“Any true breakthrough in the fight against TB won’t come from a single research team alone. If there’s anything that the COVID-19 pandemic has taught us, it’s that innovation is an ecosystem.”
One would think it was ripped from today’s headlines: a deadly respiratory disease sweeps across the world—killing one person every 22 seconds. But this disease is not COVID-19. The threat is tuberculosis (or TB), which has flourished for centuries thanks to the ability of the bacteria that cause the disease (Mycobacterium tuberculosis) to quickly spread from person to person through the air that we breathe. Even though treatments exist, TB can easily become a chronic or fatal condition if left unchecked. According to the World Health Organization (WHO), in 2019, 10 million people became ill with TB, and 1.4 million people lost their lives to the disease—a serious, even silent pandemic that is deadlier than HIV.
A Persistent Problem Requires a New Approach
Now, thanks to the COVID-19 pandemic, public health concerns have become top of mind. At the same time, however, COVID-19 has caused significant disruptions to TB services that threaten the hard-won gains the international community has made in combatting TB in recent years. Without sustained action against TB—both during and after the COVID-19 pandemic—the disease will continue to spread, with disproportionate effects on poorer and developing countries. In 2019, for instance, India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa put together accounted for two-thirds of that year’s new TB cases. The location of new cases is particularly troubling given co-infections in people living with HIV. In addition to emphasizing the need for universal access to existing tools and services, WHO has adopted a new global TB strategy that calls on stakeholders to accelerate research and innovation to improve disease prevention, diagnosis, and treatment. The rise of resistance to current antibiotics underscores the need for novel tools to win the war against TB.
This makes the research of Drs. Clif Barry and Helena Boshoff of the National Institutes of Health (NIH) even more critical. Infectious disease researchers by training, the pair have spent years studying how TB bacteria survive inside, and then kill, human immune cells, thus preventing the body from fighting off the infection. They are also experts in the mechanisms by which TB bacteria develop resistance to the antibiotics used to treat the disease. Even though multidrug-resistant TB (or rifampicin-resistant tuberculosis; MDR/RR-TB) currently affects 550,000 people, antibiotic resistance was identified by the U.S. Centers for Disease Control and Prevention as a looming threat. To address the problems of immune system destruction and antibiotic resistance, the NIH researchers created a strategy for developing a new drug with a mode of action different from that of current medications—a drug that destroys the TB bacteria within the immune cells before they can damage the cells. Such a drug could potentially be a safe and effective treatment for MDR/RR-TB.
Public-Private Collaboration Provides a Map
But any true breakthrough in the fight against TB won’t come from a single research team alone. If there’s anything that the COVID-19 pandemic has taught us, it’s that innovation is an ecosystem. Addressing global health challenges, then, require an “all-of-society” approach to leverage global know-how and investment. Helping to connect the dots is the WIPO Re:Search Consortium. The Consortium was founded in 2011 by BIO Ventures for Global Health (BVGH), the World Intellectual Property Organization (WIPO), and leading pharmaceutical companies around a common vision: to proactively share industry intellectual property assets and expertise to catalyze the discovery and development of new treatments for TB and other infectious diseases that collectively affect more than one in five people worldwide. BVGH, a non-profit that supports critical research and advises governments on public health initiatives, and WIPO, a specialized agency of the United Nations and the global forum for intellectual property services, policy, information, and cooperation, co-lead the Consortium. To date, WIPO Re:Search has convened 154 private sector and academic (including non-profit and government) members in 45 countries to advance research on neglected infectious diseases. Through collaboration and the strategic use of intellectual property, the Consortium has spurred breakthroughs for malaria, Chagas disease, leishmaniasis, human African trypanosomiasis, schistosomiasis, dengue fever, and others.
Even before the COVID-19 pandemic, collaborations between the public and private sectors on scientific research and drug development were common. Public tax dollars, for instance, fund basic, preclinical, and clinical research while the private sector takes care of highly specialized research, testing, and manufacturing of drug candidates. In this case, BVGH connected the NIH researchers with Johnson & Johnson’s Jump-stARter library—the company’s initiative to develop individual compounds for workable and safe medicines. This WIPO Re:Search ‘match’ proved fruitful, as Drs. Barry and Boshoff found several compounds within the library that killed TB bacteria without harming human immune cells. Using those data, along with the results of ongoing studies of structurally similar compounds, Johnson & Johnson will chemically optimize the most active compounds. The partners will then validate the resultant lead candidates in laboratory and preclinical studies.
We Won’t Beat TB Without IP
Intellectual property has been key to delivering multiple vaccines and treatments for the current global pandemic—and it will be key to stopping TB in its tracks. But in a vast, global innovation ecosystem, it helps to have a map. That’s why initiatives like WIPO Re:Search and the work of organizations like BVGH are indispensable to greater coordination of global R&D. And though we are far away from beating TB for good, we’ll keep an eye out for the headlines.
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