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How can we treat more than 0.5% of MDR-TB?

Posted by: David Zapol on 11/14/2011

As I prepared to go to the annual tuberculosis (TB) Union meeting in October, friends and colleagues mentioned that they had heard the good news about TB, that incidence is falling. And I would respond that only 0.5% of people who have multi drug resistant TB (MDR-TB) are being treated. I went to Lille, France with my colleagues to roll up our sleeves and do something about this.

Our work over the last six months with Eli Lilly and Company was announced last week: a five-year, $30M commitment to the third phase of the Lilly MDR-TB Partnership, focusing on second line drug supply and access, and health care provider training. With so many problems in MDR-TB, it was not easy to choose a focus. Lilly takes an approach throughout its programs to create long term impact through its activities under the framework of Research, Report and Advocate – you can read more about this work from our client, Tracy Sims in a recent blog post.

Lilly no longer manufactures TB drugs as of this year. So their work in MDR-TB means engaging with manufacturers and researchers and the field to answer big questions like how to improve the supply chain between when countries order drugs to treat patients with MDR-TB, to when those are delivered to the clinic. The exciting part of this effort was that it complements perfectly the theme of the Union conference this year which was focused on partnerships for scaling up and care. What happened in Lille was what we all hope will be the beginning of true partnership with global actors.

FSG and Lilly supported the work of a recently formed 20+ member working group set up by the Global Drug Facility within the Stop TB Partnership at the WHO, including the Bill and Melinda Gates Foundation, USAID, the Global Fund, UNITAID among others. Some very novel and bold proposals were made, like a near-term subsidy to increase volumes and drive down price as manufacturers get to scale. We were thrilled when the group walked out of the meeting with a shared vision for how to fix the problem, and a plan for how to make progress getting more drugs to patients who need them in 2012…

While this is not the answer for the 1/2 million people who live with MDR-TB, it is a step towards a collective impact approach to tough issues that have plagued the field of TB for years. Please join the discussion and tell me about your work in TB, in coalition building, or comment on the direction we’re pushing the field.

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V5 and V7 (oral M vaccae) immunotherapies have been shown to have clinical efficacy in MDR-TB and TB/HIV. These products need way more funding for internal and external clinical testing. Do you know about them?
See re V7 and re V5
Keep up the good work with worldbike!
David Zapol
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Thank you for your post Allen,
I am not familiar with V7 and V5. Our work has recently focused on access to existing second-line drugs to treat MDR-TB. However Lilly who has made significant commitments to funding R&D (see IDRI in Seattle) and our colleague at the TB Alliance fund a portfolio of projects in new TB drugs (which you can see here: ) It is tremendous to see the level of activity in the R&D side of the field despite the poor economics.
David Zapol
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Dear Allen,
I exchanged notes with someone at the TB Alliance who pointed out that the Stop TB Working Group on New Drugs monitors the TB drug pipeline, and does include the V7 candidate you mentioned above.
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