Unlocking Innovative Markets & Strengthening Diagnostics to End TB in Africa

MAA: Would you be able to give us a quick overview about the TB work Market Access Africa has been involved in?

Marlene: Globally there have been advances in the treatment and diagnosis of TB, including the optimization of treatment options, duration and modalities. At Market Access Africa, we have primarily been working in the diagnostic space, where the advances are moving towards seamless and painless detection for the patients. In this development landscape, our work with partners and clients like GH Labs bridges the gap between the developers and the end users to find a less intrusive test and overcome challenges to sample collection. In Zimbabwe, for example, the guidelines highlight that it challenging to get a good sputum sample from children. We work with partners developing products that could potentially become the new gold standard where we can get an easy-to-use sample.  

Tarisiro: Although I have mostly been involved on the diagnostic side as well, I know that in areas such as therapeutics where a lot of work has been done to limit the pill burden on TB patients.

Nancy: MAA has consistently been involved with TB diagnostics in Africa, we specialise on projects around TB diagnostic product introduction and commercialisation for organisations needing market intelligence to enter a country or to scale up.  

Usually, MAA provides companies and partners with a better and deeper understanding of the TB diagnostic landscape and the epidemiology of TB prevalence in Sub-Saharan Africa.  

Then we help them see how their products fit into the market by determining, through competitive analysis, market intelligence and go-to-market strategies on how they can position themselves strategically in the markets and countries of interest.  

MAA: Why should TB be of a concern on the African continent?

N: TB should be a major concern for Africa for three key reasons. First, the living conditions in many parts of the continent create perfect breeding grounds for tuberculosis, a good number of social determinants of health around housing conditions predispose people to tuberculosis such as poor ventilation, limited access to clean water, and crowded living spaces. These conditions allow TB to spread easily.  

Second, Africa bears a disproportionate burden of the disease. Did you know that Nigeria where I am sitting right now has the sixth highest TB burden in the entire world? Not just Africa, the world! One in five TB cases globally occurs in Africa. That’s staggering.

Finally, we’re facing a concerning situation where TB cases are rising while our diagnostic capabilities remain inadequate. We’re fighting an uphill battle with limited tools. This isn’t just an African problem-TB is categorized globally alongside HIV as a priority disease with pandemic potential.

M: In as much as we are making scientific advances, the social burden of TB is still weighted and taxing. On the therapeutic side, we have the development of Directly Observed Treatment, Short-course (DOTs), where the TB patient must report to a facility every day for their dose. They are not sent home with a week’s dose of medication. You come in, you get your days’ worth, you have to swallow them in front of the nurses, and then you go home. This remains a challenge from a therapeutic side, and this is where our work with GH Labs of finding less painful methods contributes to alleviating this social burden TB patients, their communities and the health systems experience.  

MAA: Efforts to fight TB are often combined with HIV, why is that?

N: Efforts to fight TB are often combined with HIV because they are deeply connected.  

HIV essentially attacks a person's immune system, breaking down your body’s natural defences until one becomes vulnerable to almost any infection. When the immune system becomes severely compromised and a person develops certain specific infections established from research and cases, that’s when we say a person has AIDS.

In the past, it used to be upwards of 10 years to progress from HIV to AIDS, but sadly, we’re seeing this happen faster nowadays. These infections that typically infect people living with HIV are called “opportunistic infections” with TB sitting right at the top of that list, with others such as cryptococcal meningitis and histoplasmosis to mention just a few.

Here’s why this matters; HIV weakens your body in a way that makes it incredibly easy for TB bacteria to invade your immune system. You see, most of us encounter TB daily, but our strong immune system fights off these invading infections successfully, when a person has HIV, their body loses this ability.  

MAA: The theme for this year is Yes, we can end TB commit, invest, deliver. What does that mean here at MAA?

T: This is a call to action to say we are not doing enough. MAA continues to be committed in engaging and working with research and development institutions who are dedicated to investing a lot of time and effort to make diagnostics more accessible.  

One of the key things that was discussed at the conference I attended last year was that some diagnostic tools are still quite expensive for governments to afford, why can’t we bring the cost down? And how can we bring it down? Our work with R&D is to find ways of developing low-cost diagnostics and find ways to introduce them into the market on the continent at affordable prices so that we can actually eradicate TB.  

It means the sooner people are diagnosed; the sooner people are treated. And everyone can live healthier lifestyles and live healthier lives.

M: We also need to be looking towards homegrown solutions and have less reliance on multilateral aid agencies, especially in light of recent changes in the global aid landscape. So, in terms of investing, we need continued investment into local and regional research. Furthermore, countries need to look at the value chain of TB commodities and identifying the ideal places to enter and jumpstart local production and work at scale to meet local and regional demand sustainably - whether that is therapeutics or diagnostics. A whole ecosystem view will also be key in having the necessary supporting frameworks to make business commercially viable to take care of this critical need.

TB can become a starting point because it's a very topical aspect. It is a communicable disease. We don't want it getting out of hand. It will also benefit the health ecosystem. But we need to have the political commitment for the policies, for the funding, and to invest financially and in our intellectual property.  

N: At MAA we are truly keeping our finger on the pulse of TB across Africa. We don’t just talk about it, we are actively showing up at important conferences and joining critical conversations about TB on the continent.  

We believe knowledge is power, so we’re deeply invested in understanding the complete picture-tracking how many new TB diagnostic devices have been deployed in different countries and where they are located, learning how TB is being diagnosed in different sectors and health facilities and monitoring how this valuable information is being shared across systems.

Our team delivers robust, data driven strategies that help introduce innovative products into the healthcare market in ways that are both effective and accessible to those who need them most. Think of us a s providing the roadmap that guides governments, donors, and manufacturers on the most impactful places to invest, the smartest approaches to take, and most importantly, the most effective ways to deliver solutions to communities.

For us, this year’s theme isn’t just a slogan, it’s exactly what we do every day as we work toward a TB-free Africa, one community at a time.

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