Brenda Waning

Tuberculosis may not be a priority for most of the developed world right now, but that could change. “We’re seeing dramatic increases in transient populations, and TB is going to be something that people in more countries will become familiar with,” says Brenda Waning, head of the Global Drug Facility (GDF), the world’s largest procurer of TB tests and treatments. If that happens, the world will be ready, thanks in large part to Waning’s efforts. The facility now provides 100 TB medicines from 24 manufacturers at discounted prices that all countries can afford. Since it was founded in 2000, GDF has steadily ordered TB drugs for its stockpile and reduced packaging costs, which has helped de-risk manufacturer’s investments in these drugs. 

2023 was a big year for Waning: the most widely used TB drug, bedaquiline, came off patent, a moment GDF had been anticipating for five years. During that time, the organization worked with manufacturers to ready the ingredients and production lines it would need to make generic versions of the drug. Now GDF can offer these versions at a price 53% below the branded version. GDF also helped to negotiate 30% price reductions this year for other medications needed for the combination therapy that is most effective against TB.

“GDF is so successful that if you have TB, you’re better off being in a poor country than a rich country right now,” Waning says. But she’s hoping to change that too, and some higher-income countries—such as Australia, Spain, and Sweden—are now procuring TB medications from GDF. “If you’re a kid in Spain vs. a kid in Malawi,” she says, “why shouldn’t that kid be able to access the same products?”