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SSHIFTB contributors Jonathan Stillo, Boitumelo Seepamore, Sachin Atre, and Amrita Daftary contributed social science insights at the Symposium on Emerging Resistance to Novel Tuberculosis Drugs at Columbia University Irving Medical Center, New York, on March 20-21, 2024. The symposium was a platform to exchange knowledge and insights into emerging challenges associated with TB drug resistance in the context of new treatment regimens, with focus on Bedaquiline, Pretomanid, and Delamanid.
Social and behavioral scientists were well represented at the symposium that otherwise included basic scientists, microbiologists, geneticists, immunologists, clinicians, public health workers, implementation scientists, modellers, activists, and TB survivors. Jonathan (Wayne State University, USA) characterized the situation of DRTB in Romania as socially incurable, meaning that people were dying not because of the severity of their drug-resistance, but rather due to social factors such as drug-susceptibility testing and new and repurposed drugs not reaching everyone due to legal/regulatory issues. While these are long-time challenges in Romania, Jonathan warns that several people have already been diagnosed with bedaquiline resistant XDR-TB. Sachin (DY Patil Medical College, Hospital & Research Centre, India) discussed the problem of increasing anti-TB drug resistance in India. He shared findings from a recent study where they found a high proportion of pre XDR-TB among people presumed to have MDR-TB, with emerging resistance to Bedaquiline and Linezolid. He also elaborated on patients’ complex pathways for DR-TB treatment, the greater risk of contracting MDR-TB among women, and role of the private sector which is often the first point of help seeking and source of diagnostic delays.
Boitumelo (University of KwaZulu-Natal, South Africa) shared a psychosocial support intervention implemented as part of an NIH-funded ADAPT-IV study in Durban, South Africa. A person-centred approach to DRTB-HIV care was facilitated through monthly counselling and adherence support groups. The intervention helped patients to actively engage in their care and supported reintegration back into their societal roles, families, and communities following the disruption they had experienced after being diagnosed with DRTB. Amrita (York University, Canada) distinguished the political, historical and legal determinants of DRTB, pointed to the unique multidimensional aspects of DRTB stigma as well as the chronic nature of DRTB, and patient priorities in DRTB decision-making.
Jonathan and Amrita also chaired a multidisciplinary panel with Stephen Anguva Shikoli (Network of TB Champions, Kenya), Phumeza Tisile (TB Proof, South Africa), Paran Sarimita Winarni (WHO TB Civil Society Task Force Alumnus, Indonesia), Sachin Atre, Joe Burzynski (New York City Department of Health and Mental Hygiene, USA), and Marian Loveday (South African Medical Research Council). The panel emphasized social and regulatory protections to ensure access to DRTB diagnostics and treatments, and the need to ensure inclusion of community voices when developing new DRTB regimens.
Learn more about the symposium here. Among many others, SSHIFTB helped to co-sponsor the event.
