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TB research hits record high

Global spending on tuberculosis research and development has hit a new high, according to a preliminary report.

The Treatment Action Group, a United States-based advocacy group, found that the global TB research spend increased by more than US$40 million between 2016 and 2017, to US$767.7m. The TAG released its report of 24 September.

“Funding in 2017 increased in almost every area of TB research tracked by TAG, from basic science to the development of new diagnostics, drugs, and vaccines to operational research,” its report states.

The 2017 figure is the highest since the surveys began in 2005. Spending began to climb in 2015 after a period of tapering off and eventual decline from 2009 to 2014.

Most of the rise is thanks to increased contributions from the public sector and through Unitaid, an international organisation which funds innovations against HIV/AIDS, TB, and malaria.

TAG publishes annual reports on TB research trends, with the latest final report expected in December.

The TB research funding pool remains vulnerable and lop-sided, the report warns. The United States’ National Institutes of Health and the Bill & Melinda Gates Foundation alone funded half of the world’s TB research in 2017. Private sector spending remains low and an area of concern, although the projected 2017 figure is slightly higher than in 2016.

Paediatric TB research, which TAG says is perennially neglected, almost doubled its 2016 figure.

Better but not enough

The group warns that spending is nowhere near the US$2 billion per year it says is needed to end TB by 2030. It wants governments to commit 0.1 per cent of their annual research spending to tuberculosis R&D.

“All governments at all income levels can give more to TB research,” the TAG report says.

TAG did however praise South Africa for its commitments, one of the few countries to hit the 0.1 per cent target in 2017. The country spent nearly double that, with an estimated US$8.4m.

The World Health Organization also called for more funding for TB research. It presented its annual Global TB Report to a special UN meeting on TB on 18 September, also in New York.

The WHO says a “major technological breakthrough” is needed by 2025 to ensure TB incidence drops sufficiently to reach the target set by the Sustainable Development Goals by 2030.

It warns that diagnostics research is “relatively stagnant” and says there is still “no single rapid, accurate and robust TB diagnostic test suitable for use at point of care”.

According to the WHO figures, 1.6m deaths in 2017 and 10m cases were attributed to TB, with 1.7 billion people estimated to have latent infections.

However, new cases are decreasing by 2 per cent a year, and deaths have almost halved since 2000. The WHO praised Southern Africa which has shown some of the fastest decreases in new infections, between 4 and 8 per cent for Eswatini, Namibia, South Africa, Zambia, and Zimbabwe.