The U.S. Agency on International Development (USAID) issued a report to Congress entitled “Health Related Research and Development Activities at USAID – An Update on the Five-year Strategy, 2006 – 2010” and has been releasing the report to the public in increments since October. Science Speaks reported on the release of the AIDS research chapter in late December, and now the entire report is available.
Of interest, the TB chapter notes the following as USAID funding priorities in TB R&D:
- New Drugs: Approximately 20 percent of USAID’s research funding for TB is used to support the evaluation of promising new drugs. For example:
- USAID is providing ongoing support to the Global Alliance for TB Drug Development to continue Phase IIB and Phase III clinical trials of three novel anti-TB compounds designed to shorten the duration of TB treatment.
- USAID is also currently supporting a study that will test the efficacy of a nine-month, standardized regimen that uses existing drugs for multidrug resistant TB (MDR-TB) treatment.
- New Diagnostics: USAID research targets development of innovative diagnostic tools as well as supporting the improvement of current diagnostic methods.
- For example, USAID is currently supporting evaluations on the implementation and scale up of light-emitting diode fluorescence microscopy, which is easier to use and simpler to maintain than traditional fluorescent microscopy, in countries with a high TB burden. These tools may reduce lab workloads and turnaround time for test results as well, facilitating earlier initiation of treatment.
- Improved performance of and accessibility to Directly Observed Treatment Short Course (DOTS) programs
- Improving the care of persons infected with TB and HIV:
- For example, an evaluation of adherence rates among patients with TB or multi-drug resistant TB and HIV/AIDS who are on concurrent or overlapping treatments is currently underway in South Africa, along with a separate review examining epidemiological trends, risk factors and treatments related to poor outcomes among children and adolescents with drug-resistant TB. The study results will be used to develop more effective programs for pediatric and adolescent TB patients, especially those with HIV infection.
- New Vaccines: USAID is committed to working closely with the National Institutes of Health and the vaccine community to support field trials of vaccines that have progressed to late phases of development research. Candidates for TB have emerged only recently, it is expected that his support may occur as early as 2011.
The full report, which also includes chapters on health systems strengthening, and maternal and newborn health, among others, is available online.
Meanwhile, USAID’s TB team invited TB advocates and implementers to meet regarding their portfolio and the potentially difficult choices that will have to be made if Congressional budget cutters either flat fund or cut funding for the global TB program. Among the options given level funding or program cuts, USAID is considering reducing its role in late stage TB research and specifically delaying their entry into TB vaccine research. There may well be viable TB vaccine candidates ready for Phase III clinical trials in the next five years or so, and this decision could have a real impact on the developing of a life saving TB vaccine. For more on this meeting, see the accompanying Science Speaks post.