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Tuberculosis

GSK’s research into tuberculosis (TB) is one of our priority areas at our campus in Spain. We work with many other interested organisations, including Global Alliance for TB Drug Development (TB Alliance), a not-for-profit product development partnership committed to fighting the disease through developing new TB drugs. By combining our expertise and efforts, we aim to provide better treatment options for this growing global health problem.

Tuberculosis: a global problem

Tuberculosis has been identified by the World Health Organization (WHO) as one of three priority diseases – along with HIV/AIDSand malaria – for drug research and development.

The size of the problem shows why WHO is calling for urgent action. Over one-third of the world’s population is infected with TB, with the majority of these cases in Asia and Africa. In 2007 there were 9.27 million new cases and 1.77 million deaths, of which 456,000 were people who were HIV positive.

Causes

TB is caused by a bacterium called Mycobacterium tuberculosis which usually affects the lungs, but can attack other parts of the body, such as the kidney, spine or brain. People can be infected with TB for many years without knowing it.

Around 5% to 10% of people infected with TB become sick or infectious, and even then it can take many years for this to happen, as the immune systems of healthy people can ‘wall off’ the bacteria which then lie dormant. People with a lower or weakened immune response – which may be due to HIV, other infections or old age, for example – are at greater risk of contracting or developing active TB.

TB is passed on via droplets from the throat and lungs of people with the active respiratory disease. These are transmitted through the air when they cough, sneeze or spit, and even when they talk. The disease is not highly contagious, so those most at risk are people who spend time with others who have active TB.

However, each person with active TB will infect, on average, between 10 and 15 people every year if their infection is not treated. Most active TB can be cured by combining different antibiotics, and people with inactive TB can take medicine to prevent them developing active TB.

The treatment for active TB has to be taken for several months, which many patients find difficult. Drug resistance is an increasing problem in treating TB. The two issues are linked because TB drugs are sometimes misused or taken erratically or inconsistently. As a result, a form of TB has arisen that does not respond to these standard treatments. This multidrug-resistant TB (MDR-TB) is present around the world. Another strain that is resistant to second-line drugs, known as extensively drug-resistant TB (XDR-TB), has been found in more than 50 countries.

Our collaborative research

Our collaborative research on TB started in 2004 when we set up our partnership with the TB Alliance. In December 2007 we renewed our alliance for a further three years. This helps to fund 25 scientists working on TB projects at our facility in Spain.

Our research complements the work of the Stop TB Partnership, a network of more than 400, including international organisations, countries, governmental and non-governmental organisations and individuals, which works to co-ordinate efforts to tackle the disease.

Through our TB research in Spain we are aiming to identify targets for drugs as well as lead compounds (chemical ‘starting points’ that show enough potential for future development) and candidates for clinical development.

We are looking for drugs that will allow shorter courses of treatment, which means identifying a molecule that can fight off persisting bacilli, allowing therapy that takes under two months, instead of the current six months or longer. We are also looking for candidates that are well-tolerated, can be taken by mouth just once a day and are active against the vast majority of TB strains (including the resistant MDR-TB and XDR-TB).

In all cases we are aiming to find products that are unlikely to generate any resistance because of how they work against the TB infection. GSK and the TB Alliance are also committed to ensuring these products will be affordable, so that they are widely accessible.