Pvt sector deserts war on TB, funding down 33% since 2011

Even as tuberculosis (TB) continues to haunt the world, a new study has revealed that funding for research and development of new drugs to fight the disease is floundering. Private sector funding has declined by more than a third since 2011 as pharma companies are closing their TB research programmes.

Pfizer shut down its TB drug discovery programme in 2012, AstraZeneca in 2013 and Novartis in 2014. Meanwhile, multi-drug resistant TB is rapidly spreading with 450,000-odd new cases reported in 2012 by the World Health Organisation (WHO).

The report was prepared by Treatment Action Group (TAG), a New York based health policy think tank. It pointed out that while $9.8 billion was needed to fight TB during 2011-2015 according to a Global Plan prepared by experts in 2011, the world spent only $1.99 billion by the end of 2013.

India spent around $7.6 million in 2013 on TB research according to the TAG report. The highest spender was the National Institute of Allergy & Infectious Diseases of US which invested over $158.8 million, followed by the Bill & Melinda Gates Foundation which spent $147.9 million.

New drugs are needed because current drugs require a six-month course increasing chances of patients not finishing it and thus relapsing, explained Mike Fricke, author of the TAG report. Also, new drugs are essential to fight the growing incidence of drug-resistant TB.

"There is a great need for shorter treatment regimens using fewer numbers of pills. The current regimen requires six months of treatment... making it difficult for many patients to finish therapy. For drug-resistant TB, there is an urgent need to develop safer, more tolerable drugs. Many of the drugs used to treat drug-resistant TB are decades old and carry severe toxicities including hearing loss, psychosis and peripheral neuropathy," he told PG Times.

According to the TAG report, the onus of developing new treatments for TB is now falling more on public funding. Over 60 percent of global TB research is now done under public funded programs in research institutions and universities.

India is one of the more severely TB-affected countries with about 2.8 million TB patients including 55,000 multi-drug resistant TB cases.

Why is the private sector deserting this war? They do not see much profit in TB drugs because this is a disease most widely prevalent in middle and lower income countries, says Amit Sengupta of the Jan Swasthya Abhiyan, a health activists' network in India.

"Thirty seven percent of the global pharma market is in the US while India's share is just 2%. Big Pharma prefers making and selling drugs needed by the richer countries for ailments like heart diseases, cancer, depression. They don't want to spend money on drugs and vaccines for TB or malaria which afflict millions of poorer people," he said.

Each year 3 million of the nearly 9 million people who get TB are never reported to national TB programs and don't receive a diagnosis or treatment, says Frick. This deficiency in the healthcare system is also weighing on Big Pharma's mind.

"TB affected communities will be asked to pay twice - first to fund the research behind new drugs and then again to buy those drugs back from the same pharmaceutical companies that benefited from public financing," Frick said.

Total funding needed to fight TB = $9.8 billion (2011-15)

Actual funding = $1.99 billion (till Dec 2013)

Share of TB Research Funding

Public: 59%

Philanthropic: 25%

Private: 15%

Multilateral: 1%

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