TB Research Briefing for UN Missions

The Vital Role of Research for TB Elimination 

4 June 2018

Panel 2: Devoting the Resources

Moderator Dr. Lucica Ditiu

ED, Stop TB Partnership

Remarks by Ms. Paulomi Tripathi, First Secretary

Thank you, Dr. Lucica Ditiu for giving me the floor. 

On behalf of the Permanent Mission of India, may I thank the organizers for inviting us to this important discussion on the way forward in meeting the challenge of TB.

I am not an expert in this field. However, I would like to share some perspectives on how Indian authorities are approaching this huge challenge. 

Although it has been more than 135 years since Robert Koch discovered the etiology of Tuberculosis, it continues to be the leading infectious killer disease globally. It was declared as a ‘global emergency’for public health by the WHO 25 years ago. While persistent global efforts have resulted in some progress, still about 3 million people developing tuberculosis are not diagnosed.

The slow progress in meeting the challenge of TB has multiple causes. Among the most important have been the lost opportunities over the past several decades in providing adequate R&D funding for the treatment of TB. Much of TB control measures that are in still in use today,are based on research undertaken in last century or even earlier. 

The high level event on TB, planned on the sidelines of the UN General Assembly later this September, will be a useful opportunity to raise global awareness about this issue and demonstrate collective international political will to mobilize resources needed to address this challenge, especially to drive funding into TB treatment drugs. 

The Indian leadership acknowledges the scale of challenge in our country.Prime Minister Modi has shown personal commitment and leadership to tackle TB head-on. India plans to eliminate TB by 2025, five years ahead of the global target of 2030. 

To implement this vision, a National Strategic Plan has been made operational. It is based on four pillars – Detect, Prevent, Support and Build. R&D forms a crucial element across pillars. India has allocated 430 Million USD for implementation of the NSP in the current year, an increase of 54% over last year.

India has a long tradition of TB research. 

The Indian Council for Medical Research (ICMR), India’s apex institution for biomedical research, is one of the oldest institutions undertaking TB research in the developing world. Two months back, ICMR was awarded the 2017 Kochon Prize for excellent tradition of TB research. 

The ICMR has a network of 32 institutes across India, of which the National Institute for Research in Tuberculosis (NIRT), Chennai, and the National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, work specifically on TB and mycobacterial diseases.

NIRT has conducted more than 50 randomized clinical trials in TB since 1950s. It is a WHO Collaborating Centre for TB research and training. Pioneering studies from NIRT have demonstrated the efficacy of domiciliary treatment and laid the foundation of directly observed treatment, short course (DOTS), which has been adopted by nearly 150 countries worldwide.

Successful development of rapid molecular TB tests by using indigenous, more affordable technology platforms and new digital X-Ray technology herald the potential that India holds to the future of TB research.

In 2016, an India TB Research Consortium (ITRC)was constituted to support the National Strategic Plan and to consolidate and align all efforts in TB care and elimination. The ITRC is a coalition of diverse stakeholders to develop new tools and to fast-track research to deliver effective diagnostics, shorter drug regimens and vaccines.

India’s recent initiatives to strengthen TB research agenda through increased domestic funding, collaborative networks, and transnational research partnerships needs to be seen in this evolving national and global context. 

Other areas such as private sector engagement, patient support and incentives, advocacy, communication and community outreach are also among ITRC’s priorities.The aim is to meet our own national strategic plan goals and to take step towards ending the TB epidemic worldwide.

There is strong need to change funding pattern of TB research qualitatively and quantitatively to make it interdisciplinary and result oriented.

With global health on the retreat in list of priorities for many countries, new partnerships need to be forged to reinvigorate the global TB research agenda. 

In this context, the launch of the BRICS TB Research Network under the framework of the BRICS TB Cooperation Plan is a promising opportunity to strengthen cooperation among the BRICS countries to achieve the 2030 Agenda. 

The Network is a multi-stakeholder platform for collaboration among governments, civil society, academia, PAHO and WHO, with a view to helping push fora common research agenda with global impact. The BRICS countries are currently discussing how to develop new technologies for screening and diagnosis of multidrug-resistant tuberculosis (MDR-TB), responsible for a third of all deaths due to antimicrobial-resistant infections worldwide. 

Through this partnership, our countries also aim to develop more effective preventive measures while reducing the incidence of the disease.

Another issue that requires attention is the role of private sector. Suboptimal funding from private sector in TB R&D has remained a predicament over several decades. While public financing remains the most important source, private sector must be engaged more effectively in the whole spectrum of TB R&D. 

Recent partnership between the Institute of Microbial Technology (IMTECH) under Council of Scientific and Industrial Research (CSIR) with the private sector to explore potentially more effective, safer, all-oral treatment regimens to tackle MDR-TB and new molecular entities to treat all TB patients, is an important initiative that provides a template for further such public private partnerships.

Louis Pasteur had pronounced 150 years ago that “Science and application of science are bound together like fruit to the tree”. This message needs to be revitalized. 

Funding for TB research worldwide has shifted progressively from individual investigators to large consortiums undertaking multidisciplinary research, attempting to bridge the gap between basic and applied research and expertise in public and private sector. 

Going ahead cutting-edge research needs to be integrated with developmental priorities to come up with measures that are affordable and accessible to where it is most needed. 

As resource will remain limited, making correct funding choices, partnerships and participation all stakeholders would be crucial to derive maximum benefits for people who need it the most.

Thank you.