TB Alliance (formally The Global Alliance for TB Drug Development) is a not-for-profit product development partnership (PDP) dedicated to the discovery and development of new, faster-acting and affordable

tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...

(TB) medicines. Since its inception in 2000, TB Alliance has worked to grow the field of available treatments for TB and now manages the largest

pipeline A pipeline is a system of Pipe (fluid conveyance), pipes for long-distance transportation of a liquid or gas, typically to a market area for consumption. The latest data from 2014 gives a total of slightly less than of pipeline in 120 countries ...

of new TB drugs in history. It was founded in

Cape Town Cape Town is the legislature, legislative capital city, capital of South Africa. It is the country's oldest city and the seat of the Parliament of South Africa. Cape Town is the country's List of municipalities in South Africa, second-largest ...

, South Africa, and has since expanded. It is headquartered in

New York City New York, often called New York City (NYC), is the most populous city in the United States, located at the southern tip of New York State on one of the world's largest natural harbors. The city comprises five boroughs, each coextensive w ...

and has a regional office in

Pretoria Pretoria ( ; ) is the Capital of South Africa, administrative capital of South Africa, serving as the seat of the Executive (government), executive branch of government, and as the host to all foreign embassies to the country. Pretoria strad ...

Background

Tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...

is the leading cause of infectious death worldwide, killing approximately 1.6 million people each year. However, research and development for new TB drugs came to a virtual standstill after the 1960s. Today, a four-drug combination therapy exists, but it takes six months or more to be effective. This requires a degree of monitoring (See Direct Observational Therapy, Short-course) beyond the capacity of the health infrastructure in many countries, and adequate TB treatment is not available to more than half of the most infectious cases. This can inhibit control of the disease and fuel the rise of

drug resistance Drug resistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition. The term is used in the context of resistance that pathogens or cancers have "acquired", that is ...

(See

antimicrobial resistance Antimicrobial resistance (AMR or AR) occurs when microbes evolve mechanisms that protect them from antimicrobials, which are drugs used to treat infections. This resistance affects all classes of microbes, including bacteria (antibiotic resista ...

). About 29% of deaths caused by antimicrobial infections today are due to drug-resistant TB. When infections become resistant to first-line drugs, more expensive therapies must be used to treat them. Lengthier treatment, often in hospitals, substantially increases health care costs as well as the economic burden on families and societies. The cost of treating a single case of multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB) can be thousands of times more expensive than treating drug-sensitive TB. TB is also the number one killer of people with

AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

, but it is generally agreed that current TB treatments do not work well with the antiretroviral drugs used to treat HIV. New, improved TB treatments are urgently needed. However, the TB drug market lacks sufficient financial incentives to stimulate broad-based investment from

pharmaceutical companies The pharmaceutical industry is a Medicine, medical industry that discovers, develops, produces, and markets pharmaceutical goods such as medications and medical devices. Medications are then administered to (or Self-medicate, self-administered b ...

to invest in the new research required to sustain a treatment pipeline. The TB

epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infection ...

is concentrated in developing countries where drugs must be low in cost to remain accessible. It does not generate the kind of revenue streams that private companies usually deem necessary to justify the research costs and strategic risks involved in pharmaceuticals. TB Alliance was designed to be the primary instrument to fill this vacuum and to ensure that new anti-TB drugs are affordable and accessible in endemic countries.

History

TB Alliance was conceived at a February 2000 meeting in

, South Africa, where 120 representatives from academia, industry, major government agencies, non-governmental organizations and donors gathered to discuss the problems of tuberculosis treatment. Participants stressed the need for faster-acting, novel TB drugs and highlighted the scientific opportunities involved. The resulting "Declaration of Cape Town" provided a road map for TB drug development and outlined the need for creation of the TB Alliance. Maria Freire was appointed as the first Chief Executive Officer and President in 2001 and served in that capacity until 2008, when she left the TB Alliance to become President of the Lasker Foundation. The current CEO and President is Melvin Spigelman.

Program

TB Alliance is a

non-profit A nonprofit organization (NPO), also known as a nonbusiness entity, nonprofit institution, not-for-profit organization, or simply a nonprofit, is a non-governmental (private) legal entity organized and operated for a collective, public, or so ...

product development partnership (See public-private partnership). A PDP builds partnerships between the public, private, academic and philanthropic sectors to drive the development of new products for underserved markets. PDPs retain direct management oversight of their projects, though much of the laboratory and clinical work is done though external research facilities and contractors. This model minimizes costs, including overhead and investments in infrastructure, while optimizing scientific capability to speed new TB drug development. TB Alliance has the largest pipeline of TB drugs in history and part of TB Alliance's stated mission is to ensure that any new treatments are affordable and accessible in the

developing world A developing country is a sovereign state with a less-developed industrial base and a lower Human Development Index (HDI) relative to developed countries. However, this definition is not universally agreed upon. There is also no clear agreeme ...

, and that they are adopted as soon as they become available. Pricing terms are included in all licensing contracts and end products are designed to be easy for patients to take. TB Alliance also collaborates with national and international partners, working to ensure that new therapies are adopted and accessible to

healthcare provider A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive ...

s and patients via local channels. In February 2019, TB Alliance's application for the novel tuberculosis (TB) medicine pretomanid was accepted for review by the U.S. FDA. In August 2019, TB Alliance's tuberculosis (TB) medicine pretomanid was approved by the U.S. FDA, to be used in combination with two other antibiotics, bedaquiline and linezolid, for the treatment of extensively drug-resistant (XDR) TB as well as treatment-intolerant or nonresponsive multidrug-resistant (MDR) TB.

Treating drug-resistant TB

Combination therapies are essential for treating active tuberculosis infections. Currently, there are four first-line tuberculosis drugs given as a combination therapy over an extended period of time. Some strains of the tuberculosis pathogen are resistant to two (called MDR-TB) or at least four (called XDR-TB) first-line tuberculosis drugs. Due to the contagious nature of tuberculosis, drug resistance is considered to be a serious public health issue, particularly among people with an already weakened immune system, for example people living with HIV.

Donors

The TB Alliance has a diverse set of global partnerships with both public and private sector donors that fund the company's work. The organization operates with the support of: * Australia Department of Foreign Affairs and Trade *

Bill & Melinda Gates Foundation The Gates Foundation is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was launched in 2000 and is reported to be the third largest charitable foundation in the world, holding $ ...

* Germany's Federal Ministry of Education and Research through KfW * Global Health Innovative Technology (GHIT) Fund * Indonesia Health Fund *

Irish Aid Irish Aid () is the Government of Ireland's official international development aid programme. Irish Aid is managed by the Development Co-Operation and Africa Division (DCAD) of the Department of Foreign Affairs (DFA). According to the OECD, Ire ...

* Medical Research Council (United Kingdom) * National Institute of Allergy and Infectious Disease * Netherlands Ministry of Foreign Affairs * UK Department of International Development (DFID) *

UK Department of Health The Department of Health and Social Care (DHSC) is a ministerial department of the Government of the United Kingdom. It is responsible for government policy on health and adult social care matters in England, along with a few elements of the sa ...

United States Agency for International Development The United States Agency for International Development (USAID) is an agency of the United States government that has been responsible for administering civilian foreign aid and development assistance. Established in 1961 and reorganized in 1998 ...

(USAID)

References

External links

TB Alliance

The Stop TB Partnership
{{Authority control Tuberculosis organizations International medical and health organizations