WHO Urges More R&D In Tuberculosis
By Cyndi Root
Tuberculosis (TB) incidence is higher than previously estimated, according to the World Health Organization (WHO). The agency recently published a report stating that, due to improved data collection, it estimates there are half a million more cases than previously thought. In the report, WHO states that in 2013, 9 million contracted the disease and 1.5 million of those people have died, including 360,000 people with HIV. Four treatments are available to treat TB: isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA), and two have recently been approved to treat drug-resistant TB.
WHO TB Report
WHO’s TB report is the nineteenth global report starting in 1997. The up-to-date assessment titled, “Global tuberculosis report 2014,” chronicles the TB epidemic and the countries that have the greatest incidence. It includes supplements on multidrug-resistant TB (MDR-TB), the global TB database, and profiles on 22 high-burden countries. The Executive Summary outlines the burden of disease and the progress towards 2015 global targets.
TB Research and Development
WHO states that more investment is need in R&D for TB. Because many TB cases go undiagnosed, new tests are needed and are under development, but are underfunded. Currently, 10 new or repurposed drugs are in late stage clinical trials, 15 vaccines are in development, and two drugs have been approved for treatment of multidrug-resistant TB (MDR TB) under specific conditions: bedaquiline and delamanid. Combination regimens show promise in treating TB.
Bedaquiline and Delamanid
The Food and Drug Administration (FDA) approved bedaquiline fumarate (Sirturo or bedaquiline) on December 28, 2012. The federal agency approved Janssen’s agent under accelerated approval regulations for MDR TB. The European Medicines Agency (EMA) approved Otsuka’ s Deltyba (delamanid) as part of a combination regimen for pulmonary multidrug-resistant tuberculosis (MDR-TB) in adult patients when an effective treatment regimen cannot otherwise be composed for reasons of resistance or tolerability. Deltyba is a bactericidal agent that interferes with the metabolism of the Mycobacterium tuberculosis (MTB) cell walls.
WHO Action Strategy Post-2015
WHO states that at the end of 2015, it will begin a new strategy to address the TB epidemic. This developmental framework was approved by Member States at the May 2014 World Health Assembly. By 2035, the agency hopes to end the epidemic with a 95 percent reduction in TB deaths and a 90 percent reduction in TB incidence (both compared with 2015), including a target of zero catastrophic costs by 2020 for TB-affected families.