R&D funding needed to sustain the decline of TB deaths

[PARIS] The world is on track to halve the rate of deaths caused by tuberculosis (TB) by 2015, with advances in drugs and diagnostics capable of furthering the trend, a WHO report has found.

But plugging critical funding gaps for research and development (R&D) — of up to US$2 billion a year — and treatment and control measures is critical if current progress is to be maintained, according to the ‘Global Tuberculosis Report 2012’ released yesterday (17 October).

The disease is still a major burden, particularly in developing countries in Africa and Asia, and a slow response to increasing drug resistance, as well as critical gaps in funding, are threatening future progress, the report says.

More than 20 million people are alive today because of TB treatments and control measures recommended by the WHO since 1995, while mortality and incidence rates are down in nearly all of the 22 high burden countries, which account for over 80 per cent of total worldwide TB cases, it found.

The report, which has been published annually since 1997, accredited a substantial expansion of access to TB care, improved collaboration between TB and HIV prevention activities, and innovative diagnostic tools, for the 41 per cent drop in the mortality rate.

But the scale of the problem is not to be underestimated, it said.

In 2011 alone, the report estimated, 8.7 million people were newly infected with TB, of which 1.4 million died. The burden of the problem falls squarely on developing nations, with China and India accounting for 40 per cent of worldwide cases.

Of the hurdles preventing these numbers from reducing, a growing TB resistance to drugs is one of the most serious, the report found.

Although a pipeline of promising drugs and vaccines could eventually help to tackle resistant strains, progress using current tools has been too slow, it said.

"Real progress" has been made in fighting the disease, with better measurements of TB in children and women one of the main achievements since the last report, said Mario Raviglione, director of the WHO Stop TB Department, which produced the report.

But controlling TB relies on the solving the financial problems, he told SciDev.Net.

"The big message is that we are at a crossroads of TB control," he said.

"On the one hand, we have finally the new technology coming in, but we are also seeing a huge gap in funding that is putting this all at risk."

By providing the only global TB data on mortality and resistance, the report was important, said Ann Ginsberg, vice-president of scientific affairs at Aeras, an organisation committed to developing new vaccines and drugs to combat TB.

But she raised concerns that the report highlights WHO’s preference for using current diagnostics and drugs without adequate emphasis on developing new treatments.

"They only pay lip service to R&D but it is pretty clear they [WHO] have maxed out on what they can achieve with the current tools," she told SciDev.Net.