While tuberculosis (TB) is curable and preventable, it remains the single deadliest infectious disease globally, with 1.5 million deaths in 2018. Nearly two-thirds of the 10 million new cases per year occur in Australia’s neighbours in the South-East Asia and Western Pacific regions.
Combating TB presents a major challenge for countries with resource-constrained health systems and high levels of poverty. With TB mostly affecting adults in their most productive years, the disease also undermines economic growth and the welfare of those with the least financial security.
One key problem with TB is the long treatment times: six months for drug-sensitive TB and up to two years for multidrug-resistant TB, treatment for which can require nearly 15,000 pills and injections with severe side effects. The long treatment times also increase the chance of further transmission and drug-resistance if patients do not complete the full treatment course.
With over 450,000 cases per year, WHO regards multidrug-resistant TB as a key health security threat. If left unchecked, multidrug-resistant TB is forecast to cost the global economy $US 16.7 trillion and kill 75 million by 2050.
Research and innovation to develop more effective TB treatments needs to intensify to meet this challenge. Together with improved diagnostic tests and patient-centred care, they are a means to accelerate progress towards TB elimination.
How will we address the situation?
By funding the research and development of shorter and more effective TB treatments, including for drug-resistant TB, through Product Development Partnerships (PDPs). PDPs bring together funding agencies, private industry and scientists to develop new drugs, diagnostics and other disease prevention and control technologies for use in poor-country settings where market incentives alone will not drive product development.
Global, with a focus on high-burden TB countries as defined by WHO and with a particular focus on key countries in the Indo-Pacific Region (Papua New Guinea, Indonesia, Philippines, Vietnam, Cambodia, Laos, Myanmar).
- The Global Alliance for TB Drug Development (TB Alliance) - $18.75 million 2018-2022
TB Alliance is a not-for-profit product development partnership (PDP) committed to R&D that is urgently needed for better TB treatments. A Lack of commercial incentive for private sector investment in the development of products that target poverty related and neglected diseases like TB has resulted in a market deficit.
Building partnerships between the public, private, academic, and philanthropic sectors, TB Alliance harnesses the most promising science wherever it may exist around the world. Leveraging this global network of public and private partners, TB Alliance efficiently drives the development of new TB products for underserved markets. TB Alliance’s PDP model minimises costs, including overhead and investments in infrastructure, while optimising scientific capability to speed new TB drug development.
With over 15 years of experience in TB drug R&D and significant activities along the entire TB product development and commercialisation value chain, TB Alliance has now assembled the largest TB drug portfolio in history.
What will success look like?
High burden TB countries using more effective treatments to reduce the health and economic impacts of TB.
Pretomanid, developed by the non-profit TB Alliance, has received U.S. approval in combination regimen with bedaquiline and linezolid for people with XDR-TB or treatment-intolerant/non-responsive MDR-TB.
In 2016, TB Alliance introduced new TB cures for children in the correct dose and child-friendly forms. These child-friendly TB treatments have now been ordered by 93 countries, which comprise 75% of the estimated global childhood TB burden. These new treatments are in child-appropriate doses and formulations, remedying problems that previously plagued the treatment of pediatric TB.