Tuberculosis: Trends, Challenges, and Opportunities in a Resurging Market

TB is epidemic in many developing countries, owing in part to co-infection with HIV and the emergence and spread of multidrug-resistant strains of TB (MDR-TB). The general consensus among infectious disease experts is that the entire globe will remain at risk for TB epidemics until active TB transmission is eradicated. But TB drug development faces significant challenges, and for the past 30 years, the pipeline of novel therapeutics for treatment of TB has been sparse. Now, however, given various factors--the fact that TB transmission has been on the rise since the early 1980s, the emerging threat of MDR-TB, and TB's role as an opportunistic infection in HIV patients--government agencies, nongovernmental organizations (NGOs), and pharmaceutical companies have a renewed interest in developing drugs for TB. In 2000, several foundations, government agencies, and NGOs established the Global Alliance for TB Drug Development (TB Alliance). In this report, we review TB epidemiology, etiology and pathophysiology, resistance patterns, and treatment approaches, and we highlight challenges and opportunities for the pharmaceutical industry

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