TB Drug Donation and Patient-Centered Treatment (PCT) Approach

Partnership objectives

  1. Donate gold standard TB treatment to all adult patients in Tanzania through the Global Drug Facility (GDF) of the Stop TB Partnership, which is part of the World Health Organization (WHO).
  2. Improve access to TB treatment through a Patient-Centered Treatment (PCT) approach, accompanying countrywide drug donation by Novartis.

TB diagnosis: chest X-ray at hospital in Mafinga, Tanzania. TB diagnosis: chest X-ray at hospital in Mafinga, Tanzania. Copyright Novartis

What are the health needs and challenges?

Tanzania is a high-burden country with about 60,000 new TB cases annually. TB is very complex to treat, requiring a combination of daily drugs over a half-year treatment period. To avoid resistances over the long treatment period, the WHO recommends Directly Observed Treatment Short-course (DOTS), requiring patients to take their drugs under daily observation of a healthcare professional. Although DOTS ensures better patient adherence, it burdens both providers and patients. Already overstretched healthcare personnel face an increased workload, and patients often have to walk long distances every day to receive their medication.

Description of partnership activities and how they address needs and challenges

Since 2005, Novartis has donated gold standard TB medicines for the treatment of all adult patients in Tanzania. The medicines are given to the Global Drug Facility (GDF) of the Stop TB Partnership which is part of the WHO. The fixed-dose combination therapy shortens the treatment period from 8 to 6 months. Novartis also funds logistics and independent quality control. Drug donations do not guarantee, access and adherence to TB treatment, so the Novartis Foundation for Sustainable Development, in collaboration with the National TB and Leprosy Program of the Ministry of Health and Social Welfare, has taken DOTS one step further in Tanzania. Patient-centered TB treatment gives patients the choice to follow treatment either at a health facility or at home supervised by a family or community member. PCT still adheres to DOTS but the approach avoids daily traveling for patients and helps relieve overburdened health workers.

Preventing resistances is one of the major challenges of treating TB. Healthcare staff and treatment supporters must make sure patients adhere to the daily medicine intake. To further improve knowledge about TB and PCT, the Novartis Foundation produced a training video in 2011 that gives a step-by-step explanation of PCT. The video is currently being rolled out across Tanzania, and its effectiveness in both in-service and pre-service is being evaluated.

Lessons learned

The PCT project demonstrated that the majority of patients prefer the home-based treatment option, and adherence remains high (95%). A treatment supporter in the same household is more effective in improving adherence then a treatment supporter more than 15 minutes walking away. 

Summary of impact through December 2013 and forward looking information

From 2005 to 2008 Novartis donated nearly 250,000 rifampicin-based fixed-dose combination tablets for the treatment of TB in Tanzania. Another 250,000 treatments were delivered between 2009 and 2012.

A survey revealed that 88% of TB patients chose home-based treatment, indicating the huge demand for the new treatment option. A recent study indicated that 95% of patients being treated at home adhered correctly to the medication. Home-based treatment does not, therefore, lead to a lower adherence rate compared to health facility-based treatment.

Videos

Empowering TB Patients

Training Video: Patient-centered TB Treatment (EN)

Partnership information

Company(ies) Novartis

Partner(s) Ifakara Health Institute, KNCV Tuberculosis Foundation, National Institute for Medical Research (NIMR), National TB and Leprosy Program, Tanzania, Stop TB Partnership, World Health Organization (WHO)

Type of Partner(s) Academia / Hospitals, Government, IGOs, Multilaterals, NGOs

Disease(s) Tuberculosis

Program Type(s) Availability of Treatment - Product Donations, Health System Infrastructure - Training

Targeted Population(s) Children, Elderly, Marginalised / Indigenous People, Men, Patients in needs of treatment, People with low income, Women, Youth

Region(s) Sub-Saharan Africa

Number of Countries 1

Country(ies) Tanzania

Start Date 2003

More information Novartis Foundation for Sustainable Development

Completed date 2012