Collaborative Chemistry

This is not a call to arms for a war fought with bombs and bullets, but one which is equally catastrophic in terms of human loss. We are fighting armies of microscopic bacteria called Tuberculosis (TB) that knows no country boundaries, infecting 9 million and killing 1.5 million per year. Human kind has only defended itself since the discovery of TB drugs nearly 70 years ago, yet the effectiveness of this armament is rapidly dwindling. TB has regrouped with multidrug and extensively drug resistant forms spreading across the globe. This threatens to cripple our health systems with the costly and lengthy treatments. The most effective weapons have been drugs, while an effective vaccine has eluded us, but we still invest in the 15 current clinical trials. In stark contrast, there are only 10 drugs for treating TB in clinical development, many of which are new indications for existing drugs or combinations. Knowing the very high failure rate of costly clinical trials, perhaps just one of these might prove effective but at what cost? While our knowledge of TB functioning increases, there still needs to be more ‘early stage’ drug discovery efforts to feed the clinical pipeline. In the past the European Commission has funded TB research in the FP7 program*, with over €16.3 million euros spent on vaccine projects versus €20.2 million on drug discovery projects in academia and industry. This is a drop in the ocean compared with the $billions that are needed annually. In 2016 the focus will be on vaccines although it will likely take generations for success, with no funding for drug discovery in Horizon2020 at all. The result will be loss of our infantry, the many drug researchers that battle on the front lines in their laboratories. Europe has hope for winning the war, it must reverse this retreat away from drugs in favor of vaccines and we must fund these scientists. This will take courage on the part of the politicians and program officers, as drugs are not trendy new technologies that grab headlines, but a reliable workhorse which have held TB at bay. We should not surrender the only opportunity to defeat our nemesis.

*I am involved with the FP7 funded MM4TB project.