3HP regimen soon to be accessible in Malawi

KNCV Tuberculosis Foundation Malawi welcomes the substantial reduction in the price of the anti-tuberculosis drug rifapentine, announced today at the Union World Conference on Lung Health in India. “For people eligible for TB preventive treatment in Malawi, this is a very important development”, says Mr. Emmanuel Kaonga, project manager of KNCV Malawi. “This makes the treatment more affordable and therefore accessible to those at risk of developing TB.”

TB is still the deadliest infectious disease in the world, killing over 4.000 people every day. These deaths are unnecessary. With the right treatment TB can be cured or even prevented: in most people, once they are infected with TB, the immune system keeps TB bacteria dormant. This is called a latent TB infection (LTBI). Without treatment 5 to 10 percent of infected people will at some point develop active TB and get ill. Vulnerable people, in particular young children who are contacts of TB cases and people living with HIV, are at much higher risk of developing active TB.

Treatment for latent TB infection, also referred to as TB preventive therapy, is one of the most effective ways of preventing active TB. Such treatments have been available since the 1960s, yet very few people are receiving it. Current treatment options are long— with people required to take a pill daily for 6 to 36 months. Even among the few who start treatment, many fail to complete the full course. The combination of rifapentine and isoniazid – the so called 3HP regimen – was recommended by the WHO in 2018 as alternative regimen for treatment of LTBI . It is shorter and easier to take: once a week for three months. And it has proven to be just as effective as the current longer treatment choice.

Emmanuel Kaonga: “Until now this 3HP regimen was too costly to implement in many high TB burden countries including Malawi. With the 66 percent reduction in access price of rifapentine – from $ 15 to $ 5 per monthly dose – the medicines can finally be ordered and made available in the country.”

KNCV will assist countries to implement 3HP under the Unitaid-funded IMPAACT4TB project, jointly with the National TB and HIV Programs and with other stakeholders. This project is rolled out in 12 countries by a consortium of partner organizations led by the Aurum Institute. In Malawi eligible patients in the project districts Mzimba North, Chikwawa, Mangochi, Mulanje and Nsanje will get access to this regimen through the project.

Emmanuel Kaonga: “It is our aim, together with partners, to make 3HP available to all eligible patients and scale up this treatment country wide. By treating latent TB infection, we can prevent thousands of people from developing TB disease— save lives and ultimately eliminate TB.”

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The price reduction of rifapentine was announced today by Unitaid, the Global Fund to Fight Aids, Tuberculosis and Malaria and Sanofi. More information can be found here.