For the first time in decades, new drugs for tuberculosis are under development. However, the relatively small number of pipeline compounds remains a cause for concern given the global emergence of drug-resistant TB, a new report warns.

The authors, Martina Casenghi from Médecins Sans Frontières, Stewart Cole from the Global Health Institute in Lausanne and Carl Nathan from Cornell University, say new approaches to research and development are desperately needed from governments and industry in the field.

"Of the approximately 40 compounds in the current pipeline, it is unlikely that a useful therapy will emerge, given that only about one compound in 20 successfully emerges from an anti-infective drug discovery programme", the authors write in the first of series of reports on TB in the Public Library of Science journal PloS medicine.

They praise Novartis, GlaxoSmithKline and AstraZeneca for setting up TB research units. The authors note, however, that "the few companies newly engaged in TB drug development remain risk-averse, generally embarking on drug development only when given evidence of rigorously validated targets and lead compounds that inhibit them".

Key bottleneck
Early-stage drug discovery represents one of the key bottlenecks in the search for new anti-TB drugs.

One way forward may be for academia to work more closely with industry, the authors suggest. Ideally, pure research scientists should be given greater access to industrial technology in order to speed up the discovery of new drug candidates.

Novartis and GlaxoSmithKline have stated that their facilities in Singapore and Tres Cantos, Spain, respectively, are already open to hosting academic scientists for focused collaborative projects, while AstraZeneca India is pursuing a similar policy, the authors point out.

"This interest from industry gives us hope," they comment.