to improve treatment regimens.

Every year, more than 1.5 million people die of tuberculosis (TB), a curable and preventable disease. Despite the progress made in the global TB control, multidrug-resistant TB (MDR-TB) has emerged as a major public health concern. According to the World Health Organization, the gap between the number of people diagnosed with MDR-TB and those who begin treatment has widened in recent years.  Even patients who receive treatment may not be able to complete it because of the painful side effects and long duration, which can be up to 24 months.  

Approach

Since 2012 The Union North America has worked with other Union offices and global partners to implement the STREAM clinical trial, which is evaluating shortened treatment regimens for multidrug-resistant tuberculosis in several countries worldwide. Vital Strategies will continue this important work with these partners. This landmark trial will provide evidence on the effectiveness of regimens as short as six (6) months’ duration compared to the current treatment duration of 24 months – a potentially enormous step forward for both affected communities and the health systems that serve them.

Comprised of two stages, STREAM is evaluating promising regimens that may offer shorter and more easily administrable treatments. The first stage of STREAM tested a 9-month treatment regimen for MDR-TB, with results expected in 2017. More than 400 patients in Ethiopia, South Africa, Viet Nam and Mongolia will participate in the study between 2012 and 2017. 

The second stage of STREAM will test an all-oral 9-month regimen and a 6-month regimen, which will both include bedaquiline, a new novel anti-TB medicine developed by Janssen Research & Development, LLC (Janssen). Institutions in several countries are currently under consideration for participation in Stage 2, which is scheduled to begin in late 2015.