Partnership Aims for Faster TB Drugs

October 8, 2000

The deadly disease tuberculosis gains a new foe today, a global partnership to develop fast-acting anti-TB drugs.

The Global Alliance for TB Drug Development is the latest in a series of public-private collaborations designed to fight diseases of poverty, among them malaria and AIDS. It will be launched today in Bangkok at the First International Conference on Health Research for Development, officials say.

"Our mission is to accelerate the discovery and development of new anti-TB drugs and have them on the market in 2010, at prices that are affordable in developing countries," says Giorgio Roscigno, acting chief executive officer.

TB, so deadly and widespread that it once carried the grim nickname "Captain of all the Men of Death," is still a formidable disease. It kills 5,500 people worldwide each day. An estimated one-third of the world's population is infected with the TB bacterium, and 8 million more people are infected each day. The disease is a major problem in the USA, too. The Centers for Disease Control and Prevention documented 17,531 cases in 1999. An epidemic in New York starting in the late 1980s cost $1 billion to control.

Current TB drugs initially kill about 90% of TB germs in the first week of treatment. The remaining 10% survive in a latent state that makes them tough to wipe out, forcing patients to stay on their medication for up to nine months, says Ariel Pablos-Mendez, a tuberculosis expert at the Rockefeller Foundation and an alliance board member.

When patients stop taking their medicine prematurely — as many do — the TB bug becomes resistant to treatment, which is a major reason the New York epidemic was so tough to control, experts say.

A treatment strategy, called "Directly Observed Therapy," works in nearly 90% of cases, but it is so expensive that only 20% of cases in developing nations can be treated that way. In this strategy, health workers watch each patient take his or her medication daily, for six to nine months, to make sure the infection is eradicated.

Fast-acting drugs would make it much more affordable for poor countries to treat TB patients. "If we could shorten the treatment time from six months to one month, it would save a lot of time (and expense)," Mendez says.

Lack of a lucrative market has hobbled the search for new TB drugs, Mendez says. The unmet need prompted leading experts to meet in Cape Town, South Africa, in February to review the latest scientific evidence and propose new ways of attacking the disease. Those discussions led to the formation of the new global alliance.

The alliance aims to unite government and academic researchers with those from major drug firms and upstart biotech companies to hasten drug development, Roscigno says.

With $40 million in combined funding from the Bill and Melinda Gates Foundation and the Rockefeller Foundation, the alliance has already begun to negotiate with drug firms and request proposals for promising research projects.