Europe needs to do more to back TB research efforts

27 Oct 2009

Paul Chinnock

Source: Médecins sans Frontières (see original article)

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Leading medical agency Médicins sans Frontières (MSF) says its field teams are losing too many battles in the fight for the lives of their tuberculosis patients, due to the lack of adequate medical tools. MSF is therefore calling for a significant scale-up of research and development for TB, which is estimated to claim 1.7 million lives each year.

MSF particularly wants to see increased commitment on the part of European governments, most of which it says are now “lagging far behind” the United States in TB funding.

In a new report the agency says two billion dollars are needed each year to tackle tuberculosis, whereas the 2007 total figure was only around $482 million dollars. MSF has analysed TB funds committed in 2007, concluding that France and Britain each paid about half of their “fair share”, while Germany and Italy managed only 23% and 11% respectively. The US was estimated to have contributed about two-thirds of its share. (MSF’s definition of a fair share is based on the notion that the amount each country contributes towards the two billion dollars required should be commiserate with their wealth.)

Describing current medical tools to fight TB as “inadequate”, the report sums up the problems with available methods of diagnosis, immunization and treatment:

“The most commonly used diagnostic test in resource-poor settings has essentially remained the same since it was developed almost 130 years ago. Known under the name of sputum smear microscopy, it misses about as many patients as it detects. Moreover, it is mostly ineffective in detecting TB in patients co-infected with HIV, who are most at-risk of dying.

Similarly, the commonly used Calmette-Guerin Bacterium (BCG) vaccine was developed in the early part of the 20th century. This vaccine is highly ineffective: it can protect only small children, and only from the most severe forms of TB; furthermore, immunity is not long-lasting, and the vaccine has hardly any epidemiological impact as small children rarely transmit the disease.

Treatment of TB relies on antibiotics developed decades ago. TB treatment must be followed for at least six to eight months and can have significant side effects. Treatment of resistant strains of TB is even more difficult. It requires daily injections for up to six months and a total treatment time of 18 to 24 months. Patients take a number of different drugs each day, many of which have very significant side effects. What is more, only up to 70% of patients can be cured.”

In addition to raising their levels of commitment to “fair share” levels, MSF wants European governments to support innovative funding mechanisms and sustainable R&D strategies. The agency is calling for more public–private research partnerships and to make use of novel ideas such as funding prizes. It highlights antibiotic resistance as an area particularly deserving of more research.