The third and final plenary explored recent scientific progress in tuberculosis (TB) and the implications for developing and implementing policy around new products in the field.
Frank Cobelens, Professor of Epidemiology and Control of Poverty-related Infectious Diseases and at the Amsterdam Institute for Global Health and Development (AIGHD), identified several new and emerging scientific advances in his presentation, What is the New Science?
Cobelens outlined the key areas of scientific development needed to eliminate TB, including improved diagnostics, scaling up prevention efforts, shortening treatment and blocking transmission/ prevention of disease via a vaccine.
Cobelens indicated that the research work around biomarkers was showing considerable promise and that ultimately the field would move towards developing triage tests that were predictive of cure and if successful, could also lead to taking two months off current treatment times. His optimism was tempered by the reality of the “working well” concept – the idea that TB infection spread was in a constant state of back and forth evolution between latent, active and clinical TB.
Lastly, Cobelens reviewed recent vaccine research results, citing both the BCG revaccination trial and the GSK/AERAS M72 as works in progress but evidence of a renewed energy in the field.
Soumya Swaminathan, Deputy Director General of Programmes at the World Health Organization gave a sobering assessment of the current epidemiology, saying that in terms of numbers, progress against infectious disease such as TB and Malaria was stalling.
Swaminathan went on to say that it was imperative that WHO Guidelines on new “products” such as drugs, regimens and diagnostics were developed at a faster pace, that they be shorter, less technical and very importantly, that they also deferred to ongoing programme data, not solely finalised trial results. She pointed to the guidelines around multidrug-resistant TB (MDR-TB) as being a case in point and remarked that these guidelines included strong coordination with the private sector on data collection and providers on the ground.