MDR TB

While it was revealed recently that the United States and European drug regulators are pulling out all the stops to register bedaquiline, or TMC207, the South African Medicines Control Council (MCC) has shown no intention of following suit, according to Médecins Sans Frontières (MSF).

Many other countries with stringent regulations on drug safety - including France and the United Kingdom - are already providing bedaquiline under compassionate use regulations, despite the fact that they have far less patients.

MSF earlier sought commitment from the MCC to allow expanded access to the drug and hope that they will similarly fast-track the review process which could see the registration of the first new TB drug in over 50 years.

Scientists have found an alarming number of cases of the lung disease tuberculosis in Africa, Asia, Europe and Latin America that are resistant to up to four powerful antibiotic drugs.

In a large international study published in the Lancet medical journal on Thursday, researchers found rates of both multi drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were higher than previously thought and were threatening global efforts to curb the spread of the disease.

HST’s Health Systems Research unit undertakes innovative health systems research to strengthen the district health system, its support systems and priority programmes. HIV and AIDS, tuberculosis and the special needs of vulnerable groups such as mothers, infants and children receive particular attention. Improving knowledge management, translating research into policy or practice and building capacity within the paradigm of Essential National Health Research are important areas of emphasis. Future research activities will also focus on Human Resources in Health and Health Financing. Faced with the challenges of the southern African region struggling to cope with a quadruple disease burden and health systems under pressure to improve their efficiencies in resource-constrained situations, HST’s Research Programme adds special value to the general health research environment by commissioning or undertaking relevant, high priority, multi-disciplinary, operational and applied research in a rapid, flexible, cost-effective, cooperative, innovative and principled way.

The HSR unit commissions, funds and conducts policy-relevant health systems research on behalf of the South African government and international donors. The unit has a core of highly-skilled project managers and researchers who participate in research priority setting processes within the country, develop research briefs, identify additional research consultants and manage the projects throughout the research process. In addition to the regular research project reports displayed below, the programme continues to disseminate health perspectives and health information in our highly-acclaimed annual publications, South African Health Review and District Health Barometer.

The unit’s Knowledge Management activities encourage and facilitate the use of information for evidence-informed decision making by various stakeholders. Electronic and hard copy information produced by HST and other stakeholders is disseminated. The unit also works in partnership with national and provincial legislators on promoting equity in health and health care through ongoing monitoring of health and health systems indicators and providing information and support directly to legislative structures.

The unit’s current projects are listed below and more detailed information on each of them can be accessed via the link. Although Health Systems Strengthening and Health Systems Research are listed as separate operational units, this division is not too apparent in practice as many projects are implemented on a collaborative cross-unit basis drawing on the skills of individuals from the organisation as a whole.