T reatment A ction G roup Update on Global TB Research By Claire Wingfield Treatment Action Group Advisory Council for the Elimination of Tuberculosis Centers for Disease Control and Prevention (CDC) March 20-21, 2007 Atlanta, Georgia

Who is TAG? Treatment Action Group (TAG) was founded in January, 1992, and is the first and only AIDS organization dedicated solely to advocating for larger and more efficient research efforts, both public and private, towards finding a cure for AIDS. The TB/HIV Project works to combat TB/HIV co- infection through a combination of community-based advocacy, education and mobilization efforts involving AIDS advocates in developed and developing countries. The TB/HIV Project is supported by a grant from the Bill & Melinda Gates Foundation. T reatment A ction G roup

TB Research The 1940’s and 50’s were the heyday of TB drug discovery. Between the 1940’s and 1980 there was dramatic decline in global TB disease, and as a result there was a stall in TB R&D. But TB made a dramatic comeback with the dawn of the HIV pandemic. T reatment A ction G roup

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Methodology Objective was to highlight gaps in spending as well as in areas of scientific study in TB R&D. Funding data were collected largely from original-source donors. Data were collected from public and private sector sources and were supplemented by interviews. Most of the data is based on self-reporting by recipients and representatives of funding sources. T reatment A ction G roup

1NIAID / NIH 2Gates Foundation 3Medical Research Council (UK) 4Other Institutes & Centers / NIH 5Centers for Disease Control 6Company X 7Wellcome Trust 8NHLBI / NIH 9European Commission 6th Framework 10Otsuka TOP 10 Donors to TB Research (2005) Who Are the Funders? T reatment A ction G roup Feuer C. Tuberculosis Research & Development: A Critical Analysis. Treatment Action Group (TAG); 2006

T reatment A ction G roup Feuer C. Tuberculosis Research & Development: A Critical Analysis. Treatment Action Group (TAG); 2006 Overall TB R&D Investment (2005 = $392.7M)

T reatment A ction G roup ? ?? Feuer C. Tuberculosis Research & Development: A Critical Analysis. Treatment Action Group (TAG); 2006 Investment in TB Research Actual vs. Need (2005)

T reatment A ction G roup 2005 Spending

T reatment A ction G roup 2005 Spending

T reatment A ction G roup 2005 Spending

T reatment A ction G roup 2005 Spending

T reatment A ction G roup 2005 Spending

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T reatment A ction G roup 2005 Spending

FY05 GP 2006 base 5-foldGP2TAG 10 yr Actualestimateincrease2015rec By new tool category TB diagnostics TB drugs TB vaccines New tools sub Basic research Applied/Infrastructure Operational research Subtotal Total TB R&D How Much TB R&D Funding is Really Needed (Dollars in Millions) T reatment A ction G roup Why are the Global Plan Numbers Insufficient?

Action Points A comprehensive global TB R&D agenda is urgently needed. TB R&D needs better global/national coordination. Industry needs to be more transparent about TB R&D investments. Reporting consistency is needed to better track and annually update TB R&D. Need greater involvement from all funders in TB R&D. Emerging countries such as Brazil, China, India, Russia, South Africa and Thailand should play a bigger role. A five-fold (400%) increase in annual TB R&D expenditures is the minimum necessary to achieve the goals set out in The Global Plan II. T reatment A ction G roup

THANKS Javid Syed, TAG Mark Harrington, TAG Eric Goemaere, MSF