Tuberculosis Problem Is Typical For Neglected And Orphan Diseases

A number of diseases prevalent in the Third World are considered now as so called orphan or neglected diseases. TB might be common worldwide, but with only 98 patients in the US in 2011 it is considered as orphan disease which is unlikely to bring any profits to those who invest money into developing cure for this condition. Many other well-known infections belong to the same category.

Malaria, leprosy, river blindness and sleeping sickness do not have effective treatments. These diseases are more common in sub-Saharan Africa and tropical parts of Asia and Latin America. Most countries in these regions are too poor to afford providing any new expensive patented medicine to their citizens.

There is also a significant number of rare diseases (such as some genetic disorders) which suffer the same problem as infectious diseases of Third World. When the potential market for a new drug is measured by only few thousands of patients, there is no financial incentive to spend hundreds of millions of dollars to the development of this drug.

Threat of multidrug-resistant tuberculosis to the Western health care system

It is obvious that the lack of financial incentive prevents the profit-driven pharmaceutical companies from entering the markets for orphan and neglected diseases. This is the area of significant global concern. Now, when the global movement of people is fast growing, the national borders don’t protect from the spread of infections any longer. Tuberculosis is one of such infections.

Unfortunately, the response of most governments around the world to this threat has been so far complacent and mostly neglectful.

Call for urgent political action

Under these circumstances, new political decisions must be made. And it is very important that these decisions are made as soon as possible. Money for new drug development should be found from non-commercial sources. Drug development takes many years. If it doesn’t start now, there will be no hope for tackling the XDR form of TB once it spreads. TB treatment and management strategy requires good rethinking. Even in many Western countries, the detection of multidrug resistant strains of M. tuberculosis is not done as a matter of routine. These results in prescribing wrong drugs to the patients, leading to unnecessary and avoidable negative effects to the health and further promoting the rise of drug resistant TB strains.

A series of articles dedicated to the growing problem of TB was published in March this year in The Lancet. The articles written by established academics, medical professionals and dignitaries highlight the need for urgent action and outline what needs to be done. They suggest a number of action points that has to be acted upon in the near future. From the professionals’ point of view, situation is still manageable at present time. But if the resources are not found and political decisions are not made, TB is bound to shake the foundation of modern healthcare.

Bright spots in TB drug development

Despite the lack of commercial interest in the development of TB drugs, some work in this area is being performed. In December 2012, U.S. Food and Drug Administration (FDA) has approved a drug called Sirturo. This is the first treatment for TB approved in the last 40 years, which is based on a completely new mechanism of action and targets the MDR form of the disease. Introduction of Sirturo is an important step in improving the management and treatment of TB, but clearly much more needs to be done to improve the general global situation.