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Last week, the World Health Organisation launched a report assessing the antibacterial clinical development pipeline for treating drug-resistant infections, including drug-resistant tuberculosis.

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It found that most drugs currently used are modifications of existing classes of antibiotics and will not overcome multiple existing resistance mechanisms in the long-term. The report emphasises that current treatment cannot provide a sustainable solution to the global threat of antimicrobial resistance.

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Drug-resistant TB, which already kills an estimated 250,000 people each year, has been identified by the WHO as one of the infections posing the greatest threat to world health. The report highlighted that there is a serious lack options for treating drug-resistant TB, particularly strains that are resistant to the two most powerful anti-TB medicines. Patients with drug resistant TB require complex and costly treatment. It is arduous – most patients take roughly of 14,000 pills over 18 months – and toxic, with potential severe side effects like blindness. The report stresses that treatment is exacerbated by the devastating economic hardship, stigma and discrimination associated with TB. Not only is TB a disease of poverty, but one that pushes people even further into poverty.

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TB has long been neglected – only two new antibiotics for the treatment of multi-drug resistant TB have reached the market in over 70 years. Despite the increasing threat of drug resistance, investment in drug research and development for TB remains woefully underfunded and is at its lowest level since 2008. While treatment of TB infections requires a combination of a minimum of three antibiotics, only seven new agents for TB are currently in clinical trials and progress is slow.

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The WHO report recommends that innovative treatments for drug-resistant TB are desperately needed. It concludes that TB must be a global priority for research and development.

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Commenting on the report, Dr Tedros Adhanom Ghebreyesus, Director-General of WHO said “there is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”

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Dr Mario Raviglione, Director of the WHO Global Tuberculosis Programme added “if we are to end tuberculosis, more than US$ 800 million per year is urgently needed to fund research for new antituberculosis medicines.”

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