By Wendell Roelf CAPE TOWN, Nov 7 (Reuters) - Expanding human clinical testing for tuberculosis drugs is vital, even if it means increasing resistance, a top Medecins San Frontieres doctor said on Wednesday, amid fears of a global TB health crisis. MSF's Tido von Schoen-Angerer said researchers should drop conventional testing of drugs which involve only patients with "normal" TB and test all new TB drugs on people suffering from the multi-drug resistant (MDR-TB) form of the illness. "When you have almost 500,000 new patients with MDR worldwide every year and 116,000 are dying, we really are pretty desperate to have any kind of improvement," he told Reuters ahead of an international TB conference in Cape Town. Resistance to antibiotics builds up because of poor TB control and when patients do not take the medication properly, rendering treatment regimes ineffective. Von Schoen-Angerer said some researchers were worried that expanding drug-testing to patients with MDR-TB might cause the TB bacillus, which is virtually immune to modern antibiotics, to mutate and become even more potent. "I think we need to take that risk because patients are dying today," he said. About 1.7 million people die every year from TB, which remains the leading cause of death from a curable infectious disease. It is also the primary cause of death in HIV-positive people in Africa, which has some of the world's highest HIV rates. Outdated drugs, a lack of new vaccines and poor diagnostics for TB are factors hampering treatment, leading to higher and faster mortality rates among those co-infected with TB and HIV. Von Schoen-Angerer, executive director of the MSF's Access to Essential Medicines Campaign, said patients did not have the luxury of waiting a decade or more for new drugs to be marketed. "You can develop the drugs quicker if you do it in MDR patients and we need to do everything to accelerate development. All the drugs in the pipeline should be tested in MDR patients, which is currently not yet the plan." Von Schoen-Angerer said the most common test for TB, in which a microscope is used to detect the germ in a sputum sample, had a success rate of only about 50 percent. This meant millions of latent TB carriers could spread the disease without even knowing they were infected. "There are better tests, but then you need extremely complicated reference labs, you need large machines which are not realistic to get out in remote areas," he said. (Editing by Gordon Bell and Mary Gabriel)
