Chinese researchers will work with a US-based product development partnership in a bid to develop new tuberculosis drugs from ingredients used in traditional Chinese medicine, under a deal signed on Tuesday.
The agreement between the Institute of Microbiology at the Chinese Academy of Sciences (Imcas) and the Global Alliance for TB Drug Development - a group mainly funded by the Bill & Melinda Gates Foundation and the governments of the US, the UK and the Netherlands - is part of a new global effort to fight the disease, which has re-emerged as a big health threat in developing countries.
It comes as health ministers of 27 countries, organised by the World Health Organisation, are to meet in Beijing on Wednesday to address the problem of multi-drug resistant TB. India, China, the states of the former Soviet Union and many developing countries are seeing a rapid spread of this form of the disease, according to the WHO.
The gathering represents an escalation in commitment by developing countries themselves, which have some of the greatest incidence of TB. It comes after a fresh initiative last week by Brazil, which pledged to produce a fixed dose combination of existing off-patent antibiotics designed to help boost patient compliance with their medicines and fight drug resistance.
While the latest estimates suggest the global burden of TB peaked in 2004, the decline since then has been very modest, with a growth in multi-drug resistance TB now accounting for 500,000 of the 9m annual cases and up to 50,000 cases a year of extreme drug resistance in 54 countries.
With little market in the developed world, pharmaceutical companies have long lost interest, and the Beijing co-operation is part of a fresh effort to find new and more effective and rapid treatments.
The project seeks to identify potential active ingredients from natural sources, which the partners believe are less likely to meet with resistance. "We have already identified 24 leads in a pilot screening," said Zhang Lixin, director of Imcas's high-throughput screening centre.
Melvin Spigelman, CEO of the TB Alliance, said the drugs that could potentially be developed using active ingredients found by Imcas under the co-operation would be made "affordable to those in need". This could involve deals under which future licensees would generate profits by selling the product at markedly higher prices in developed markets.
The ambition to utilise centuries-old remedies in modern medicine is not new. However, China's own efforts in this direction have yielded only moderate success so far. A key example is Artemisinin, a drug used to treat multi-drug resistant malaria strains. It was developed from a plant Chinese traditional doctors had used for centuries to cure malaria.
Imcas and the TB Alliance said they were optimistic of succeeding because they would use the scientific methods of modern western medicine. "The surface has still barely been scratched on traditional Chinese medicine because the medical records from practitioners are few and do not live up to scientific requirements," Mr Zhang said.
Mr Spigelman said the TB Alliance was also in contact with a research institution in Kunming in south-west China, which had an even larger number of species samples specific to that region. The Alliance is also scouring many other countries for potential drug ingredients.