Tuberculosis

Each year, about 1.8 million people die from tuberculosis (TB), which is a curable disease. Although there are no simple solutions to the challenges TB brings to developing nations, BD Global Health deploys a strategic combination of resources and technologies aimed at making a positive and sustainable impact.

Rapid culture and drug susceptibility testing is more important than ever in the face of increasing multidrug-resistant TB (MDR-TB) and even extensively drug-resistant TB (XDR-TB). The BD TB liquid-culture method, the BD MGIT™ system, provides diagnostic results much sooner than traditional culture methods, which can take as long as 40 to 50 days to yield a result. 

To make high-quality TB diagnosis accessible, especially to HIV-positive patients, BD has an agreement with the Foundation for Innovative New Diagnostics (FIND) to offer access pricing in high-need, low-resource settings. This collaboration established demonstration sites in Africa, Eastern Europe, Brazil and Asia to introduce advanced culture technology at the district hospital level.

In 2014, BD began collaboration with the U.S. Agency for International Development (USAID) in Indonesia to support the establishment and thereby strengthen Indonesia's national reference laboratory systems in an ongoing effort to prevent and control infectious disease outbreaks globally. Modeled after the BD-PEPFAR Labs for Life program, the partnership supported Indonesia's National Tuberculosis Program (NTP) with the aim to improve and expand quality-assured laboratory services. In particular, the collaboration emphasized the early detection and confirmation of TB cases, as well as monitoring and treatment services. The partnership ended in December 2016, with the following outcomes:

• Good laboratory practices for TB culture and drug susceptibility testing (DST) have been introduced at 10 sites across the country, and training has been conducted for its implementation.
• BD has helped establish criteria, approach, training and monitoring teams to expand and monitor safe working practice (SWP) and quality assurance for TB labs.
• Fifty technicians in 10 laboratories have been trained on liquid culture and DST.
• An equivalent national monitoring program has been established. Now, one laboratory—which is National Reference Laboratory (NRL) Surabaya—is in charge of the National TB External Quality Assurance (EQA) program. Previously, the laboratories in Indonesia had to engage in a certification body outside of the country. Seven laboratories have been certified, and three are involved in an ongoing certification process under the EQA program.
• A "Train-the-Trainer" program was conducted at NRL Surabaya. The laboratory technicians will be spearheading the succeeding trainings for the TB liquid and culture network laboratories.
• The rollout of a standardized DST package is slated for the second half of 2017, where second-line-drug TB antibiotics will be included on the test procedure.
• BD is transferring the responsibility of training to NRL Surabaya laboratory technologists for their TB sustainability.