No new drugs in over 40 years for developing world’s eighth largest killer.
In the lead-up to World TB Day, on 24 March, UNITAID (http://www.unitaid.eu) calls on research institutes and pharmaceutical companies to accelerate the development of new, faster-acting treatment regimens, and on multilateral agencies and developing countries to help create market space for these. Infecting approximately nine million people yearly, TB is treated with old medicines difficult to take and often with serious side effects.
“We will simply not reach the Millennium Development Goal of eliminating TB if we continue in a business-as-usual manner,” said Philippe Douste-Blazy, Chair of the UNITAID Executive Board. “Innovation in diagnosing and treating – but also in creating market incentives for that innovation – must be at the forefront of the global fight against this serious public health problem.”
Most recent tuberculosis drugs are variations of pre-existing medicines. The last TB drug with a completely new active ingredient, rifampicin, was discovered almost half a century ago. The current regimen for standard TB involves four different medicines taken over six to nine months. Because of the lengthy, arduous process, many patients desist on their treatment and go on to develop resistant strains of the disease. Medicines for multi-drug resistant TB are extremely expensive – ranging from US $ 2 000 to 5 000 for six months – and few are quality-assured. Treatment can take up to eighteen months.
Although children account for up to a fifth of all new cases of active tuberculosis in high-burden settings, paediatric TB diagnosis and treatment has been largely neglected and there is a dearth of appropriate and adapted paediatric TB drug formulations.
“TB is largely a developing world problem and this is why there is little incentive for companies to invest in research and development,” said Jorge Bermudez, Executive Secretary of UNITAID. “Agencies involved in TB control need to pool their resources and provide innovators the needs forecasting and predictable funding that will hopefully translate into innovators’ investment into research and development.”
According to WHO, there are around 9 million new cases of TB, and close to 2 million people die from the disease each year. TB ranks as the eighth leading cause of death in low- and middle-income countries (seventh for men and ninth for women). Among adults aged 15-59, it ranks as the third cause of death, after HIV/AIDS and ischaemic heart disease. TB is now the top killer of people living with HIV.
UNITAID uses innovative financing (mostly from a solidarity levy imposed on airline tickets in a number of its donor countries) to purchase and distribute medicines and other health commodities to test and treat AIDS, TB and malaria in 94 developing countries.
UNITAID invests in a number of TB projects with the aim of fostering the creation of a (currently limited) market for quality paediatric medicines for children under 15, including special formulations for children under four, and better medicines for multi-drug resistant TB. In accordance with its mandate of innovation, UNITAID has also invested in a new diagnostic for multi-drug resistant TB, which shortens the testing timeline from two months to two days.