Tuberculosis (TB) rarely gets much news coverage. It’s sometimes described as the neglected middle child of the three big diseases – HIV, TB and malaria – that are targeted under Millennium Development Goal 6. And this means that it hasn’t always been easy
for researchers to secure resources for developing new TB diagnostics, drugs, and vaccines.
But over the past month, TB has captured high-profile attention from The Washington
Post,
The New York Times,
TIME,
NPR,
AFP and other major media, generating big headlines about the rising challenge we face in tackling one of humanity’s oldest and most resilient infectious diseases.
So what has public health experts worried?
We have known for years that currently available antibiotics – those wonder drugs first developed in the 1940s to fight a broad spectrum of bacterial infections – are gradually becoming less and less effective in curing TB because of increased drug resistance.
But new research published in
The Lancet has confirmed that resistance to second-line TB drugs is much more prevalent than we previously thought. And more worrisome is the data from a survey of TB drug resistance in China, published in the
New England Journal of Medicine, showing that more than five percent of new TB cases had multi-drug resistant TB (MDR TB), indicating transmission of MDR TB.
This means that MDR TB can spread faster than we previously thought. And it means that MDR TB can infect
anyone. It doesn’t just affect people who don’t take their medicines correctly.
Why should we be concerned? First, the worldwide number of MDR TB cases is growing. There were an estimated 650,000 MDR cases in 2010.
Second, it costs a lot of money to treat MDR TB – to the point where many developing countries can hardly afford it.
Third, MDR TB patients must go through two years of intensive treatment, including daily injections for the first six months. As a result, many patients simply drop out of therapy, and the success rate for curing MDR TB is currently only 53 percent. (To
learn more about one survivor’s hard fight against MDR TB,
read the story of Endalkachew.)
But despite these challenges, the global health community has many reasons to believe that we can turn the tide on TB. The pipeline for the discovery and development of new tools against TB has never been stronger. Innovations in TB diagnosis and treatment
are becoming more widely available in developing countries, where 95 percent of all TB deaths occur. And we are building public-private partnerships that are accelerating the identification of new drugs and vaccine candidates in ways that were inconceivable
just a few years ago.
Last month, the foundation joined USAID, PEPFAR, and UNITAID to
expand access to GeneXpert®, a molecular diagnostic system that provides a two-hour rapid diagnosis of TB, TB/HIV co-infection, and drug-resistant TB. As the
Wall Street Journal reported, the new agreement will immediately reduce the cost of cartridges used to
diagnose TB by more than 40 percent and dramatically improve the capacity to deliver timely and accurate treatment to those who need it.
There are also at least 9 new TB drug candidates in clinical studies, replenishing a development pipeline that hasn’t produced a viable new treatment in more than 40 years. Seven pharmaceutical companies also recently agreed to collaborate on identifying
new TB drug candidates under the framework of the
TB Drug Accelerator partnership. The partnership’s goal is to identify an effective combination therapy that can reduce TB treatment from the current regimen of 6-9 months to less than one month. Finally, we are making strong progress on collaborative efforts
to identify promising
new TB vaccine candidates and move them into clinical trials.
What’s clear now, more than ever, is that making progress on TB will require a comprehensive approach that includes new and better approaches to diagnosis, treatment, and prevention. To learn more about what the foundation is doing to support TB research
and development, read our newly updated
Strategy Overview.