With 2 billion cases of tuberculosis infection worldwide and 2 million deaths from the disease each year, Prof. Stefan H. E. Kaufmann (Max Planck Institute for Infection Biology) and Dr. Carl Nathan (Weill Cornell Medical College) discussed the challenges for current tuberculosis research, along with drastically needed changes in both infectious disease research and research funding.
One week after World Tuberculosis Day, on March 31, 2011, the German Center for Research and Innovation (GCRI), in cooperation with the Max Planck Florida Institute, hosted a discussion on the treatments and challenges of Tuberculosis (TB) featuring highly cited immunologist Prof. Stefan H.E. Kaufmann.
Prof. Kaufmann, who is the founding and current director of the Department of Immunobiology of the Max Planck Institute for Infection Biology in Berlin and president of the International Union of Immunological Societies (IUIS), was joined by Robert Koch Award recipient Dr. Carl Nathan, the R.A. Rees Pritchett Professor and chair of the Department of Microbiology and Immunology at Weill Cornell Medical College in New York. Dr. Ann Ginsberg, Chief Medical Officer of the Global Alliance for TB Drug Development (TB Alliance), a not-for-profit product development partnership focused on the discovery and development of improved and affordable treatments for TB, moderated.
According to both speakers, part of the problem with infectious disease research is the way in which researchers approach disease. There is an insistence on a one-drug cure, a narrow focus on synthetic over natural antibiotics, and a limited view of how to target the disease-causing pathogen. Traditional drugs attack only a pathogen’s ability to replicate.
Prof. Kaufmann illustrated clinical trials as time-consuming and expensive. Even if a new vaccine existed, it would take ten to twenty years for the drug to exit the testing phase and become available to those who need it. As the principle investigator (PI) of the Grand Challenge 6 “Tuberculosis in the Context of HIV/AIDS in Africa,” Prof. Kaufmann’s work had the unique benefit of starting research with patients before going into the lab. He used the natural human immune response to TB as a guide to develop a new vaccine. The first of the 11 vaccines his lab produced has had very promising results. “Optimistically speaking the current drugs in development could reduce TB by 60-70% by 2015,” Prof. Kaufmann said. However, this would not meet the World Health Organization’s set goal for the eradication of TB worldwide by 2015.
To treat all TB cases with drugs worldwide, two billion dollars are needed, said Prof. Kaufmann, a mere one-tenth of the USD 20 billion in financial losses that result from the disease. The amount of funding currently available for TB is USD 500 million.
Dr. Nathan, whose talk was titled “Taming Tuberculosis: A Challenge for Science and Society,” spoke about the highly competitive nature of funding processes. Topics that are more attractive within the public’s imagination have received more funding than those that are not, he said. Competition between researchers leads to a high amount of unshared or destroyed data. If shared, this data could not only save time and money, but also speed up the development of new treatments. No matter the disease, research is expensive – and most people infected with TB are too poor to pay for most medicine. In the words of the health activist and a Congressional Gold Medal recipient Mary Lasker: “If you think research is expensive, try disease.”
