Current Status and Research Strategies in Tuberculosis Drug Development

There is no doubt that the future success in the battle to end the scourge of this debilitating disease relies heavily on the discovery of new drugs. At the moment there are a worryingly low number of potential new chemical entities in the TB drug pipeline. To overcome the high rates of attrition, many more need to be discovered and developed. To ensure this, a growing and sustainable supply of new drug discovery and development programmes must be fostered by highly multidisciplinary collaborative partnerships. This will only be possible by the growing number of academic, pharmaceutical, and not for profit organization collaborations having access to open and available data, compound libraries, and expertise to assist all involved in such research initiatives. Support for clinical trials to evaluate a steady supply of promising compounds is critical as well as funding to sustain biomarker research to provide surrogate end points to accelerate candidate selection during drug discovery and dose selection in early clinical research and ultimately to shorten the time to licensing of new drugs. As combination therapy is unavoidable and treatment of HIV co-infection is of paramount importance, funding must also be made available to address the inherent pharmacokinetic issues raised. Critical to the success of these strategies is sustained financial and legislative support from the public sector to ensure that TB drug discovery remains a viable and attractive proposition for academia and pharmaceutical companies to engage with as they did in the mid-20th century. This paradigm shift in the way that TB drug discovery research is coordinated and conducted is vital for its success, and the time for its implementation is now! © 2011 American Chemical Society.