March, 24, 2003
Each year on March 24, World TB Day reminds us of the importance of focusing our attention and resources on the challenges of overcoming tuberculosis, and of the goals to be achieved before we can successfully control this deadly disease. World TB Day also provides an opportunity to congratulate the researchers, health care workers and public health officials who have made so much progress in understanding this disease and developing new and improved interventions.
Despite global efforts, TB (caused by the bacterium Mycobacterium tuberculosis) continues to claim more than 2 million lives each year. These deaths occur among approximately 8 million new cases of TB that develop from a reservoir of an estimated 2 billion individuals infected with M. tuberculosis worldwide. These figures clearly underscore the serious global threat posed by tuberculosis. The growing numbers of TB patients worldwide are due to many factors, including the global pandemic of HIV/AIDS and the occurrence of drug-resistant TB, which in many settings has limited the effectiveness of current TB therapies.
In order to reduce the burden of TB, concerted efforts are underway worldwide to develop more effective drugs that would allow for shorter and less complex drug treatments. The ultimate weapon to contain the worldwide spread of TB, however, would be an effective vaccine to prevent infection with M. tuberculosis and the development of TB disease.
All TB research depends upon the creation of a solid base of scientific knowledge about M. tuberculosis and an understanding of how TB develops from an infection with this bacterium. The National Institute of Allergy and Infectious Diseases (NIAID) plays a key role in the global fight against TB by conducting and supporting research – – and providing research resources – – to advance the understanding of TB and translate basic research findings into useful medical interventions such as therapeutics, diagnostics and vaccines. NIAID supports this ambitious research agenda in collaboration with partners around the world in countries such as Mexico, Brazil, Peru, Uganda, Tanzania, and South Africa.
In the past few years, these energetic partnerships and multinational collaborations have resulted in an enormous return on the NIAID commitment to fighting tuberculosis, not only in terms of new research findings, but also in developing enhanced research capacity worldwide. Scientific advances have facilitated the creation of novel drug candidates, treatment regimens and vaccine candidates that are rapidly progressing toward human studies. For example, three of the many new TB vaccine candidates that are being developed will enter safety testing in humans in the near future, and the value of new TB treatment strategies is being assessed.
NIH and academic scientists have been instrumental in successfully translating basic research findings to create vaccine, drug and diagnostic candidates for clinical evaluation. Now, partnerships with the private sector will be critical to access the specific expertise needed for the production and evaluation of these candidates. Furthermore, with new TB interventions within reach, we will need to assess with the global public health community how these products can fit into and be implemented within existing TB control strategies.
In order to speed TB research, global partners must recognize the strength and relative contribution of each collaborator in the continuum from basic science, through product development and production, to clinical studies. These contributions must be coordinated such that promising medicines and vaccines can be rapidly developed – – and so that unsuccessful strategies can be shelved. World TB Day reminds us that the global medical and public health communities, as well as policy makers and activists, must work together to create a roadmap for the coordinated development of TB medicines and vaccines so that we can reduce the burden of this scourge, and move as quickly as possible toward the elimination of TB as a public health problem.
Anthony S. Fauci, M.D., is Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health. Christine F. Sizemore, Ph.D., is the Program Officer for Tuberculosis, Leprosy and other Mycobacterial Diseases in the NIAID Division of Microbiology and Infectious Diseases. Barbara E. Laughon, Ph.D., is Chief of the Complications and Co-Infections Research Branch of the Therapeutics Research Program in the NIAID Division of AIDS.
Prepared by:Office of Communications and Public LiaisonNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesda, MD 20892 U.S. Department of Health and Human Services
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Last Updated March 24, 2003