Médecins Sans Frontières - 5 minutes to explain

Unique Identifier Code / URN MSF218626

Date taken / Date Recorded 15/12/2017 12:00 AM

Country Armenia

Commissioning section MSF-FRANCE

Photographer / videographer / producer Armelle Loiseau

Copyright MSF

Usage Rights (MSF) External Media, Social Media

Formal Consent Copy available no

Editor's rating ★★★★★ (C)

Video format h264 (Constrained Baseline) (avc1 / 0x31637661)

Duration 5m30s

Maximum Size 1920px × 1080px 559.69 MB

Additional Information / Shotlist 5 minutes to explain…Tuberculosis in 2017

Charlotte:
Hi everyone. Today’s topic is tuberculosis. TB is the world’s deadliest infectious disease. Here are some figures:

- 10 million people infected with TB in 2016.
- 1.7 million people died from TB in 2016.
- Tuberculosis is the leading cause of death in people living with HIV-AIDS.

Behind me is a derelict sanatorium outside Paris.
This is where TB patients used to come for care. Obviously progress has been made with treatment since then, but TB research is basically in the same sorry state as this building.

ON-SCREEN TEXT
Tuberculosis - 10 million cases – 1.7 million deaths – Tuberculosis - HIV
SLATE
The Fundamentals

There are several types of tuberculosis. But, to keep it simple, there’s drug-sensitive TB and drug-resistant TB. Drug-sensitive TB is relatively easy to treat, with six months of four antibiotics.
What about drug-resistant tuberculosis? Well, it’s resistant—to one, several or sometimes almost all antibiotics available. It’s called multi-drug or extensively drug-resistant tuberculosis, and treating it is a real challenge. Because there was no innovation, many patients ran out of options.

ON-SCREEN TEXT
TB – Drug-sensitive – Drug-Resistant– Tuberculosis – Multidrug-resistant – extensively drug-resistant - Innovation

Dr Bruno Barroso, ARCHIVE / 1998
I can’t see myself telling a patient “we have no treatment to offer you, so we’ll leave the disease to progress and you’ll die.”

Nothing new happened for a very long time. But, a few years ago, two new drugs became available.

ON-SCREEN TEXT
Delamanid – Bedaquiline

Dr Francis Varaine, ARCHIVE / 2015
These new drugs give real hope for patients suffering from tuberculosis. It’s an historic moment after 50 years at a standstill.

SLATE
So what’s the problem?

It’s not just one, but lots of problems! Let’s look at just a few.
The complications start right from diagnosis. Tests are too expensive, hard to access and ill-adapted. They’re not suitable for children, for example, or for people living with HIV. This means over four million cases are not notified or go undiagnosed.

ON-SCREEN TEXT
Test – Diagnosis – Drug-resistant tuberculosis – deafness - psychosis – 2 years – nausea - one in two chance

Then, when somebody is diagnosed with drug-resistant tuberculosis, they’re given treatment with several drugs. They have to take them for two years and the side effects are barely tolerable.
And, with all that, they have only a one in two chance of being cured.

Let me tell you about these new drugs available. They’re only given to patients for whom we know standard treatment is unlikely to work.

ON-SCREEN TEXT
Delaminid – Bedaquiline – Clinical trials

MSF was one of the first to use these new drugs in its medical programmes. Here’s what we’ve been doing on the drug-resistant TB front.
MSF is playing a pivotal role in drug-resistant TB research by running several clinical trials. Since 2013, we’ve used these new drugs to treat over 1,500 people in a number of countries.
Let’s see what’s happening on the ground.

SLATE
In the field
ON-SCREEN TEXT
Kenya - In 2014, Elizabeth found out she had extensively drug-resistant tuberculosis.
Staff were able to prescibe bedauailine.
Her son was sick too.

Elizabeth Wangeci (in English)
I looked at my kids and wondered, if I don’t get this medicine, I’ll just pass away…
After a month, I thank God the medication for extensively drug-resistant TB arrived and I started the treatment.

Hussein Haji Kerow, clinical officer, MSF (in English)
The child was taking almost 7 to 8 pills per day, and an injection every day except on Sundays. For the mother it was the same, she was taking almost 15 pills per day plus the injections.

Elizabeth Wangeci (in English)
Physically I was very unhealthy. I was weak and I had to carry John every day to the clinic.
After his medication, my son would sleep and sleep. And the injections were painful so he couldn’t play like other children.
I couldn’t look after my house or go to my job. I stopped because I was too weak.

ON-SCREEN TEXT
Two and half years later, Elizabeth went to the MSF clinic in Nairobi for her last dose.

Elizabeth Wangeci (in English)
Everyone there was waiting for me, so it was a very nice day. It was the best day in that part of my life.

SLATE
Interview

So you see, these drugs are extremely important. But, we estimate that in 2016 they were available to only 5% of patients who needed them. How come? Let’s talk to Cathy Hewison, Médecins Sans Frontières’s tuberculosis specialist.

Charlotte: Hi Cathy. So what’s stopping us from using these new drugs on a bigger scale?

Cathy Hewison, tuberculosis specialist, MSF (in English)
I think today there’s a lot of hesitation and fear, a widespread misconception that they should only be used for extreme cases and exceptional circumstances. It’s true that the price of one of the drugs is an issue but the other drug is free, so it’s not only price. There are still questions about the best combination, the best duration of the drugs but I think the main factor is fear.

Charlotte: So that’s for drug-resistant tuberculosis. But there’s no problem with drug-sensitive TB, right?

Cathy Hewison, tuberculosis specialist, MSF (in English)
No. 10 million cases per year, many of them undiagnosed, the treatment is 6 months which is still long. And we don’t do enough to prevent TB in children and family members who are at high risk of developing the disease.

Charlotte:
Thanks Cathy. For several years now MSF and others have been raising the alarm about tuberculosis and lack of research. We’re still doing so because patients continue to suffer. Until we increase access to new, more effective and less toxic drugs for patients with multidrug-resistant TB, treatments will continue to be as draining as the disease itself.

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5 minutes to explain - TB in 2017 (ENG)

5 minutes to explain - TB in 2017 (ENG)