Tackling TB through partnership (Guest blog)
16.06.16
While MDR-TB hits hardest in low- and middle-income countries – India and China are the leading hot spots – the problem is growing here in Europe as well. In fact, Eastern Europe registered a staggering 65,000 cases in 2013, according to the World Health Organization.
TB drug resistance arises primarily from inadequate or incomplete regimens. The standard TB treatment – which consists of drugs that were invented before we landed on the moon – demands taking medicines multiples times, every day, for up to six months. When people don’t take the full regimen, they are at risk of developing resistant strains that are more difficult and expensive to treat.
What this means is that we can prevent many cases of MDR-TB simply by doing a better job of treating TB – by robbing the bacteria of any opportunity to develop resistance. To accomplish this, we absolutely must invest more resources in R&D to create better, faster-acting TB drugs.
We know of one such significant effort underway. The Lilly Tuberculosis Drug Discovery Initiative – part of the Lilly MDR-TB Partnership – is collaborating on a groundbreaking partnership with seven other pharmaceutical companies and eight research institutions – in conjunction with the Bill and Melinda Gates Foundation – to speed the discovery of essential new TB treatments. The TB Drug Accelerator (TBDA), as the partnership is called, pools resources and focuses our collective efforts around early-stage research.
Lilly’s contribution to the project is a combination of funding, drug discovery and development expertise, and access to Lilly’s molecule libraries. Ultimately, the partnership aims to develop five new pre-clinical drug candidates with treatment-shortening potential within five years, and proof-of-concept for a one-month three-drug regimen within ten years.
These efforts are connected to the work we’re undertaking with the Infectious Disease Research Institute (IDRI) on early stage discovery efforts for new TB molecules. We have committed more than 20 million USD in funding and in-kind contributions, and we’ve opened up our corporate compound library that now includes more than a million molecular entities. Both IDRI and the TBDA are tapping our library to screen the compounds for impact against TB bacteria.
These are just a few of the efforts in motion at Lilly and through our partners in the search for new TB medicines – but much more action is needed. According to the Review on Antimicrobial Resistance, it would cost about $16bn to overhaul the antibiotics and TB R&D pipeline using new market incentives, such as market entry rewards. Owing to the extraordinary costs involved, the report recommends the creation of an AMR Global Innovation Fund, endowed with $2bn over five years.
We must recognise that MDR-TB is not some distant problem in the developing world. It is a disease that knows no borders, and it is gaining ground in Europe every day. TB has surpassed HIV/AIDS as the leading infectious disease worldwide. Every day that we fail to invest in new TB medicines, the disease only grows stronger.
