Dr Helen Bygrave Discusses Ending Cryptococcal Meningitis for Persons Living With HIV

After tuberculosis, cryptococcal meningitis is the second biggest killer of people living with HIV, but there are no global targets for ending this disease and several key drugs used to treat it are not available through national programs, stated Helen Bygrave, MD, chronic diseases advisor for the Médecins Sans Frontières (Doctors Without Borders) Access Campaign.

Transcript

Can you tell us about MSF’s Access Campaign and how it is addressing care disparities in HIV?

I'm looking across noncommunicable diseases and HIV. In our HIV dossier, our main piece of work at the moment is actually on advanced HIV disease. In particular, we're looking at cryptococcal meningitis. MSF, as part of the Access Campaign, is also part of a group of organizations which has put together a strategic framework calling for the end of cryptococcal meningitis by 2030. Because currently there are no clear global targets on a disease which is the second biggest killer of people living with HIV after [tuberculosis].

What's also clear when we've surveyed national programs in the countries where MSF is working is that the key drugs to treat and to prevent cryptococcal meningitis are not available through the national program. So this is amphotericin; and more ideally, liposomal amphotericin, which is less available and more expensive currently; and importantly, flucytosine.

We're really working collaboratively to really push the agenda with international agencies—WHO, UNAIDS—but also, importantly, with the donor community to really kind of recognize this unmet need in terms of treating cryptococcal meningitis.