Tuberculosis

Tuberculosis research under FP7

Approximately 1.7 million people die each year because of Tuberculosis and today up to 2 billion people are infected with the causative agent, Mycobacterium tuberculosis. These numbers demonstrate why M. tuberculosis is considered to be one of the most successful pathogens ever encountered. In FP6 a portfolio of more than 20 TB projects with an overall budget of over € 60 million was established. These projects contribute to lightening the burden of tuberculosis and can be broadly divided into three areas: vaccines, drugs and diagnostics.

The FP6 Integrated projects in TB vaccines and TB drugs form a firm base from which new solutions to the TB problem are likely to emerge. They represent a rational approach to the design of new candidate vaccines and new anti-TB drugs. In addition, Specific Targeted Research Projects (STREP) give a focused view of more specific aspects of TB. The importance of STREPs is highlighted by the fact that it is widely recognised that because of the complex nature of interaction between M. tuberculosis and the human host, new ideas and risky projects are required to gain more understanding of the mechanisms of pathogenesis and disease in tuberculosis.

The dual strategy of utilizing both large translational research projects and smaller discovery oriented projects has proven to be fruitful in FP6. These activities should continue in the future, but some aspects revealed by latest research results should be taken into account in planning of FP7 Work Programme:

• In many regions of the world, including some European regions, M. tuberculosis strains have become resistant to most of the drugs currently being used to control the growth and spread of the disease.
• There is a great diversity of TB strains, which should be taken into account in the TB vaccines and drugs -fields.
• There is evidence suggesting that a single vaccine might not necessarily be sufficient for efficient TB control, but that different target groups around the world might have different needs. In addition, the HIV-TB co-infection should be taken into account.

In FP7 the above mentioned aspects of the ever growing TB problem should be addressed. In addition, emphasis should be put on translational research that would guarantee that results from the ongoing translational research activities from FP6 will be utilized and that there will be continuity in the field. Small innovative projects would support the ongoing major activities and would help to keep the drug discovery pipeline filled. Future topics could include development of drugs against multi-resistant strains, new technological tools for diagnostics, utilisation of the information from genomics and identification of new targets involving, for example, persistence related factors.

Tuberculosis is a global problem and the responsibility to support research activities should be shared. The Commission should show the way and build partnerships with the Member States and other stakeholders. Primed by the good examples from FP6, global initiatives will hopefully increase their participation and FP7 activities could facilitate integration of European efforts with the global TB research agenda. Fostering the transfer of the drug- and vaccine candidates to human clinical trials, and liaison the EDCTP should also be on our agenda to enable further large clinical trials in developing countries.