Preventive Tuberculosis Treatments Can Save 850,000 Lives

The Lancet Global Health published an early-release study funded by Unitaid that estimated preventive tuberculosis (TB) treatments offered to people with HIV/AIDS (PLWHA) and household contacts of newly diagnosed TB patients could save nearly 850,000 lives by 2035.

People living in close contact with a person with TB disease are at highest risk of infection, accounting for a significant percentage of the 10.6 million new TB infections yearly.

These researchers wrote on July 18, 2023, that the costs of scaling up a TB preventive treatment (TPT) program, including TPT drugs and investigation to rule out active disease, are a major barrier to implementing TPT guidelines and allocating resources.

This study found implementing short-course TPT is likely cost-effective for people living with HIV/AIDS, including child and adult contacts in most countries. 

Between 2023 and 2035, scaling up TPT prevented 0.9 (95% uncertainty interval) people from developing TB and 0.13 (0·05–0·27) TB deaths per 100 PLWHA at an incremental cost of $15 per PLWHA.

“The imperative for TB prevention is clear,” said Vincent Bretin, Director of Results at Unitaid, in a related press release.

“This cost-effectiveness analysis proves that preemptively reaching all at-risk individuals – even when it requires the logistical hurdles of going into communities to find those who may not be actively seeking care – is not just ethically sound. It is a smart investment capable of making an enormous impact on the fight to end TB worldwide.”

Previous studies found deploying the 100-year-old BCG vaccine with children offered ample protection against TB and would save billions in healthcare costs.

As of July 2023, over 14 types of BCG vaccines are in use globally. In the U.S., the BCG vaccine is considered for people who meet specific criteria.