Malawian doctor Bern Nyang’wa awarded prestigious prize for developing drug resistant TB treatment 

UK-based Malawian doctor, Bern Thomas Nyang’wa — who is director of medical services for Medicins Sans Frontier (MSF) — has been awarded by AMR Centre a prestigious prize for leading a successful clinical Tuberculosis (TB) treatment.

Established in May 2016, The AMR Centre is a key part of the UK’s response to the global threat from antimicrobial resistance. It is a joint private-public initiative to support/accelerate the development of new antibiotics and diagnostics through a fully integrated development capability, offering translational R&D through to clinical proof of concept.

Nyang’wa; I’m honoured to receive the prize

London School of Hygiene & Tropical Medicine (LSHTM) reports on its website that Nyang’wa was awarded as Student Prize Winner alongside Zimbabwean Collins Timire while Khalid Beshir won the Staff Prize

In its citation, LSHTM takes cognizance that Nyang’wa was chief investigator of TB-Practecal — a phase II-III MDR-TB clinical trial pivotal in the change of World Health Organisation (WHO) 2022 guidelines for treatment of rifampicin resistant tuberculosis (RR-TB).

“Bern’s clinical, programmatic and research work in the past decade has focused on drug resistant TB treatment,” it said. “His current research work includes population pharmacokinetics and pharmacodynamics of anti-TB drugs, exploring use of volumetric absorptive microsampling techniques for measuring anti-TB drug levels and using small hair samples to quantify cumulative anti-TB drug exposure.”

The Malawi won the Student Prize for a publication entitled: ‘A 24-Week, All-Oral Regimen for Rifampin-Resistant Tuberculosis’ published in The New England Journal of Medicine, which contributed to global policy change for the standard of care for RR-TB.

Nyang’wa is quoted as saying: “I’m honoured to receive the prize. The TB-Practecal clinical trial publication shows how much progress can be made with the right investment and strategic collaboration in research in Tuberculosis.

“Thank you to colleagues at LSHTM, MSF and around the world to make this happen. Now a focus on getting the BPaLM regimen accessible to all who need it.”

As soon the clinical trial was unveiled in May last year, it was highly acclaimed and convinced the WHO to update its TB treatment guidance.

A media report then indicated that Nyang’wa began his research some nine years back after observing that patients were being subjected to “lengthy, ineffective and grueling treatment that disrupted their lives making treatment plans difficult to stick to”.

“Little progress was being made to find kinder treatments; diseases that are most prevalent in low-and-middle-income countries don’t attract investment,” said the report further.

The clinical trials stage of the research began in 2017 and enrolled 552 patients in South Africa, Belarus and Uzbekistan, giving them a treatment consisting of four drugs — whose results showed 89% of patients on this treatment were cured, compared to 52% among those getting the usual much more complicated tuberculosis treatment, which often comes with nasty side-effects.

The reports quoted MSF as saying about half a million people fall sick each year with drug-resistant tuberculosis — many of them from low income countries — thus WHO has set conditions to global pharmaceutical giants who need it to lower its prices.

Two of the drugs in the new ground-breaking treatment are sold by big pharmaceutical companies at prices that make it prohibitively expensive — about $800 for the six-month dosage required

The report quotes Christophe Perrin — the tuberculosis advocacy pharmacist with MSF’s Access Campaign — as saying the new treatment “will only see meaningful changes if treatment is affordable”.

However, Johnson & Johnson, one of the biggest pharmaceutical companies in the world, with IS$93.77 billion in sales in 2021 has previously said its medication for drug-resistant tuberculosis is priced fairly — and calls to reduce the price are “not realistic”.

Nyang’wa, a product of Kamuzu Academy (1991-1997) studied medicine in Malawi at College of Medicine — now Kamuzu University of Health Sciences (KuHes) — for his first degree before doing his postgraduate training in International Public Health at University of Leeds.

He completed a PhD in TB drugs pharmacology at the London School of Hygiene and Tropical Medicine.

He said he joined MSF in Malawi in 2004 having worked with Queen Elizabeth Central Hospital and in 2007 he went to work in Nigeria, Chad, Central African Republic with MSF France.

He joined MSF-UK in 2009 when he moved to the UK as he followed my wife, Maggie, who was undergoing a paediatric specialisation training. His wife, Dr. Kumwenda-Nyang’wa is a consultant paediatrician with specialist interest in infectious diseases, immunology and allergy and does her clinical/research portfolio at University Hospital Lewisham.

She is also an honorary visiting lecturer for KUHeS as well as Malawi HIV Implementation Research Scientist Training (MHIRST) research fellow.

Meanwhile, the Zimbabwean, Collins Timire, who attained the Student Prize Winner alongside Nyang’wa, is reported as a public health specialist/researcher and final year PhD Fogarty Fellow at the London School of Hygiene & Tropical Medicine, focusing on impact of drug resistant TB (DR-TB) on livelihoods of people and their households in Zimbabwe.

He also works as a senior operational research fellow with the International Union Against Tuberculosis and Lung Disease, being seconded to the National TB Control Programme Zimbabwe where he provides research technical expertise.

Collins was awarded the Student Prize for his paper entitled: ‘Coverage and effectiveness of conditional cash transfer for people with drug resistant tuberculosis in Zimbabwe: A mixed methods study’ — published in PLOS Global Public Health.

The recommendations from this paper were incorporated in the TB Strategic Plan for Zimbabwe (2021-2025) and the National TB Programme plans, to streamline conditional cash transfer (CCT) procedures to help avert both community transmission of DR-TB and emergence of extremely drug resistant TB strains (XDR-TB).

Khalid Beshir – the Staff Prize Winner, is an assistant Professor of genomic epidemiology, specialising in malaria drug resistance and diagnostics, whose current research focuses on understanding molecular mechanisms of antimalarial and diagnostic resistance to inform public health policy.

He leads research on the emergence and spread of Plasmodium falciparum variants and developed a rapid molecular tool which is supporting surveillance efforts globally.

Beshir was awarded the Staff Prize for his paper entitled: ‘Prevalence of Plasmodium falciparum haplotypes associated with resistance to sulfadoxine–pyrimethamine and amodiaquine before and after upscaling of seasonal malaria chemoprevention in seven African countries: a genomic surveillance study’ — published in The Lancet Infectious Diseases, showing that sulfadoxine–pyrimethamine and amodiaquine can be used as seasonal chemoprevention without high risk of emergence of resistance genetic markers.

Each year, the AMR Centre awards prestigious prizes for antimicrobial-related research publications to LSHTM staff and PhD students.

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