At the heart of the report is a recognition that TB preventive therapy can be an effective intervention to reduce TB incidence globally. Specifically, the report finds that preventive treatment of TB infection could, by reducing population-level transmission, interrupt the cycle of infection, illness, and death from TB—which killed 1.6 million people in 2017. And presented at CROI earlier this month demonstrates that one such preventive treatment—known as 3HP—can safely be co-administered with (DTG)—the first-line drug to treat HIV in many high-burden TB countries.
If left untreated, latent TB infection can develop into active TB disease—the form of TB that makes people sick and is capable of being transmitted from one person to another. The World Health Organization (WHO) estimates that about a quarter of the world's population has TB infection and have a 5-15 percent lifetime risk of falling ill from TB. That risk is however much higher in children under the age of five and people living with HIV—who are 20 to 37 times more likely to move from latent infection to active TB.
The findings of the Lancet Commission, as well as the recent study showing that 3HP can safely and effectively be used among adults with HIV taking DTG, are particularly relevant to South Africa, where TB remains the leading cause of death and where about 60 percent of TB patients are also HIV positive.
Beyond TB prevention, the report highlights the need for a comprehensive response to the TB epidemic, one that includes ensuring that high-quality diagnostics, prevention and treatment are available to all. Beyond intensifying current, proven approaches, the report recognizes the need for new and better tools to fight TB and emphasizes the need to significantly increase our global investments in TB research and development-- from $772 million per year in 2017 to at least $2 billion per year during the next four years.