Tuberculosis Research Needs Covid-19 Pace

India has made great strides in tuberculosis (TB) control, but newer approaches and tools need to be developed to achieve our goals. TB-Mukt BharatIn fact, India has set an ambitious goal of eliminating tuberculosis by 2025, five years ahead of the international timeline. By 2021, it is estimated that approximately 10.6 million people worldwide will have contracted tuberculosis.

First, to effectively manage a public health crisis of the magnitude of tuberculosis, we need to have resilient financial flows in place to consistently promote research and innovation in new technologies.

A December 2022 report (Tuberculosis Research Funding Trends, 2005–2021) found that for the first time in history, tuberculosis research and development funding will reach $1 billion globally in 2021. However, governments pledged twice his amount at his 2018 UN General Assembly High-Level Meeting on Tuberculosis. Here, the Indian Council for Medical Research (ICMR) is proud to say he is one of his top three funders of tuberculosis-related infrastructure and other investments.

The other two are US NIH and USAID. All three companies jointly contribute 72% of the total investment in this sector. ICMR’s expenditures are directed primarily towards supporting scientific laboratories and health research activities and reflect the organization’s priorities.

Furthermore, the report also reaffirmed that the public sector is the single largest source of funding for tuberculosis vaccine research, which is critical to the future eradication of tuberculosis. Again, ICMR is one of three organizations that in 2021 will spend more than $1 million on TB vaccine research.

Tuberculosis Research and Development Priorities

Vaccines are arguably the most effective way to protect people from disease. Again, the pandemic shows that an effective vaccine can be developed in as little as 1-2 years. No country still relies solely on the 100-year-old tuberculosis vaccine BCG. The BCG vaccine is effective in preventing tuberculosis in children, but its effectiveness in adolescents and adults is still controversial.

To this end, India must be commended for making positive progress over the years in reaching a potential vaccine. A viable recombinant BCG vaccine is being researched. Other vaccine candidates are also in the pipeline and have been shown to prevent tuberculosis in TB-infected and HIV-negative adults. However, there is a need to have ready-to-use vaccines on the market and introduce clearer and structured bench-to-bedside policies so that we can expect these promising vaccines to become available sooner. there is.

In addition to improving preventive capacity, we also need to ensure strong therapeutic measures. More targeted investment and support must be scaled up to develop newer and safer anti-TB drugs and regimens. For example, regimens such as BEAT-TB, which use bedaquiline, delamanid, linezolid and clofazimine and may shorten XDR TB treatment from the current 18 months to 6-9 months, should be urgently considered.

Research is ongoing, but mechanisms need to be put in place to rapidly track specific research. Here, mention should be made of the BPaL (bedaquiline; pretomanide and linezolid) regimen using the newest anti-TB drug, pretomanide. This WHO-approved regimen is currently undergoing field trials in India and may reduce the duration of treatment from 18 months to about 6 months.

In addition, an outdated regimen containing more than 10 different anti-tuberculosis drugs that patients take daily. With both BEAT and BPaL, you only need 3-4 tablets per day. But we also need to ensure that trials of life-saving drug regimens are accelerated so that they can actually impact lives in the field. In this context, it may be helpful to seek collaboration between developers of drug regimens (such as BPaL) and Indian research institutes to eliminate the need to bridge research on new drug regimens. This will ensure that future new treatment options are effectively introduced into the country without delay.

We already have experience in rapid deployment of Covid-19 therapeutics, diagnostics and vaccines. Based on these learnings, seamless policy mechanisms should be put in place to facilitate the deployment of new tools for other disease areas. India also has the necessary political will and has made clear its intent to prioritize financially against tuberculosis. We need to reflect on what motivated us to move quickly in Covid-19 research and development, and use the same to further our research. Jan Andran against tuberculosis.

The author is Director of the ICMR National Tuberculosis Institute. Views are personal.