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Groups Slash Cost of Advanced TB Test for Developing Countries

An important new diagnostic test for tuberculosis is about to become more affordable where it’s needed most — in the developing world.

The U.S. government, the Bill & Melinda Gates Foundation and UNITAID, a global health-funding initiative, announced a plan this week to reduce the cost of cartridges for the test by 41% for 145 countries where the burden of tuberculosis is high. Cartridges for the Xpert MTB/RIF rapid diagnostic test will be $9.98 now in those countries as of Aug.6, down from $16.86. The prices will hold until 2022, the partners said.

The idea is to bring the cost more in line with that of the currently used method of diagnosing TB. The Xpert assay, developed by Cepheid, represents the first major advance in TB diagnostics in more than a century, reducing diagnosis of TB to hours from weeks.

The only method used in most laboratories in the developing world has been smear microscopy, developed in the 1880s. It requires visual detection of the TB bacterium under a microscope — and it easily misses TB in the millions of patients who are infected with HIV. TB is the leading cause of death among people living with HIV in Africa. Smear microscopy also can’t detect drug-resistant strains of TB, which are an increasing concern.

“We’ve seen Xpert as a real breakthrough, but the next thing is it has to be taken to scale,” says Joanne Carter, executive director of Results and Results Educational Fund, an advocacy organization that fights hunger and poverty globally. “Price has been a significant barrier to date.”

More than 8.8 million people were sickened with TB in 2010, with nearly 1.5 million deaths, according to the World Health Organization.

The price reduction won’t apply to all purchasers of the cartridges in developing countries, meaning they could still remain pricey in the private sector. And the price of the diagnostic machines themselves will still make the system unattainable for many in developing countries, said the Treatment Action Group, an independent AIDS research and policy think tank, and the European AIDS Treatment Group, a community organization.

Still, reducing the price of cartridges should help stimulate further investment as well as research and development, Carter said.

The U.S. government (including the U.S. President’s Emergency Plan for AIDS Relief and the Agency for International Development) and the Gates Foundation are investing $3.5 million each in the venture, though the final amounts from all partners will depend on the volume of cartridges sold.

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