Statement on World TB Day by Christine Sizemore, PhD, Barbara Laughon, PhD and Anthony S. Fauci, MD

On March 24, 2006, the US National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) and similar health agencies worldwide commemorated World TB Day, which honors both the struggles and successes in the worldwide fight against tuberculosis, a longtime microbial adversary.

TB, a global infectious disease threat, claims the lives of more than 1.7 million people each year and disables many of the 15.4 million individuals currently afflicted with this disease. Co-infection with HIV, the steady increase in the number of multi-drug resistant cases of TB, and the recognition that our current arsenal of drugs may be failing, only increases the urgency and the need to expedite the development of new approaches to the identification, treatment and prevention of this ancient scourge.

This year began with a sense of hopeful resolve as the Stop TB Partnership announced “The Global Plan to Stop TB 2006--2015” at the World Economic Forum in Davos, Switzerland. This plan articulates a coordinated global strategy to stop the spread of TB through implementation of optimized TB care worldwide. The plan assesses current research needs and activities for the development of new drugs, vaccines and diagnostics to meet the Millennium Development goal “to have halted by 2015, and begun to reverse the incidence” of TB.

The importance and impact of a solid scientific foundation on current strategies and specific changes to improve TB care during the next 10 years is evident in each chapter of the Global Plan.  The National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) has a central role to play in this process: the Institute supports research to increase fundamental knowledge about TB and other infectious, allergic and immunologic diseases and to translate this knowledge into new health care interventions for human populations worldwide. 

Dedicated TB investigators supported by the NIAID have shown tenacity and vision in their research endeavors and have created new candidate vaccines, drugs and diagnostics now being evaluated in human studies. These successes have shown that investments in fundamental and translational science, often criticized as being far removed from patients, is a prerequisite of, and the first step toward, the production of new health care interventions. The TB research community is to be congratulated for translating the support of research funders all over the world, including the NIAID, into tangible outcomes.

Much work remains, but for the first time in the history of TB research, a significant number of TB countermeasure candidates are available for clinical testing. For example, this past June, a promising new TB drug called PA-824 entered clinical trials. Preclinical studies suggest that the drug is effective against both proliferating and slow-growing forms of Mycobacterium tuberculosis, the microorganism that causes TB. Current treatments for active TB require multiple drugs for long periods; however, PA-824 may potentially decrease the required duration of treatment. More than ten additional drug candidates are currently undergoing preclinical evaluation.

In addition, several promising TB candidate vaccines also have been developed. Two vaccines, rBCG30 and Mtb72f, currently are being tested in clinical trials in the United States and a third vaccine has been shown to be safe and immunogenic in tests conducted in Europe. Nearly a dozen additional vaccine candidates also are being evaluated in preclinical studies.

These promising drug and vaccine candidates have been developed in part through successful public-private partnerships among government-funded researchers, industry, philanthropies and others. There is reason to be optimistic that several additional advances will result in new products for TB and TB/HIV care worldwide, or will at a minimum, teach us how to enhance development of improved strategies and methods for combating this disease.

Each year, World TB Day provides a time to reflect on the milestones we have set for the elimination of TB and to evaluate whether we are moving expeditiously toward the goals we have agreed to pursue. This year, with multiple new drug, vaccine and diagnostic candidates on the horizon, NIAID is proud to support talented investigators within our research portfolio and applauds the efforts of other institutions throughout the world that are involved in this endeavor.

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 Acting Chief of the Tuberculosis and Other Mycobacterial Diseases Section 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.