Three global public health experts have asked governments to make major commitments to fund the research in combating tuberculosis, noting that efforts to curb the “world’s deadliest infectious disease” remain underfunded. Mel Spigelman, President and CEO, TB Alliance, Catharina Boehme, CEO of FIND, an international non-profit organisation and Jacqueline Shea, CEO, AERAS, also a nonprofit biotechnology organisation developing new tuberculosis (TB) vaccines, have made a strong pitch for promoting research in fighting the disease. Their remarks come following the World Health Organisation’s ministerial meeting, which was recently held in Moscow, where health ministers, diplomats and other representatives met to discuss tuberculosis. According to the WHO, in 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease (including 0.4 million among people with HIV). Over 95 per cent of TB deaths occur in low-and middle- income countries and seven countries account for 64 per cent of the total, with India leading the count, followed by Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa. “While the meeting in Moscow will inform future discourse on TB, it must also serve as a springboard toward decisive action against the disease,” the three experts said in a statement.
“TB is the world’s deadliest infectious disease and efforts to curb it remain underfunded. We are calling on governments to make major commitments to fund the R&D that will end TB once and for all,” their statement said. They said there were 10.4 million new cases of active TB in 2016 — of which only 6 million were diagnosed and notified — while drug-resistant infections are on the rise. There remains a dire need for better, faster-acting drugs, a new vaccine, and technologies that quickly diagnose TB and determine the degree of drug-resistance, the experts said. “Science is not holding us back, funding and political will to implement is,” they said.
The WHO estimates that R&D budgets need more than $1 billion annually to turn around the odds of patients potentially losing years of their lives to a toxic treatment course, missing the opportunity for treatment due to poor diagnostics, or contracting TB in the first place because of an ineffective vaccine. The WHO also reports that despite accounting for about 2 per cent of deaths globally, TB receives only 0.25 per cent of the estimated $265 billion spent worldwide on medical research each year. “Simply put, TB science is woefully underfunded. Governments must work together to dramatically reshape the investment landscape,” the statement of the experts said. They maintained that there is no vaccine that can effectively play a major role in eliminating this disease.
“Today, the Bacillus Calmette–Guérin vaccine is the only TB vaccine available. It is nearly a century old, only moderately effective in preventing severe TB in infants and young children, and it does not adequately protect teens and adults, who are most at risk for developing and spreading TB,” the experts said. Noting that progress has been made but greater commitment is needed, they said there are 12 different TB vaccine candidates in clinical trials today, a significant increase from 2000, when there were zero. Data from multiple mid- and late-stage efficacy trials will become available over the next 3 years, providing data that will help optimise and accelerate TB vaccine development.
But it will take a significant increase in resources to achieve critical breakthroughs and to reach success quickly, they said. “At first glance, the TB diagnostics pipeline looks healthy. However, emerging game-changers are at risk due to underfunding at the clinical trial stage. “In addition, very few diagnostic candidates would address the most critical need — a point of care test for primary care facilities. Diversification of the point of care pipeline, and identification of new biomarkers are urgently needed,” they added.
Union minister J P Nadda, who had also taken part in the conference in Moscow, had said there that over 30 million tuberculosis patients residing in remote areas in India have been screened as part of special campaigns. He had asserted India’s commitment to eliminate the disease by 2025. The health minister had said the country has already eradicated polio, and will use similar intensified efforts to end tuberculosis (TB). India is a major manufacturer of anti-TB drugs for the world, having almost an 80 per cent global market share, he had said.