Alliance Wants Drug Makers to Help in Fight Against Tuberculosis

November 14, 2001

A nonprofit health group will issue a report today designed to enlist drug makers in the fight against tuberculosis, a rising global health concern that has infected 8.4 million people.

Despite a huge need for TB- fighting drugs -- millions of cases may be yet undiagnosed -- the market for such treatments is not particularly strong. Most cases are in poor regions such as Africa and Russia, where people can't afford costly medicine.

The Global Alliance for TB Development is hoping to persuade drug makers to rechannel some of their research dollars and end a 30-year drought in new tuberculosis medicines.

"The reality is these companies pick the low-hanging fruit -- diabetes, central nervous system or cancer," said Maria Freire, a former National Institutes of Health official who now heads the TB alliance. "These countries are huge markets, but these are also poor people."

The market for tuberculosis drugs is estimated to reach $700 million by 2010, a 55 percent increase. Investing in a new drug should yield a return of between 15 percent and 30 percent, the group said.

"There's a sizable opportunity here, but the market has been misunderstood," said Giorgio Roscigno, an adviser to the alliance, which was formed last year with $40 million in funding commitments from the Gates Foundation and the Rockefeller Foundation.

The issue is growing more urgent each day, Roscigno added, because drugs are needed to combat new strains of the disease. Not only are these variations showing up with alarming frequency, they also are proving highly resistant to older medicines.

"The destabilizing factor was HIV, which promotes the spread of TB in susceptible individuals," said TB specialist Jerrold Ellner of the University of Medicine & Dentistry of New Jersey. "But it's off the radar screen here because 95 percent of the cases occur in developing countries."

The alliance argues that new drugs also would yield a social return by reducing the length of treatment from six months to two months or less. Savings per patient could reach 65 percent, depending upon the number of hospital days and clinic visits that could be eliminated.

It is unclear whether the report will have its desired effect. A spokesman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said several companies are developing antibiotics, but couldn't specify if any are for tuberculosis.

The alliance is negotiating with several unnamed public and academic research centers, as well as biotech and drug makers, for five separate compounds that are at various stages of development.

The group has enlisted support from such big drug makers as Eli Lilly Co., which placed an executive on its board of directors. Other participants include the World Bank, Wellcome Trust, the World Health Organization, Doctors Without Borders, the American Lung Association, the U.S. Centers for Disease Control and Prevention, Chiron Corp. and Warburg Pincus.

The lineup reflects the growing trend to form public-private partnerships to combat infectious diseases that are rampant in poor nations but for which there are not sufficient treatments. Similar entities have been formed to develop drugs for malaria and HIV.

Despite the effort to woo drug makers as development partners, the TB alliance said it will bargain hard to retain patent rights, a growing concern among patient advocates monitoring these new partnerships.

"All the terms and conditions will have to be spelled out up front, and each situation could vary, depending on whether we license a compound or work together in developing one," said Joelle Tanguy, the alliance's advocacy director. "We're saying: Trust us."