The story of research and development funding for tuberculosis (TB) has shown some progress, but not nearly enough, according to two recent reports on the state of R&D funding for neglected diseases.
Between 2000 and 2011, only 3.8 percent of newly-approved drugs were for TB and other neglected infections, even though these infections account for 10.5 percent of the global disease burden, according to analysis by the Drugs for Neglected Diseases initiative (DNDi) and Doctors Without Borders/Médecins Sans Frontières (MSF).
“People are still dying of archaic diseases [such as tuberculosis]. Doctors and nurses are handcuffed by the shortcomings of available medicines, forced to treat their patients with decades-old, often brutal drugs. There are drug-resistant TB patients enduring two years on an absolutely horrific course of treatment—debilitating nausea and pain, depression, social isolation, hearing loss, and even psychosis, are just some of the few side effects they can have while on these medicines,” said Dr. Unni Karunakara, MSF International President, in a press release.
It’s not all bad news for TB R&D. An FDA priority review of a new multidrug-resistant TB drug bedaquiline is underway. So far, research has shown the new drug to be safe and effective. Bedaquiline, if it moves to market, will be the first new TB drug in fifty years.
This year also brought the scale-up of the new TB diagnostic GeneXpert MTB/RIF, the result of the work of product development partnerships (PDPs). PDPs work across sectors, with blended funding, to accelerate the development of new drugs, vaccines, and diagnostics to address the world’s most critical health needs. Xpert is a huge breakthrough for much more accurate, efficient, timely diagnosis of TB, including drug resistant strains, however continued research is needed for a cheaper, point-of-care diagnostic.
Earlier this week, UNITAID announced $120 million in new funding for global health, including $16 million for product development partnership TB Alliance to support the production of child-friendly TB medicine formulations. Currently, a lack of child-adapted TB medicines contributes to high rates of TB among children.
While there has been a decrease in philanthropic and government funding for neglected diseases R&D over the past five years, there has been an uptick in private investment from multinational pharmaceutical firms, according to the latest G-FINDER report.
But government funding is still the largest contributor to global health R&D, so even small decreases in investment have a large impact. R&D for TB has remained relatively steady from 2007 to 2011, the last year for which data is available, essentially holding steady with a 17% percent share of total funding for neglected disease R&D.
The main point, however, is not its share of total funding, but that the total pot of funding for global health R&D must increase in order to fund basic research and accelerate promising technologies already in the pipeline. Given the long timeline for bringing drugs, vaccines, and diagnostics to the market, sustained investment over time is needed, especially in expensive late-stage clinical trials.