Areas of research necessary to speed up progress in global TB control

Research across a continuum is necessary to speed up progress in global TB control. Key areas of research on the continuum include the following:

1. applied research focusing on the development of new tools to better detect, prevent and cure TB control, including new diagnostics, drugs and vaccines;
2. operational and programme-centred research to optimize the use of current strategies and tools and to operationalise the introduction of new ones by linking their use with epidemiological, operational, behavioural, social, health systems, health economics and policy research.
3. basic research for discovery

Progress in global TB control is constrained by the lack of effective new "tools" (diagnostics, drugs and vaccines). The diagnosis of most cases of pulmonary TB relies on nineteenth century technology, namely sputum smear microscopy (developed by Robert Koch in 1882) and radiography (based on X-rays discovered by Röntgen in 1895), the only TB vaccine (BCG) was first used in 1922, and the last new anti-TB drug to be widely introduced was rifampicin in the 1970s.

The Stop TB Partnership and WHO are promoting the development of better technologies for preventing TB and improving the diagnosis and treatment of TB through its three Working Groups on new tools development: Working Group on New TB Diagnostics, Working Group on New TB Drugs, and the Working Group on New TB Vaccines. Each of these three Working Groups has developed its own ten-year strategic plan in contribution to the overall Global Plan to Stop TB, 2006-2015. There is scope for the three R&D Working Groups to work together on issues of common interest (e.g. stimulating basic research, regulatory processes, trial capacity, and re-tooling). Re-tooling refers to the preparatory work necessary to ensure rapid uptake and use of new tools in the field as they become approved and available.

Diagnostics

Strategic plan of the Working Group on New TB Diagnostics
Diagnostics for tuberculosis - global demand and market potential

Drugs

Strategic plan of the Working Group on New TB Drugs

Vaccines

Strategic plan of the Working Group on New TB Vaccines

Re-tooling

Report of the re-tooling task force
Executive Summary

Improving our understanding of basic science

Basic science underpins the development of new tools and will enable the revolution in TB control technology needed to achieve the goal of TB elimination by 2050. Engaging those researchers involved in basic science in academic and other research institutions will be crucial to the successful development of the Research Movement as a broad alliance of all those involved in TB research.