September 6, 2018

Research Roundup: Funding gaps in health innovation, new regimen for TB treatment, and a malaria drug resistance model

Ansley Kahn
Program Assistant
PATH/Mike Wang

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A new analysis has found that many of the products needed to combat the world’s most prevalent infectious diseases are not likely to be developed based on the current candidates in the research and development (R&D) pipeline and exposed significant funding gaps for R&D. According to the analysis—which was conducted by Duke Global Health Institute using a modelling tool developed by the World Health Organization’s Special Programme for Research and Training in Tropical Diseases (TDR)—there are 500 products for neglected diseases already in development which would cost an estimated US$16.3 billion to complete, yielding approximately 128 expected product launches. Additionally, the study identified 18 high-priority products it deemed “missing” from the current pipeline, such as vaccines for HIV/AIDS, tuberculosis, and hepatitis C. The research also exposed an annual funding gap of $1.5–2.8 billion, comparing current annual spending on product development to the costs required to move current products through the pipeline as well as develop the 18 “missing” products.

TB Alliance announced the launch of a new clinical trial, known as SimpliciTB, which will evaluate whether a new four-drug regimen against tuberculosis (TB) can treat most types of the disease more quickly and effectively than currently available treatments. The trial, which will launch in Tbilisi, Georgia, will enroll 450 patients across at least 10 countries. It will test the efficacy of a four-month treatment with the BPaMZ regimen—comprised of the newly FDA-approved drug bedaquiline, an investigational drug known as pretomanid, a re-purposed antibacterial medication called moxifloxacin, and a standard drug regularly used in treatment, pyrazinamide—in individuals with drug-sensitive TB. It will also test a six-month regimen of BPaMZ among patients with multidrug-resistant TB. A previous eight-week trial of the BPaMZ regimen among 250 patients revealed that patients on the regimen cleared bacteria at the fastest rate ever seen, up to three times faster than the standard first-line regimen. If proven successful in SimpliciTB, the BPaMZ regimen could significantly impact the way TB is treated globally.

Competition between parasite strains in a human host reduces the odds of drug resistance developing in a high-transmission area, according to a new mathematical model for malaria developed by researchers at Emory University and the Centers for Disease Control and Prevention's Division of Parasitic Diseases and Malaria. Where multiple strains of malaria already exist, a drug-resistant strain will usually go extinct simply because it has the disadvantage of being a “late-comer.” However, if a drug-resistant strain does become established, that same competition facilitates the spread of the drug-resistant strain more quickly. The researchers are developing a software tool based on the model they’ve developed, which can be applied to studying a range of pathogens and infectious diseases.