A new partnership announced today will increase efforts to coordinate the development of complementary novel tools to fight TB, including drug-resistant TB, and identify emerging drug resistance trends around the globe.
The partnership between the Foundation for Innovative New Diagnostics (FIND), which is driving the development and early implementation of diagnostic tests for TB and other diseases of the developing world, and the Global Alliance for TB Development (TB Alliance), which is working to discover and develop better, faster-acting tuberculosis treatments, holds the promise of dramatically improving how TB treatment is handled, especially in the world's most vulnerable countries.
"There is an urgent need to understand the drug resistance profiles of TB patients around the world and have ready the necessary new tools to combat those different presentations of the disease," said Mel Spigelman, M.D., President and Chief Executive Officer at TB Alliance. "By coordinating drug and diagnostic development efforts, we can optimize TB diagnosis and treatment for the millions in need and get patients on the proper course of treatment as quickly as possible. This need is particularly critical with a new generation of improved TB treatments on the horizon."
With the rise of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) around the world, it is crucial that treatment providers identify what they are treating within a much quicker timeframe. To this end, the partnership between FIND and TB Alliance will seek to introduce new and better drug regimens by developing tests that can detect resistance to crucial TB drug components.
Currently, few drug-resistant patients in lower-income countries are correctly diagnosed. Drug-resistant TB is often "found" by determining a patient's reaction to first-line treatment, which means that by the time they are identified as having drug-resistant TB, patients have become even more resistant than they were prior to their latest therapy. By developing a new arsenal of diagnostics that complement drug regimens in development, health care providers will be able to modernize their approach to TB management and treat patients with drugs to which they will respond right from the start.
"It's not enough to just detect the presence of TB. We need to know the resistance patterns of the disease we're confronting," said Philippe Jacon, CEO of FIND. "Oftentimes, the testing for drug resistance takes days or even weeks, and doctors are left to guess at the proper course of treatment to prescribe. Our work with TB Alliance will help refine this approach, making TB treatment more efficient, effective, and responsive."
Indeed, FIND and partners have been making great strides in the development of technologies that can diagnose resistance to vital medicines for the treatment of TB and these tools are now being made available to the populations who need them most. In December 2010, FIND's collaboration with Cepheid resulted in the endorsement by WHO of Xpert MTB/RIF-, a molecular test that detects the presence of TB, including rifampin resistance for MDR-TB, in less than 2 hours.
FIND will seek funding from donors to advance the development of newer diagnostics for rapid detection of drug resistance. The collaboration will initially focus on fluoroquinolone and pyrazinamide resistance, two drugs used in current treatments which are also critical in new treatment regimens under development.
Tuberculosis is the world's second deadliest infectious disease after HIV/AIDS, killing almost 1.4 million people each year. The disease, which dates back thousands of years, has even been found in the remains of Egyptian mummies. Roughly 9 million people develop TB every year. At this point, one third of all people on earth-more than nearly 2 billion people, have a latent form of the disease.
Resistant strains of TB develop when treatment is not administered or taken correctly and/or completely. Surviving bacteria can acquire a permanent resistance to the drug, which is then communicated along with the infection to new patients. Standard TB treatment involves four different drugs and lasts six months to ensure that all TB bacteria in the patient are eradicated. If resistance is determined-or suspected-doctors prescribe more complex drug regimens that can last two years or more, and often have debilitating side effects.
This week, the World Health Organization (WHO) is expected to release new findings that track how the disease is faring in all parts of the world. One of the elements on which advocates and researchers are focused is the continued impact of the development and transmission of MDR-TB and XDR-TB as one of the most threatening features of the TB pandemic.
Global Alliance for TB Development