New Federal Research Agenda Set for Drug-Resistant TB

The National Institute of Allergy and Infectious Diseases announced a new research agenda to fight drug-resistant tuberculosis in both of its forms -- multidrug-resistant (MDR) and extensively drug-resistant (XDR). Both "are occurring at an ominous and accelerating rate," according to the NIH agency's announcement. NIAID Director Dr. Anthony S. Fauci and members of the NIAID Tuberculosis Working Group created the agenda, which is available online in The Journal of Infectious Diseases.

"The TB diagnostic tools in use today are antiquated, slow, and insensitive; TB drug regimens are complex and lengthy; and the only vaccine available does not provide effective protection against adult pulmonary TB," said Fauci. "The challenge of TB control is further compounded by the rise of drug-resistant TB, and we anticipate that the NIAID Research Agenda for Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis will contribute substantively to the fight against this emerging threat."

The World Health Organization estimates 500,000 people worldwide have MDR-TB, while XDR-TB has been detected in 46 countries. Factors contributing to these increases include lack of routine testing to determine TB drug-sensitivity, incomplete treatment of people infected with TB-causing bacteria, an epidemic of TB in HIV-infected people, and limited TB research by pharmaceutical companies, the agency said.

The agenda identifies areas of biomedical research that are likely to contribute to a global public health response. The priorities include efforts to develop and test reliable technologies to rapidly diagnose TB and to identify drug resistance; define the most effective use of existing TB therapies and other antibiotics available to treat drug-resistant TB and develop new drugs, particularly to treat MDR-TB and XDR-TB; better understand the basic biology of TB-causing bacteria and their interaction with the human host that underlie the development of drug-resistant TB; understand the epidemiology of drug-resistant TB; investigate the various manifestations of TB in adults, children and those with co-infections, including HIV/AIDS; and conduct research to develop new vaccines and other preventive strategies.

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