Global Investments in Tuberculosis Research and Development: Past, Present, and Future
Tuberculosis is the leading cause of death from a single infectious agent globally. The present and future threat that TB poses to human health is mainly a consequence of the enormous neglect the TB research field has experienced over the past several decades. Reversing this neglect and ending the TB epidemic by 2030 – as called for by the United Nations Sustainable Development Goals (SDGs) and WHO End TB Strategy requires a decisive action by all countries and stakeholders to increase their support for TB research and innovation. Funding for TB R&D must increase substantially over past levels, and regulatory and other institutional barriers to research should be resolved with urgency. The End TB Strategy indicates that new tools must be introduced by 2025 in order to reach the 2030 targets of a 90% reduction in TB deaths and 80% reduction in TB incidence compared with 2015 levels. For this, a renewed, global commitment to TB research and development led by country governments working in concert with the private and philanthropic sectors, civil society and communities affected by TB is essential.
This policy paper was prepared together with various stakeholders from civil society groups, academia, and product development partnerships, for use in the context of the “WHO’s First Global Ministerial Conference on Tuberculosis in the Sustainable Development Era – A Multisectoral Response” in Moscow in November 2017. This document aims to articulate a coherent vision of the research needs to end TB and elaborates on the funding and structural requirements that are necessary to operationalize this vision. It describes how some of the research funded in the past has delivered benefits to patients and influenced policy- and decision-making, but also how little is being invested in TB R&D in comparison with other diseases, such as HIV and malaria, that also affect poor populations. The paper shows that, despite significant progress, previous investments were not sufficient to warrant success in tackling difficult challenges, such as multidrug-resistant TB (MDR-TB), expedited development of new and improved tools, and effective deployment of such tools. To tackle these challenges, the present policy paper recommends the development of a global strategy for TB Research to foster collaboration, improve efficiency and increase R&D financing. The strategy will serve as a coherent source of direction to reach the targets of the WHO End TB Strategy, ensuring that opportunities commencing from the forthcoming meetings are used optimally. Further findings from this report are expected to inform the debate at both national and global levels on prioritizing the policy approaches that are urgently needed to advance TB R&D in the era of the SDGs.